MMS Physician Focus: November 2010
By Barbara Herbert, M.D.
Americans are using prescription drugs in ever-increasing
numbers. According to the Centers for Disease Control, nearly half
of Americans - 48 percent - now take at least one prescription
drug, and nearly a third - 31 percent - use two to four.
While the benefits of these medications are vast in preventing
and curing disease and alleviating pain and suffering, there's a
terrible downside to this explosive growth: prescription drugs are
being abused more than ever before.
Prescription medications are now the second most commonly abused
category of drugs, behind only marijuana. The National Institutes
of Health estimates that nearly 20 percent of people in the U.S.
have used prescription drugs such as painkillers, sedatives,
tranquilizers, or steroids for non-medical reasons.
The behavior isn't confined to any one age group. Seniors are
vulnerable because they develop more painful disabilities, take so
many prescriptions, and their metabolism changes with age. Among
Americans 60 and older, more than 75 percent use two or more
prescriptions, and 37 percent use five or more, according to the
CDC.
Young people are particularly susceptible. In its first
assessment of prescription drug abuse among high-school students in
2009, the CDC found that 1 in 5 high-school students has taken a
prescription drug without a doctor's prescription. Pain relievers,
stimulants, sedatives, and tranquilizers are the most commonly
abused items. Youth have easy access to them in home medicine
cabinets, and because the drugs have a legitimate use, a known
amount, and are prescribed by health care providers, teenagers
think they're a safe way to "get high." The abuse is so widespread
that the Partnership for a Drug-Free America estimates that every
day 2,500 teenagers, some as young as 12, use a prescription drug
to get high for the first time.
The abuse of prescription drugs is a national public health
problem: there are now more deaths from prescription drug overdoses
than from heroin.
Lawmakers and public health officials have stepped up efforts to
combat such abuse. Prescription monitoring programs, which track
prescriptions written and filled, now operate in at least 34
states. Using electronic data bases, these programs support
physicians who keep patients out of pain by helping to deter and
prevent drug abuse. The programs can record excessive prescribing
and help to prevent such activity as "doctor shopping" for
prescriptions.
But more can be done. Each one of us, as consumers, patients,
and health providers, can do something about this. Here are steps
to take -- and not take:
- Trust your doctor when addressing an illness. If your physician
knows that a prescription medication won't do anything for your
condition, don't ask for one.
- Ensure you're using these drugs precisely as directed. If you
have any questions at all, check with your physician or
pharmacist.
- Store medications safely, under lock and key, if necessary, so
that they won't be susceptible to misuse or theft.
- Parents must be especially alert. Of youth 12-17 who have
abused pain relievers, 64 percent cite
friends or relatives as their source, typically without their
knowledge. Talk to your children about the misuse of prescription
medication and the dangers it presents.
- If you care for an elderly person, take all steps to see that
the patient understands how and when to take the medication. Advise
other family members or caretakers as well.
Proper disposal of unused or out-of-date drugs is also
critically important. Here's what the experts recommend.
- Bring them to a community drug take-back or household hazard
waste program, if your community conducts such efforts. Recent
take-back programs have been very successful in recovering these
drugs and thus potentially taking them off the
streets.
- Do not flush drugs down the toilet unless the label says it's
okay to do so. Disposal in these ways can have an adverse impact on
the environment, putting drugs into ground water and drinking water
supplies.
- Throw in the trash only after crushing, mixing with an
undesirable substance such as kitty litter or coffee grounds, and
putting into a sealed container. Make sure you remove all personal
identifying information from the bottle or package.
The Partnership for a Drug Free America offers more information
at www.drugfree.org/notinmyhouse,
including video presentations by physicians and addiction
specialists, and the Substance Abuse and Mental Health Services
Administration at www.samhsa.gov is another fine
resource.
Barbara Herbert, M.D. is Medical Director of the
Comprehensive Addiction Program at St. Elizabeth's Medical Center
in Boston. Physician Focus is a public service of the Massachusetts
Medical Society. Readers should use their own judgment when seeking
medical care and consult with their physician for treatment.
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