About Prescription Drug Abuse

Prescription Drug Statistics7

    • Nearly 15.1 million Americans reported abusing prescriptions in 2005. This number is up from 7.8 million in 1992 revealing that prescription drug abuse has nearly doubled in 13 years.
    • Young adults aged 18-25 had the highest rates of nonmedical use of prescription drugs in the past year, followed by adolescents 12 to 17 (2.5 percent at age 12, 13.9 percent at age 19, 8.1 percent by age 25).
    • In 2005, the most prevalent source from which prescription drugs were obtained was from a friend or relative for free.
    • The misuse of prescription drugs is second only to marijuana as the nation’s most prevalent drug problem.
    • Males had higher rates than females for misuse of pain relievers, stimulants and methamphetamine among the overall population aged 12 or older. 
    • Only 12.5 percent of those with a prescription drug use disorder in the past year received specialty treatment for drug problems in that period.

The prescription drug epidemic is unique in some ways. Prescription drugs are not inherently bad. When used appropriately, prescription drugs are safe and vitally needed by millions of Americans suffering from pain, disease and mental illness. The threat to public health and safety comes from the escalating misuse, abuse and diversion of prescription drugs. Often people mistakenly believe that because prescription drugs are legal or are prescribed by a doctor, they are safer than illicit drugs. Research clearly shows, however, that when prescription medications are used in ways other than they are prescribed, they can be very harmful and sometimes addictive. See below to learn more about this growing problem.

What Is Prescription Misuse?

Twin Epidemics: Finding Equilibrium

What Prescription Drugs Are Most Often Abused?

What Are the Federal Drug Schedules?

Factors Fueling the Abuse Epidemic

Methods of Prescription Drug Diversion

Prescription Drugs Are Easy to Obtain

At Risk Populations – Adolescents & Young Adults

At Risk Populations – The Elderly

What Is Prescription Misuse?

Nonmedical use of prescription drugs is defined as taking a higher-than-prescribed dose of a pharmaceutical, taking a pharmaceutical prescribed for another individual, malicious poisoning of another person, or substance abuse involving pharmaceuticals.

The consequences of misusing prescription medications can include:

    • Overdose

    • Toxic reactions

    • Drug interactions that can lead to life-threatening conditions such as respiratory distress, hypertension or hypotension, seizures and death.

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Twin Epidemics: Finding Equilibrium6

There are two epidemics that intersect around prescription drugs: prescription drug abuse and unrelieved pain. An estimated 50 million Americans live with chronic pain caused by disease, disorder or accident. An additional 25 million people suffer acute pain.

How a person’s pain is managed or mismanaged within our community not only affects the person’s quality of life, but it has long reaching societal consequences that affect all of us. When pain is not managed adequately, patients, their families and employers, the health and mental health systems, and taxpayers all endure the burden.

In a recent interview, Nathaniel Katz, MD, MS, Tufts University School of Medicine Adjunct Assistant Professor of Anesthesia and a national authority on pain management issues, discussed some of the difficult challenges presented by prescription drug misuse/abuse. “When used appropriately, prescription medications help ease the pain and suffering of people who need them for legitimate medical reasons,” he said. “In fighting the illegal misuse of these drugs, we must not hinder patients’ access to beneficial medical treatments. However, we also must not ignore the fact that prescription drugs are potent and must be managed and monitored appropriately. There is an equilibrium that must be achieved.”

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What Prescription Drugs Are Most Often Abused?

    • Opioids or pain relievers like OxyContin or Vicodin

    • Central nervous system (CNS) depressants like Valium, Librium, or Xanax used to treat anxiety, panic, sleep disorders, acute stress reactions, and muscle spasms

    • Stimulants like Ritalin or Adderall typically prescribed to treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy

    • Anabolic-androgenic steroids like Anadrol or Equipoise, which enhance athletic performance and body sculpting

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What Are the Federal Drug Schedules?2

The Federal Controlled Substances Act (CSA) of 1970 created a system for classifying drugs according to their medical value and potential for abuse. The Food and Drug Administration oversees these schedules, which include illicit and prescription drugs. By law, every drug under the purview of the CSA is assigned to one of the following five categories.

Schedule I: No medical use, high abuse potential (e.g., Heroin, Ecstasy)

Schedule II: Accepted medical use, high abuse potential (e.g., OxyContin, Ritalin)

Schedule III: Accepted medical use, less abuse potential than schedules I and II (e.g., Vicodin, Anadrol)

Schedule IV: Accepted medical use, lower abuse potential than Schedules I-III (e.g., Valium, Xanax)

Schedule V: Accepted medical use, lowest abuse potential of scheduled drugs (e.g., Robitussin AC)

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Factors Fueling the Epidemic

    • Since the 1990’s, there has been an increase in the legitimate commercial production and disbursal of pharmaceutical drugs.

    • There has also been an increase in marketing to physicians and the public about pain medications.

    • Physicians have become more willing to prescribe new medications, particularly for pain management.

    • Prescriptions written for controlled drugs increased more than 150 percent from 1992 to 2002 – almost 12 times the rate of increase in the population and almost three times the rate of increase in prescriptions written for all other drugs.

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Methods of Prescription Diversion

CASA defines diversion as “any criminal act that causes controlled prescription drugs to be sidetracked from their lawful medical purpose to illicit use.”2 Diversion can occur at any point in the prescription manufacturing and distribution chain.

While the overwhelming majority of prescription drugs are manufactured and sold legally through traditional distribution routes, diversion of prescription drugs is a major factor that must be handled by law enforcement professionals. The U.S. Drug Enforcement Administration says that the diversion of legitimately produced controlled pharmaceuticals constitutes a multi-billion dollar illicit drug market nationwide. Methods of diversion include:1

    • Pharmaceuticals manufactured lawfully, but stolen during distribution

    • Medications obtained inappropriately from legitimate end-users, (e.g., friends share prescription drugs, family members leave medicine in easily accessible places, etc.)

    • Fraudulent prescriptions written on prescribing pads that have been stolen from medical offices

    • “Doctor shopping” is a method where individuals see several doctors in an attempt to obtain multiple prescriptions without revealing what they are doing. Often these individuals will have their prescriptions filled at several different pharmacies to avoid detection.

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Prescription Drugs Are Easy to Obtain

    • SAMSHA indicates that prescription drugs are easily obtainable through family, friends and health care professionals (including doctors, dentists and pharmacists).1

    • 70 to 80 percent of those 12 years or older said they got their drugs from a friend or relative and, very likely, those came from the family medicine cabinet.1 Only 4.3 percent got the pain relievers from a drug dealer or other stranger.8

    • Parents and other caregivers should store their prescription drugs carefully and dispose of any unused drugs before they fall into the wrong hands.1

    • The Internet is also contributing to the prescription drug problem. Often online pharmacies do not require prescriptions or appropriate identity verification. Thus, almost anyone with a credit card number who has access to a computer is able to obtain drugs online.5

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At Risk Populations – Adolescents & Young Adults10

Although overall illicit drug abuse has decreased for adolescents over the past five years, when it comes to prescription drugs the rates of abuse have increased. Among specific age groups, the 2002, 2003 and 2004 National Survey on Drug Use and Health showed young adults aged 18 to 25 tended to have the highest rates of nonmedical use of prescription drugs in the past year, followed by youths aged 12 to 17. The brain is still developing during adolescence, and exposure to drugs is concerning because of the potential for interference with these developmental changes.

    • An alarming number of teens have a false sense of security about the safety of abusing prescription medications

    • 19% of teens report abusing prescription medications to get high

    • 40% believe that prescription medicines are safer to use than illegal drugs

    • 31% believe there is nothing wrong with using prescription medicines without a prescription once in a while

    • 29% believe prescription pain relievers are not addictive

Research also shows that use of prescription drugs by college students continues to rise. Like adolescents, young adults cite a variety of reasons for misusing prescription medications: getting high, staying awake and focused to study, and controlling weight are the most commonly noted. 

A troubling trend with adolescents and college students is a recent phenomenon known as “pharming.” Young people have pharming parties where they trade prescription drugs, mix them with alcohol and ingest some or all of them at once, unaware of the potentially severe drug interactions.

SAMHSA and the Food and Drug Administration have a comprehensive public education campaign targeted specifically at 14 to 25 year-olds about the dangers of misusing and abusing prescription drugs. The Buzz Takes Your Breath Away Permanently campaign includes posters, brochures and print advertisements.

The National Youth Anti-Drug Media Campaign hosts a Web site called FreeVibe, which is targeted at young adults and includes information about the dangers of misusing prescription drugs.

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At Risk Populations – The Elderly

Prescription abuse among the elderly is also on the rise. While people 65 years of age and above comprise only 13 percent of the population, they are prescribed about one-third of all medications in the United States.4 Admissions for substance abuse treatment increased by 32 percent among older adults from 1995-2002 says SAMHSA. The percent of older adults with opiates as their primary substance of abuse increased from 6.8 percent to 12 percent during this time period. Opiates are the second most frequent reason for treatment admissions among older adults after alcohol.11

Several factors put elderly populations especially at risk for abuse of or addiction to prescribed medications:4

    • Age-related changes may influence the way in which their bodies metabolize and respond to prescription drugs.

    • Older adults are more likely to have undiagnosed psychiatric and medical illness.

    • This population is more likely to be taking several medications in complex drug regimens, increasing the risk of drug interactions or errors in dosing.

SAMHSA and the Food and Drug Administration have collaborated to educate older Americans about the proper use of prescription medications. The As You Age campaign warns people in this age group about the risks of mixing certain prescription drugs or prescription medications and alcohol. Do the Right Dose materials are also available, which highlight the dangers of misusing prescription drugs. Click here to learn more.

In 2004, NIDA sponsored a symposium called Drug Abuse in the 21st Century: What Problems Lie Ahead for the Baby Boomers? A number of informative presentations are available online. Click here to view them.

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