What Is The Prescription Drug Problem?

Increased Rates of Misuse and Diversion
Societal Attitudes and Behaviors
Changes in Physician Attitudes

Increased rates of misuse and diversion of prescription drugs have been occurring since the 1990’s.  The rate of prescription drug abuse has nearly doubled. As reported by Columbia University’s National Center on Addiction and Substance Abuse (CASA) nearly 15.1 million Americans report abusing prescriptions. This is more than the combined number of people who admit to abusing cocaine, hallucinogens, inhalants and heroin. Prescriptions drugs most often abused include opioids, CNS depressants and stimulants. This growing public health crisis presents some unique difficulties, particularly for health care providers.

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Societal attitudes and behaviors contribute to the problem. Prescription medicines are often perceived by the public as safer than illegal drugs, even when misused.  Many consider them as not addictive. Such false beliefs make prescription drugs easy to access.  Prescription drugs are most often obtained from family or friends for free, through sharing or by raiding a medicine cabinet.  Adolescents  and the elderly have been particularly affected. Among teens, abuse of prescription medicines is so prevalent it is now “normalized”. Physicians can help by educating patients on the dangers of misuse and how to safeguard their drugs, and by following effective office protocols.

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Changes in physician attitudes are taking place given the steady rise in national measures of prescription drug abuse.  “Safe and effective opioid therapy requires that clinicians both optimize pharmacologic outcomes and undertake the assessment and management of risks associated with abuse, addiction and diversion” (Portenoy for Passik, Kirsh, & Casper, in press). Such risk assessment and management will often involve a new skill set.  Organizations, such as Pain Edu are responding to the need for training.  Accessing multidisciplinary resources such as local prescription drug monitoring agencies, pain specialists, and substance abuse professionals is also useful.

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