Social Problem
There are many issues that come to mind when it comes to prescription drug abuse. Many people think of the norm, such as those addicted to pain medicines, anti-depressants, antipsychotics, etc. Although this is the most rampant problem that arises from prescription drug abuse, there are more issues that people seem to disregard. For example, the criminal activities that go along with prescription drug abuse, the devestating consequences, the unnecessary prescribing and misuse of antibiotics, and the corruption of physician privileges. Perhaps the exploitation of prescription drugs stems from the lack of consumer knowledge. In order to fix these issues, there is one thing we all can agree on and that is to promote patient education.
Prescribed Killers
Drug abuse has become a prevalent issue in our growing society. Despite efforts by law enforcement and public health officials to curb prescription drug abuse, drug-related deaths in the United States have continued to rise. The numbers were a disappointment for public health officials, who had expressed hope that educational and enforcement programs would stem the rise in fatal overdoses.General Facts:
In 2009, drugs overtook traffic accidents as a cause of death in the country and this gap continues to widen.
Prescription drug abuse causes the largest percentage of deaths from drug overdosing. Of the 22,400 drug overdose deaths in the US in 2005, opioid painkillers were the most commonly found drug, accounting for 38.2% of these deaths.
( To break it down, the death in 2005 of those abusing prescription painkillers was approximately 8,095. This number more than doubled within the next 5 years as shown in the paragraph below with numbers in the 16,000's.)
According to the CDC, overdose deaths involving prescription painkillers rose to 16,651 in 2010. That was 43% of all fatal overdoses.
This one particular issue has given rise to many other issues in our society. For example, due to the misuse of prescription pain medications the DEA can virtually halt any deliveries from outside vendors that supply pharmacies with their pain medicines. This causes many patients who actually require these medicines to go without for several weeks, if not months.
Neonatal Abstinence Syndrome
Another prevalent issue that arises from abusing prescription drugs (not just pain medicines) are the number of infants born with serious, if not fatal, complications. This is known as neonatal abstinence syndrome.
According to the National Institute of Health, NAS can occur when the mother is taking the following drugs:
- Amphetamines (Ritalin, Adderall)
- Antidepressants (Paxil, Zoloft)
- Antipsychotics (Seroquel, Zyprexa)
- Barbiturates (Phenobarbital)
- Benzodiazepines (Xanax, Valium, Ativan, Klonopin)
- Opiates/Opioids (heroin, methadone, codeine, OxyContin, Vicodin, oxycodone)
Criminal Activity
Most pill mill customers know that there are rules to visiting the clinic. First rule is that all of the transactions are "up-front cash only". Many of the patients engage in criminal/immoral activities in order to attain the money needed to frequently visit these pill mills and acquire their prescriptions. These criminal/immoral activities include but are not limited to:- Stealing medications and money from friends, family, and strangers.
- Doctor shopping and faking illnesses.
- Stealing prescription pads and forging doctor signatures.
- Breaking and entering.
Hippocratic Oath
The Hippocratic Oath is basically an oath historically taken by physicians and other healthcare professionals swearing to practice medicine honestly. The number of physicians exploiting their privileges to prescribe opioids is becoming more widespread. This is what I like to call the "never-ending cycle".Step 1: Patient has appointment with physician for joint pain.
Step 2: Physician prescribes Vicodin, Lortab, Norco, etc. (These are class III drugs)
Step 3: Eventually these class III drugs stop working as effectively due to tolerance build-up.
Step 4: Physician prescribes stronger pain medicines such as Methadone, Oxycodone, OxyContin, etc. (These are class II drugs)
Step 5: Patient becomes addicted to pain medicine and is forced to visit physician for refills.
These are daily scenarios in which physicians can easily avoid the use of pain medications and instead should first encourage the patient to try physical therapy and/or topical remedies before resorting to pain medicines. If the patient is truly looking for relief and not convenience, they will understand the physicians judgement call.
All physicians know the harm these medications can cause after long-term use and the addiction it can bring to patients but, some still choose to prescribe them to keep patients coming back.
Different Perspective
I'd like to say that prescription drug abuse strictly entails those addicted to pain relievers,
tranquilizers, sedatives, and/or stimulants, but that is simply not the case.
Let's take a look at things from a different perspective. Let's say you come down with the flu and make an appointment to visit your physician. You walk into their office, sign in, wait for a while and are then called back to the examination room. The physician finally enters your room and you explain your symptoms and what you are feeling. The physician is almost positive that what you have are symptoms from the flu, but to be sure he or she may want to run some tests and possibly blood work. This is where it gets interesting! Before you leave the office 8 times out of 10 you will be handed a prescription for an antibiotic.
This prescription for the antibiotic is completely and utterly unnecessary. Let's think about this logically. We know that the flu is caused by a VIRUS that makes its way into our bodies through different means of exposure. In order for antibiotics to properly work, you must first be infected with a BACTERIA. Not only must you be infected with a bacteria, but the actual strain of the bacteria must not be resistant to the antibiotic prescribed to you.
“ Without immediate action many patients will be in the post-antibiotic era. For some organisms and some patients, it’s already too late.” - CDC director Tom Frieden, MD, MPH.
The overuse and misuse of antibiotics is pushing us closer and closer to the brink of the post-antibiotic era.
Solution
There are several ways we can attempt to deter the misuse of prescription drugs. For starters, we must attempt to make it very clear to practicing physicians of laws, fees, incarceration, and other consequences they may face if caught running a pill mill or illegitimate pain clinic. I believe that as a nation we should weed out those, who took an oath to serve in our best interest, yet are breaking that oath and corrupting the field of medicine. In addition to this, I believe that the penalties should be exaggerated to an extent.
Societal education is by far one of the most crucial aspects in breaking this cataclysmic cycle. The reason I chose societal education versus patient education is mainly because it is all of society that needs to be aware of these ubiquitous patterns. For example, all health care professionals are required to complete CE credits each year. These credits are acquired through courses online or by attending seminars. Perhaps "Prescription Drug Abuse" should be a mandatory topic. This course would entail everything there is to know about prescription drug abuse including patient signs and symptoms, understanding difference between need and want, how to handle situations, and how to offer help to those in need.
AWARENESS IS THE KEY!!!
Media
This blog is from our local Morgan & Morgan firm right here in Fort Myers, FL. He is a huge advocate on cracking down pill mills such as the one in this blog and video in the link.
Morgan & Morgan This is an audio that has been played on the radio for the past couple of weeks. John Morgan makes a case against prescription drug abuse and pill mills. He also states that a healthier alternative could be medical marijuana. I'm not convinced that legalizing medical marijuana is the best option. What's to say that history won't repeat itself? Fortunately, we have a slight advantage in this case. We have a basic idea of what this kind of corruptions looks like, therefore we can anticipate and prepare or perhaps have a better handle on the situation.
The National Coalition Against Prescription Drug Abuse (NCAPDA) was established to help reduce the number of deaths and addictions caused by prescription drug abuse, through the implementation of a nationwide awareness campaign, the initiation and support of pertinent legislative action and through partnerships with educational, medical, law enforcement and other appropriate entities.
