Prescription Drugs and Abuse – The Trend, the Epidemic, the Future
The paper discusses prescription drug abuse and addiction, including epidemic, trends, and future recommendations to curb the effects of abuse. The most abused drugs are opioids, tranquilizers, stimulants, and sedatives. The paper reports that almost 20% of the teens between 12 and 17 years of age have used these drugs without prescription by acquiring them from their parents and friends. On the contrary, most elderly users acquire medications from physicians through legitimate prescription to treat diseases but end up abusing them and becoming addicts. The paper states that 18% of non-medical users get drugs from only one physician and 4.3% acquire them from strangers and drug dealers. The trends in the prevalence and epidemiology of this health challenge have varied over different periods, but the situation is worse at the current moment, which indicates that the future levels of abuse may worsen further if no action is executed. Furthermore, the increase in the prevalence of prescription of these medications is associated with an increase in the prevalence and incidence of their abuse. However, improved health education and storage of drugs both in homes and in the hospital, as well as cautious prescription among healthcare professionals, can help mitigate this problem in the future.
Keywords: prescription drugs of abuse, trends, epidemiology
Prescription Drugs and Abuse – The Trend, the Epidemic, the Future
A healthy society requires the adoption of healthy behaviors with minimal rates of drug abuse. Much concern has been expressed over the rising number of people using illicit drugs and alcohol. However, there is much to be done when it comes to prescription drugs because the prevalence of abuse and addiction to these medications is also posing a huge challenge to not only the American population but also the entire world. Manubay, Muchow, and Sullivan (2011) explain that although prescription drugs have been utilized effectively and appropriately in the treatment of psychiatric and medical conditions in many patients, the rates of abuse have risen at alarming rates in the previous decade. An increase in the availability of prescription drugs is a strong contributor to the dramatic rise of both non-medical use and abuse of medications. Most abusers are either care providers who have direct access to medications or locals who get them through somebody linked to healthcare facilities among others.
An increase in the occurrence of recurring chronic pain has further complicated the abuse and addiction problem related to prescription drugs, which explains the concurrent rise in the public health issues concerning chronic pain and these medications. Manubay et al. (2011) explain that, in the United States of America (US), more than 75 million people, which amounts to 25% of the entire population, have either chronic or recurrent pain. The burden of chronic pain and the subsequent abuse of the prescription drugs when treating pain symptoms among patients worsen the health outlook of the population. However, most primary care professionals have little training in the prescription of pain medicine and addiction; thus, they are unsure about how to prescribe these medications safely (Manubay et al., 2011). The issue of chronic pain is likely to become worse in the future because of the increase in the aging population. Consequently, there is a need to discuss prescription drugs of abuse, including their epidemic, trends, and the recommendation to curb their future impact on health.
Epidemiology of Prescription Drugs of Abuse
The prevalence of drug abuse among different groups of people in the US is high, with the elderly population recording the highest prevalence. The National Survey on Drug Use and Health found that teens are more likely to have abused prescription drugs than illicit drugs like alcohol and marijuana (Basca, 2008). This finding reveals that the abuse of these medications is a huge threat because their impact on the health of the public may be worse than that of illegal drugs. The prevalence of abuse in teenagers also differs depending on gender. Basca (2008) reports that almost 20% of the teens have used a prescription medication not prescribed to them, and teen girls of 12 to 17 years of age account for 9.9% of abuse cases compared to 8.2% of males.
In most cases, children and the youths abuse Vicodin and OxyContin without the prescription from a healthcare provider. People who misuse these drugs are either naïve individuals who have a legitimate prescription or children who can access medications in their homes and become addicts. In the study conducted by Carise et al. (2007), about 5% of all admitted individuals for prescription drug addiction treatment had prior use of OxyContin, with 4.5% reporting the use of this drug on a regular basis for at least one year and 2% during the previous thirty days before admission. Youths are most likely to access these medications in the medicine cabinets of their parents who take them either for treatment purposes or because of addiction (Basca, 2008). However, most abusers and victims of the effects of OxyContin are people who used it for treatment rather than children who accessed it through their parents. Carise et al. (2007) report that 78% of the subjects who used OxyContin obtained it through the prescription for the treatment of medical conditions, 86% used it to achieve euphoria, which indicates that they might have developed an addiction after the initial prescription use, and 78% had a prior treatment of substance use disorders. Therefore, the root cause of the high prevalence of these drugs among the populations emanates from addiction developed after the use of medications in treating diseases and their symptoms.
Recent reports have found alarming statistics that show the severity of the problem of the non-medical use of prescription drugs and its effects on the society. In particular, 6.5 million people of at least 12 years old in the US use prescription psychotherapeutic drugs non-medically (Manubay et al., 2011). The majority of the users of drugs acquires them from either their relatives or friends at no cost. This means that the primary cause of the increased prevalence of abuse and addiction of medications is their availability in the community. Furthermore, 18% of the same non-medical users acquire the drugs from only one physician while 4.3% get them from strangers or drug dealers (Manubay et al., 2011). Manubay et al. (2011) further assert that marijuana is the illicit drug with the highest level of abuse accounting for over 4.2 million users, followed by prescription pain relievers with more than 1.7 million users. Such figures are alarming for drugs that should otherwise be used for treating conditions instead of using them to achieve euphoria.
The prevalence and epidemiology of these drugs vary depending on different types of medications. The lifetime prevalence of the non-medical use of prescription drugs is the highest for stimulants and opioids, namely 4.7%, followed by 4.1% for sedatives and 3.4% for tranquilizer users (Manubay et al., 2011). The approximate percentages of those population groups that used sedatives, tranquilizers, opioids, and stimulants and ended up abusing them and becoming addicted are 20.7%, 22.6%, 23.8%, and 31.0%, respectively (McCabe, West, Morales, Cranford, & Boyd, 2007). These statistics bring another angle to the menace as stimulants take the lead in causing addiction in non-medical users of prescription medication. The most impacted populations are the men from the western states of the US, African Americans, Hispanics, Asians, as well as divorced, widowed, and never-married individuals (Manubay et al., 2011). Therefore, the risk factors for medication abuse and addiction include male gender, race, ethnicity, and single marital status.
Trends in Abuse of Prescription Drugs
The challenge of the prescription drug abuse has been varying in intensity and prevalence for many years. Kolodny et al. (2015) explain that in the 1840s, the national supply of morphine and opium could support no more than 0.72 opioid-addicted individuals per 1,000 persons. However, in the next 50 years, the consumption of opioids rose by 538% (Kolodny et al., 2015). The percentage increase is huge for this time interval. However, the rate of the use and supply has declined for some years. After reaching the peak in the mid-1890s, the supply of opioids to support addicted individuals began to drop together with the rate of addiction until, in 1920, there were less than 1.97 opioid addicted individuals per 1,000 people in the US (Kolodny et al., 2015). Such a drop is a good indicator of the health of the public because drugs and addiction are a risk factor that relates to many medical and mental health conditions.
Nevertheless, the abuse of prescription drugs began to increase again as their medical use gained momentum. The prevalence of prescription drug abuse in the US rose dramatically all through the late 1990s to -the mid-2000s (McHugh, Nielsen, & Weiss, 2015). The rise was accompanied by an increase in the prescription of these medications in healthcare facilities. Dart et al. (2015) reiterate that the event rate of opioid prescription increased from 1.5 per 100,000 persons in 2002 to 2.9 in 2012 before showing a slight reduction to 2.5 in 2013. Consequently, the abuse of opioid analgesics increased from 0.20 per 1,000 persons in 2003 to 0.56 in 2010 before reducing to 0.35 by the end of 2013 (Dart et al., 2015). These trends show a positive relationship between the increase in the prescription of these medications in healthcare facilities and the subsequent drug abuse that has a tremendous impact on the society. Therefore, it means that the prescription influences the availability of drugs in the community, which may lead to their abuse.
The trends further indicate that the use of medical drugs has reached an alarming rate. From 1992 to 2012, the number of prescriptions increased from 4.9 to 12.5 million people, with opioid disorders becoming the second most common problem after the one caused by alcohol (McHugh et al., 2015). Dart et al. (2015) assert that the rise is a huge challenge because the future may be worse concerning this menace. In 2012 alone, at least 16.7 million people of 12 years and above abused these drugs in the US, with about 2.1 million meeting the criteria for diagnosis of substance use disorders, showing an increase of more than 250% in prescription drug abuse in the last two decades (McHugh et al., 2015). During the same time, the rates of accidental overdose involving prescription opioids increased by 400%, which surpassed accidental overdose deaths from cocaine, heroin, and other stimulants combined (Calcaterra, Glanz, & Binswanger, 2013). Therefore, the rise in the use of the drugs is an indication that the situation may become worse in the future unless appropriate action is immediately taken.
Recommendation for the Future
Healthcare institutions and agencies, care providers, the government, and the population can work together to help reduce the intensity of prescription drug abuse and addiction. Public patient programs targeting healthcare professionals and their patients, as well as the community at large, will provide adequate information about the problems of drug abuse and the warning signs and measures to combat its effects (Manubay et al., 2011). Professionals should help reduce the incidence of iatrogenic opioid addiction through the cautious prescription of medication for both chronic and acute pain (Kolodny et al., 2015). Furthermore, it is important to target the non-medical use of these medications. In most cases, children and youths acquire drugs through their friends or family members who have legitimate prescriptions (Kolodny et al., 2015). There should be specific efforts targeting this population by encouraging cautious prescription of drugs and educating parents on how to store their medications in areas that children cannot reach (US Drug Enforcement Administration, 2014). All these efforts in addition to the established policies that control the availability of drugs in care facilities will help improve the future health of the people.
The abuse of prescription drugs has become an enormous problem of to the human race with varying trends in its intensity over time intervals, and the situation may worsen in the future if no strict measures are adopted. The problem of abuse and addiction affects both the youths and the elderly. Most people acquire these prescription drugs of abuse legitimately when treating a health problem and end up becoming addicted. However, children mainly get them through friends or parents who use medication for medical purposes. The prevalence of drug use and addiction varies depending on the type of drug, although opioids and stimulants are the most commonly abused. The trends in prevalence have been varying but recent indications have shown the increase in the prevalence, something that may indicate the worsening of the problem in the future. The increase in the prevalence of abuse and addiction is associated with the increased availability of medications. Health education and cautious prescription and storage of these drugs can help mitigate the intensity of this health problem.