Causes of Prescription Pill Abuse: Unmasking the Epidemic

Understanding Prescription Drug Abuse

Before diving deeper into the causes of prescription pill abuse, it's important to define what constitutes prescription drug abuse and identify some of the most commonly abused prescription drugs.

Defining Prescription Drug Abuse

Prescription drug abuse refers to the misuse of prescription medications, either by taking a drug in a manner or dose other than prescribed, taking someone else's prescription medicine, or taking the drug to experience euphoria (getting high). Misuse of prescription drugs can lead to dependence, addiction, and severe health consequences. This form of drug abuse is a growing public health concern worldwide, with opioids, central nervous system (CNS) depressants, and stimulants being the most commonly misused substances.

Commonly Abused Prescription Drugs

According to Mayo Clinic, the most commonly abused prescription drugs fall into three classes: opioids, central nervous system (CNS) depressants, and stimulants.

1. Opioids: These drugs, such as hydrocodone, oxycodone, morphine, and codeine, are often prescribed to treat pain. They are commonly abused due to their euphoric effects. Over time, individuals may become physically dependent on these drugs, which can lead to addiction.
2. CNS Depressants: This class of drugs includes benzodiazepines (e.g., Valium or Xanax) and barbiturates. They are typically used to treat anxiety, panic disorders, and sleep disorders. They are often abused for their calming effects and can result in physical dependence and withdrawal symptoms with long-term use or abuse.
3. Stimulants: Drugs like Adderall or Ritalin are prescribed for conditions such as attention deficit hyperactivity disorder (ADHD) and narcolepsy. These drugs increase alertness, attention, and energy. Prolonged use can lead to tolerance, dependency, and severe health consequences.

According to SAMHSA, misuse of prescription pain relievers (a category that includes opioids) is the second most common form of illicit drug use in the United States, after marijuana use.

Understanding the common prescription drugs abused is the first step towards acknowledging the extent of the problem and developing effective strategies to combat prescription drug abuse.

The Prevalence of Prescription Drug Abuse

Prescription drug misuse is a significant public health concern that continues to gain traction in the United States. The issue spans across various demographic groups and involves a range of prescription medications, underscoring the complexity of the problem.

Prescription Drug Abuse Statistics

The misuse of prescription drugs, particularly opioids, has escalated over the years, contributing to a substantial number of overdose deaths. For instance, in 2019, more than 70,000 people died from drug overdoses, with nearly 70% involving opioid use. In fact, more overdose deaths involved prescription opioids than heroin and cocaine combined.

The economic burden associated with prescription drug misuse is also staggering. It is estimated that the economic cost exceeded $72 billion in the United States in 2009, encapsulating healthcare, lost productivity, criminal justice, and addiction treatment costs.

Demographics of Prescription Drug Abuse

Prescription drug misuse is prevalent across various demographic groups. However, some groups report higher rates of misuse than others. For instance, youth have a high rate of prescription drug misuse, with 1 in 12 high school seniors reporting non-medical use of Vicodin and 1 in 20 reporting abuse of OxyContin [2].

Misuse of prescription pain relievers is the second most common form of illicit drug use in the United States, after marijuana use. In the past year, 12.5 million people reported misusing pain relievers out of the 97.5 million people aged 12 or older who used pain relievers [3].

Among different age groups, the most common source of misused prescription pain relievers was also from a friend or relative for free. However, this was a more common source for young adults aged 18 to 25 and adults aged 26 or older (50.0% and 51.8% respectively) than for adolescents aged 12 to 17 (43.1%). Young adults were less likely to obtain prescription pain relievers from one doctor and more likely to buy them from a friend or relative compared to adolescents and adults aged 26 or older [3].

Prescription drug misuse is a pervasive issue that requires concerted efforts to address. Understanding the prevalence and demographics of prescription drug misuse is the first step towards formulating effective strategies to combat the issue.

Causes of Prescription Drug Abuse

Understanding the causes of prescription drug abuse is key to preventing and treating this growing issue. Two major factors contributing to the abuse of prescription medication are the easy accessibility of these drugs and misconceptions about their safety and usage.

Accessibility and Prescription Drug Abuse

In many cases, the misuse of prescription medication begins simply because these drugs are readily available and easy to obtain. Opioids such as hydrocodone, oxycodone, morphine, and codeine are some of the most commonly abused prescription drugs due to their euphoric effects Mayo Clinic. They are often prescribed for pain management, making them accessible to many individuals.

Similarly, central nervous system depressants, like benzodiazepines (e.g., Valium or Xanax) and barbiturates, are also often abused for their calming effects Mayo Clinic. These are commonly prescribed for anxiety, stress, and sleep disorders.

Stimulants like Adderall or Ritalin, used for conditions like ADHD, are also commonly abused due to their ability to increase alertness, attention, and energy Mayo Clinic.

According to the SAMHSA, 50.5% of users obtain these drugs from a friend or relative for free, 22.1% get them from one doctor, and only 4.8% of people buy them from a drug dealer or other stranger.

Misconceptions and Prescription Drug Abuse

Misconceptions about prescription drugs also play a significant role in their misuse. Many individuals believe that prescription drugs are safer than illicit drugs because they are medically prescribed. This misunderstanding often leads to misuse, and eventually, addiction.

The misuse of prescription pain relievers is the second most common form of illicit drug use in the United States, after marijuana SAMHSA. This indicates a significant misunderstanding about the risks associated with these drugs.

Prescription drug abuse can have serious health consequences, including overdose, organ damage, and mental health issues Mayo Clinic. Therefore, it's essential to educate individuals on the dangers of misusing prescription medication and emphasize the importance of using these drugs only as directed by a healthcare professional.

Health Risks of Prescription Drug Abuse

Abusing prescription drugs can have serious health consequences, impacting both physical and mental health. Understanding these risks can provide a deeper insight into the dangers posed by the misuse of these medications.

Physical Health Risks

The physical health risks of prescription drug abuse can be severe, and often depend on the type of drug being abused. Some of the most commonly abused prescription drugs are opioids, central nervous system (CNS) depressants, and stimulants, each carrying specific health risks.

Opioids such as hydrocodone, oxycodone, morphine, and codeine are often abused for their euphoric effects. Over time, individuals may become physically dependent on these drugs, leading to addiction. The health risks associated with opioid abuse include mood and behavior changes, breathing problems, coma, and even death, especially when combined with alcohol, antihistamines, or CNS depressants [4].

CNS depressants, such as benzodiazepines (e.g., Valium or Xanax) and barbiturates, are often abused for their calming effects. Long-term use or abuse can result in physical dependence and withdrawal symptoms. Abuse of CNS depressants can lead to symptoms like sleepiness, confusion, slurred speech, slowed breathing, and seizures. Suddenly stopping these drugs, or combining them with other medications or alcohol can be life-threatening [4].

Stimulants like Adderall or Ritalin are commonly abused due to their ability to increase alertness, attention, and energy. Prolonged use can lead to tolerance, dependency, and severe health consequences including heart problems, panic attacks, and violent behavior. The risks increase when stimulants are mixed with other medications, even common over-the-counter ones like cold medicines [4].

Mental Health Risks

In addition to physical health risks, prescription drug abuse can also have serious consequences on mental health. These drugs, while beneficial when used correctly, can lead to significant mental health issues when abused. Potential mental health risks include changes in mood, increased anxiety, confusion, and paranoia.

Continued misuse of these drugs can lead to more severe mental health disorders, such as depression and anxiety disorders. Moreover, withdrawal from these substances can also exacerbate pre-existing mental health conditions or trigger the onset of new ones, making it even more challenging for individuals to stop abusing these drugs.

Prescription drug abuse is a serious issue with severe health risks. It is essential for those struggling with this form of abuse to seek help from healthcare professionals to minimize these risks and begin the path towards recovery [5].

Preventing Prescription Drug Abuse

Preventing the abuse of commonly misused prescription drugs is a multifaceted issue that requires the involvement of various stakeholders, including healthcare professionals and patients themselves.

Role of Healthcare Professionals

Healthcare professionals play a crucial role in preventing the misuse of prescription drugs. They can help identify potential risk factors for abuse and implement strategies to address them. According to the National Institute on Drug Abuse, physicians are advised to balance patients' legitimate medical needs for prescription stimulants, sedatives, or opioids with the risks of misuse.

A key tool for monitoring and preventing prescription drug misuse is the Prescription Drug Monitoring Programs (PDMPs). These programs track the prescribing and dispensing of controlled prescription drugs to patients and have been linked to lower rates of opioid prescribing and overdose in some states.

Moreover, healthcare professionals can also contribute to the development of abuse-deterrent formulations (ADF) for opioid medications. These formulations are designed to prevent misuse by making it difficult to snort or inject the drugs. ADF opioids have shown to decrease the illicit value of drugs, and efforts are also underway for ADF stimulants.

Importance of Proper Drug Disposal

Proper disposal of unused medications is another critical aspect of preventing prescription drug misuse. As per the Mayo Clinic, patients should follow their healthcare provider's instructions when taking prescription drugs to reduce the risk of abuse and addiction. They should also inform healthcare professionals about their current medication regimen before starting new prescriptions.

Unneeded or expired prescription medications should be removed from the home as soon as possible to reduce the chance of accidental ingestion, theft, or misuse. Many pharmacies and local law enforcement agencies offer medication take-back programs that provide safe and convenient ways to dispose of unused drugs.

Furthermore, it is vital to store prescription medications securely, preferably in a locked cabinet, out of reach of children, teenagers, and visitors.

Prevention of prescription drug abuse is a shared responsibility. It requires collective efforts from the medical community, policymakers, patients, and their families. By implementing effective monitoring systems, prescribing practices, and educational initiatives, it is possible to curb the misuse of prescription drugs and protect public health.

Strategies for Combating Prescription Drug Abuse

In response to the growing concern over the misuse of prescription drugs, many strategies have been implemented to curb this alarming trend. The two main strategies include Prescription Drug Monitoring Programs and the development of Abuse-Deterrent Formulations.

Prescription Drug Monitoring Programs

Prescription drug monitoring programs (PDMPs) are crucial tools that help prevent and identify prescription drug misuse. They track the prescribing and dispensing of controlled prescription drugs to patients. While the impact of these programs varies, the use of PDMPs in some states has been linked to lower rates of opioid prescribing and overdose [6].

Moreover, in 2015, the federal government launched initiatives to reduce overdose and prevent opioid use disorders. These efforts included the Helping End Addiction Long-term (HEAL) Initiative and the issuance of guidelines such as the CDC Guideline for Prescribing Opioids for Chronic Pain in 2016. The continued federal efforts are focused on addressing opioid misuse while managing pain and addiction.

Development of Abuse-Deterrent Formulations

In addition to monitoring programs, the development of Abuse-deterrent formulations (ADF) of opioid medications is another significant strategy. These formulations are designed to prevent misuse by methods such as snorting or injection. Drug manufacturers are investing in the development of ADF opioids, which have shown to decrease the illicit value of drugs. Efforts are also underway for ADF stimulants. The regulation of medication has proven effective in reducing opioid prescribing [6].

Healthcare professionals play an important role in combating prescription drug misuse. Physicians are advised to balance patients' legitimate medical needs for prescription stimulants, sedatives, or opioids with the risks of misuse. Patients should properly dispose of unused medications and inform healthcare professionals about their current medication regimen before starting new prescriptions.

Moreover, the exploration of safer, non-addicting pain medications is vital. Researchers are investigating alternative treatments that target different signaling systems in the body, such as the endocannabinoid system, to address pain. More research is needed to enhance chronic pain management and prevent non-medical use of prescription medications.

These strategies aim to tackle the issue of commonly abused prescription drugs by addressing the root causes and providing safer alternatives for pain management. The combined efforts of healthcare professionals, researchers, and federal entities are essential in this endeavor.

References

[1]: https://www.webmd.com/mental-health/addiction/ss/slideshow-commonly-abused-drugs

‍[2]: https://www.tfah.org/releases/drugabuse2013/

‍[3]: https://www.samhsa.gov/data/sites/default/files/report_2686/ShortReport-2686.html

‍[4]: https://kidshealth.org/en/teens/prescription-drug-abuse.html

‍[5]: https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/symptoms-causes/syc-20376813

‍[6]: https://nida.nih.gov/publications/research-reports/misuse-prescription-drugs/how-can-prescription-drug-misuse-be-prevented