The statistics on prescription drug abuse in the U.S. are startling to say the least. For instance, the number of Americans who misused prescription medications in 2012 exceeded 12 million. To cite just one state, more Tennessee residents die from overdose of prescription medication than from automobile crashes. Drug deaths across the U.S. have passed up fatal auto accidents in sheer numbers. Moreover, the Centers for Disease Control and Prevention (CDC) has noted that painkiller overdoses are taking more lives today than cocaine and heroin overdoses combined.
How did this problem take root? Why is it that Americans took 80 percent of the world’s painkillers in 2011?
The Epidemic’s Origins
In 1997, the American Society of Anesthesiologists, the American Academy of Pain Medicine, and American Pain Society issued separate reports suggesting that doctors in the U.S. should prescribe pain medications more frequently. Other newly-formed pain management organizations released similar proposals in subsequent years.
Clearly, many doctors took those recommendations to heart. The number of painkiller prescriptions in the U.S. began to surge during the late 1990s; since then, painkiller addiction rates have risen in roughly proportionate numbers. Doctors in this country are now prescribing almost three times as many painkillers to their patients as they did 20 years ago. According to the Trust for America’s Health, a nonprofit policy organization, four times as many people died in 2010 as a result of painkillers than in 1999.
Addiction and Medical Ignorance
For years, the vast majority of patients who took painkillers believed that their medications were completely safe. After all, their doctors had approved those treatments. However, prescription opioids are addictive in the same way that heroin is. That is, opioids make people feel high and crave more. At the same time, opioid overdoses often lead to fatal respiratory failure. Therefore, the truth is that many doctors failed to recognize the powerfully addictive nature of certain prescription drugs. Indeed, to this day, primary care physicians often lack training in the area of addiction and pain medicine.
Those points are especially salient in the case of OxyContin, a brand name for extended-release oxycodone manufactured by Purdue Pharma. The Food and Drug Administration (FDA) first approved OxyContin in 1995. In its initial years on the market, Purdue Pharma marketed the drug as non-addictive due to its time-release nature. Many doctors in the U.S. trusted that selling point and proceeded to prescribe it widely. However, many consumers and addicts soon discovered that they could simply crush their OxyContin tablets and then snort, smoke or inject it.
In the years since its introduction to the marketplace, OxyContin abuse became an epidemic, one that struck rural areas such as southwestern Virginia and eastern Kentucky particularly hard – earning it the nickname “Hillbilly Heroin”. In August 2010, after nearly fifteen years on the market, Purdue came out with its tamper-resistant OxyContin. So while Oxy abuse has dropped, there are still plenty of opiates – legal and illegal – available to users and addicts across America. The new pure hydrocodone drug, Zohydro, is notably NOT tamper-resistant yet was inexplicably approved by the FDA.
Another issue relevant to the rise of prescription drug addiction is a general acceptance of prescription drugs among the population. While prescription drug use is nothing new, such as the use of valium, the “Mother’s Little Helper” in the 1960s, by the 1990s many people started to feel more comfortable with the idea of taking pills to cure their ills; there no longer seemed to be any stigma attached to those drugs. The emergence of online pharmacies and the fact that there are now 67,000 brick-and-mortar pharmacies in the U.S. have also contributed to the prevalence of pills.
Another cause of these changing perceptions is that advertisements for antidepressants and other drugs started becoming commonplace on television and in magazines. In the year 2000 alone, drug manufacturers spent a combined sum of $2.5 billion to promote their products. In the process, they helped to normalize such concepts as giving addictive psycho-stimulants like Ritalin and Adderall to children to make them “perform better”, “pay attention” and do as they’re told. This has been combined with programs in schools wherein teachers and counselors essentially give parents “no choice” but to drug their kids, violating the parents’ and child’s rights.
Pain management clinics have played a role in this epidemic as well. Many people in law enforcement refer colloquially to those establishments as “pill mills”. The typical pill mill functions as follows: A person enters the building and claims to suffer from pain. One of its medical staff members will then prescribe a painkiller in exchange for cash or a money order; the typical charge is between $100 and $400 per visit. No formal medical tests take place, and as you might imagine, no insurance company would ever cover such a visit. Furthermore, customers can keep returning in order to have their prescriptions renewed.
Some of the first of these clinics opened in Florida. When that state took measures to outlaw them, they started appearing in various other states. In many parts of the country, they’re still legal.
Nowadays, the majority of prescription drug abusers are employed and married; in addition, more women than men are addicted to prescription medication. In many cases, addicts get their drugs from friends and family. Approximately 17 percent of them have prescriptions from their doctors, and about 16 percent steal medications from people they know or obtain them from drug dealers. Notably, a large percentage of drugs are now obtained online.
Can This Plague Be Curbed?
Many people and agencies have offered ideas on how to fight prescription drug abuse. For example, Richard Segerblom, a state senator in Nevada, introduced legislation in February 2013 that would allow patients with painkiller addictions to sue their doctors as well as drug manufacturers. That bill, however, failed to pass.
Another corrective measure would be for the FDA to tighten the regulations that govern prescription drugs – both in what gets approved for the market and how their prescription is regulated. Some progress has been made in this area. The FDA has finally agreed with the DEA and hydrocodone drugs like Vicodin will now be classified under Schedule II under the Controlled Substances Act. Other authorities maintain that opioid painkillers should only be available to patients with severe pain, not moderate pain. But in the case of the FDA, it seems a lot like one step forward and two steps back; so we can’t sit back and wait and assume the government will take care of it.
A Human Problem
This is a problem amongst American citizens and human beings in general. No matter the regulations or lack thereof, until drug education, detoxification and rehabilitation significantly surpass the supply and demand, the problem can appear overwhelming. Witness the fact that cocaine, heroin and meth are illegal yet those drugs are still very much a problem.
The answer is to educate our youth and adults alike on the pitfalls inherent in controlled and illicit substances. At the same time, effective treatment is needed in every major city, state and rural zone in our nation. That is why I have dedicated my life to this cause. The more people wake up, the faster we can turn the tide.