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Prescription Drug Abuse (04-12-01)

A News Analysis By Terence T. Gorski
GORSKI-CENAPS Web Publications
www.tgorski.com
Published On: April12, 2001          Updated On: January 26, 2002
Terence T. Gorski, 2001

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Prescription Drug Abuse

A News Analysis By Terence T. Gorski

April 12, 2001

On April 10, 2001 Paul  Recer of The Associated Press reported on the most recent volley of information in the war on drugs - an assault on prescription drug abuse.  

Nobody is denying that prescription drugs are important to the health care of many Americans.  Prescription drugs play a critical role in the treatment of a variety of medical problems and improve the lives of millions of Americans.  They can also be dangerous.  Pharmaceuticals designed to relieve pain, calm stress, or bring on sleep provide great benefit for millions.  Many patients who start taking sedatives, stimulants, tranquilizers, pain killers or opioids for appropriate medical reasons, however, can begin to use the pills inappropriately and can slip into an addiction cycle that dominates their lives and damages their health. 

To combat this health risk, NIDA and seven other organizations representing the elderly, pharmacies, drug manufacturers, and patients are starting a campaign to combat what Alan Leshner, head of the National Institute of Drug abuse called ``a dangerous new drug abuse trend'' - the nonmedical use of prescriptions. 

While on the surface the attempt to stop prescription drug abuse seems like a good thing, it is important to remember that this initiative will be conducted under a National War On Drugs Policy which instantly turns people who are addicted to prescription drugs, the pharmacists who dispense them, and the doctors who prescribe them into criminals.  Currently Federal Agencies are sending mixed messages.  NIDA is talking exclusively about the treatment aspects of prescription drug abuse while not even mentioning the enforcement implications.  The full NIDA Report On Prescription Drug Abuse says nothing about enforcement.  The Drug Enforcement Agency (DEA), on the other hand, gives lip service to treatment while gearing up for major legal crack-downs on drug manufacturers, pharmacies, prescribing physicians, and people using the medications for "non-medical reasons.

Before reading the information on the abuse of prescription drugs that was reported by the Associated Press, it's important to remember that addiction is public health problem.  Prescription addicts need early intervention and treatment that can best be provided by training medical professionals in how to recognize and intervene upon people who are abusing prescription medications.  

The question that needs to be asked is this:  Who should have the ultimate say on when a prescribed pain killer or sedative is medically necessary?  Should it be medical professionals or the enforcement professionals at the DEA who are ready and willing to step in, over-ride medical doctors, and criminalize the acts of prescribing, filling, and using prescription medications.  

I am afraid that this new offensive against prescription drugs might once again prove the law of unintended consequences by increasing, not decreasing the illicit drug trade.  Here's how it could happen.

The patients most at risk are those who are terminally ill or sufferring from severe pain disorders that require above average doses of pain medications.  As physicians who treat these patients feel threatened by the long arm of drug enforcement, they are less likely to prescribe adequate amounts pain killers.  This means that patients either have to suffer the pain or find some other way to acquire the pain medications.  This could drive them to seek illegal sources of supply, opening up a new and more lucrative market for the drug trade.

With that in mind, here's a summary of the Associated Press's information reported by Paul Recer.

1.    In 1999, four million people used prescriptions for nonmedical purposes, half were abusing the medications for the first time that year. This shows, according to NIDA, that prescription abuse is growing. 

2.    This increase in prescription drug abuse has accompanied a rapidly rising trend in the legitimate use of mood-altering medications.  From 1990 to 1998, new users of pain relievers rose by 181 percent; new use of tranquilizers went up 132 percent;  people starting taking sedatives went up by 90 percent, and the use of stimulants rose by 165 percent. 

3.    Some people recovering from surgery use pain-relievers far longer than needed and eventually become addicted. 

4.    Poor sleepers take sedatives and may mix it with alcohol or other drugs. Eventually, they need more and more of the drug to achieve the same effect. 

5.    It is estimated that misuse and abuse of prescription medication has more than a $100 billion impact on the nation's health care costs.  (The formula used for arriving at this figure was not mentioned.  This number seems close to the total estimated costs from all substance abuse rather than just from prescription drugs.)

6.    About 17 percent of Americans age 60 and older are affected by prescription drug abuse. Leshner said that is because this age group uses about three times more of the drugs than do young people. 

7.    Women are two to three times as likely to be diagnosed as needing drugs, such as sedatives, and are about two times as likely to become addicted.

8.    Prescription drug abuse among adolescents, age 12 to 17, and among young adults, 18 to 25, is particularly damaging to health because ``their brains are still developing'' and the effects of overuse of the drugs can be particularly severe.

Enforcement experts fear that prescription pain medications will flood the black market with a supply of illicit prescription drugs.  Here's their rationale:  

1.    Some patients with chronic pain often keep supplies of drugs in their homes for legitimate use.  In some cases (the percent not specified) the drugs are stolen by family members for sale on the street.  

2.    Morphine is often used in large doses by patients with terminal cancer or other conditions.  These packages of morphine can be stolen and sold because they are in high demand on the street.  (Again no statistics on this theft of morphine was provided.)

3.    Patients habituated to the drugs may ``doctor shop'' to find physicians who will prescribe the pills and some addicts will establish accounts at different pharmacies to disguise the number of pills they are actually using.

4.    Ritalin, or methylphenidate, a drug commonly used to treat the 3 to 5 percent of America's children with attention-deficit hyperactivity disorder, is becoming a frequently abused stimulant. The drug is being crushed and snorted, dissolved and injected, or mixed with street drugs to create what is called a ``speedball.'' 

Notice the mixed messages between enforcement and treatment and remember the key question:  Who should have the ultimate say on when a prescribed pain killer or sedative is medically necessary - medical professionals or the enforcement professionals?  If you have a strong opinion, now is the time to make it heard or the War On Drugs will move its offensive to incarcerate addicts into the ranks of those most at risk for prescription addiction - adolescents, women, the sick, and the elderly. 

About the Author

Terence T. Gorski is internationally recognized for his contributions to Relapse Prevention Therapy. The scope of his work, however, extends far beyond this. A skilled cognitive behavioral therapist with extensive training in experiential therapies, Gorski has broad-based experience and expertise in the chemical dependency, behavioral health, and criminal justice fields.

To make his ideas and methods more available, Gorski opened The CENAPS Corporation, a private training and consultation firm of founded in 1982.  CENAPS is committed to providing the most advanced training and consultation in the chemical dependency and behavioral health fields.

Gorski has also developed skills training workshops and a series of low-cost book, workbooks, pamphlets, audio and videotapes. He also works with a team of trainers and consultants who can assist individuals and programs to utilize his ideas and methods.
Terry Gorski is available for personal and program consultation, lecturing, and clinical skills training workshops. He also routinely schedules workshops, executive briefings, and personal growth experiences for clinicians, program managers, and policymakers.

Mr. Gorski holds a B.A. degree in psychology and sociology from Northeastern Illinois University and an M.A. degree from Webster's College in St. Louis, Missouri.  He is a Senior Certified Addiction Counselor In Illinois.  He is a prolific author who has published numerous books, pamphlets and articles.  Mr. Gorski routinely makes himself available for interviews, public presentations, and consultant.  He has presented lectures and conducted workshops in the U.S., Canada, and Europe.  

For books, audio, and video tapes written and recommended by Terry Gorski contact: Herald House - Independence Press, P.O. Box 390 Independence, MO 64055.  Telephone: 816-521-3015 0r 1-800-767-8181.  His publication website is www.relapse.org.

Mr. Gorski Is Available To Speak Or Consult On 
Public Health Addiction Policy As An Alternative To The War On Drugs
Call 708-799-5000 or www.cenaps.com

 

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