Prescription Drug Misuse: Consequences and Prevention

Introduction

Studying, experimenting, relaxing, and increasing energy are just some of the reasons that today’s youth give when rationalizing why they use prescription drugs. Young adults between the ages of 18 and 25 years old are the largest group of abusers of prescription drugs in the United States.1 Students in high school and college are abusing a wide range of prescription drugs. Since these drugs are available for prescription use, many youths believe these drugs must be safe to use.2 While this may be the case for individuals who are prescribed these drugs for certain ailments, improper use of prescription drugs can have severe consequences. Individuals taking prescription drugs in excess or mixing them with other substances, like alcohol, may experience unintended results.

The three most commonly abused types of prescription drugs are opioids, depressants, and stimulants.

There are several types of prescription drugs that are most commonly misused and abused, with many of them being found in medicine cabinets across the globe. The three most commonly abused types of prescription drugs are opioids, depressants, and stimulants. Opioids are prescription drugs that are used to treat pain, such as codeine, OxyContin, or Vicodin, while Adderall and Ritalin are well known stimulants used for treating ADHD. Depressants are used to relieve stress, anxiety, or are used as sleep aids; they include drugs such as Xanax or Valium.2 Although prescription drugs have an intended purpose, they are widely misused and abused among adolescents and adults in almost epidemic proportions across the United States. 2,4

Consequences of Prescription Drug Misuse

The consequences of recreational prescription drug use can be fatal, with more than 1,700 young adults between the ages of 18 and 25 years old dying from prescription drug overdoses in 2014, which is four times as high as the overdose deaths in 1999.5 Unintentional overdoses from opioid prescription painkillers have outnumbered unintentional overdoses from heroin and cocaine since 2002. 3,5 Besides the fatal consequences of overdoses, those who manage to survive overdoses may experience mental, physical, and economic costs as well. For every death caused by prescription drug overdose, there are 119 emergency room visits6 and 22 admissions for treatment.7 The consequences can have detrimental life-long impacts for those who suffer from addiction and overdose.

An additional consequence of recreational prescription drug use is that it can lead to addictions of other narcotics. Research suggests that abuse of prescription drug medications may be a gateway to heroin use. Between 50 and 80 percent of young people who use heroin via injection reported they abused prescription opioids before switching to heroin.8,9 The switch to heroin often occurs because heroin is cheaper and easier to obtain than prescribed medications.

The Centers for Disease Control and Prevention estimates that there is also an economic burden on the United States due to prescription opioid misuse. There is a $78.5 billion yearly burden placed on the United States in the form of increased healthcare costs, lost productivity, addiction treatment, and criminal justice involvement.10 This economic burden is experienced by all, including individuals who are not intimately close to someone misusing or abusing prescription drugs. This should be a call for communities to seek out preventative methods, as the effects of prescription drug abuse are far reaching.

School & College Involvement

Drug abuse in schools has long been around, due to the congregation of large populations of youth who are more susceptible to risk-taking, thrill-seeking, and irresponsible behavior. Teens are swapping prescription pills like Vicodin, OxyContin, and Xanax at “skittles” or “pharming” parties.11 Kids raid their parents’ medicine cabinets for legal drugs to share illegally at parties. 11,12,13 Generally, a large bowl is filled with the pilfered drugs, and partygoers swallow an assortment of pills, usually with alcohol. The consumption of prescription pills in combination with alcohol can cause difficulty breathing, lowered or increased heart rate, and death.11 Teens have been abusing prescription pills for years, but “pharming parties” elevate the risk of overdose, as many partygoers do not know what they are consuming. This party trend is dangerous and wide-reaching, as teens from all walks partake in the festivities. As with most prescription pill abuse, much of the problem is rooted in easy access.11,12,13

There have been programs geared toward drug prevention for decades, with the two most popular programs being the Drug Abuse Resistance Program (DARE) and Red Ribbon Week. However, while these programs have been in place for decades, there has been stark criticism of their effectiveness, particularly the DARE program. Since 2001, when a U.S. Surgeon General report came out questioning the effectiveness of the DARE program in deterring drug use,14 there has been a struggle to find programs that work effectively with youth.

The NOPE program is one of many programs geared toward educating high school and middle school students about the dangers of prescription opiate painkillers, and the deadly consequences that can come from abusing such drugs.

One program that is geared specifically toward prescription drug misuse and abuse is the Narcotics Overdose Prevention and Education (NOPE) program. The NOPE program is one of many programs geared toward educating high school and middle school students about the dangers of prescription opiate painkillers, and the deadly consequences that can come from abusing such drugs. The specificity of these targeted programs is thought to potentially be more effective than generalized anti-drug programs of the past, with the target of painkillers as the focus, which is a highly selected narcotic choice for teens and young adults. Though college campuses often do not have specific anti-drug courses, many campuses across the country have anti-drug movements and policies that are implemented to keep campuses drug-free.

Treatment & Prevention

Treatment of prescription drug misuse and abuse can range from withdrawal management to counseling. Counseling treatments include both group and one-on-one therapy treatments with certified professionals, to discuss resources and methods to help achieve sobriety from prescription drug abuse and to help prevent relapse of drug abuse. Withdrawal management involves medical facility aid, where individuals and specially trained physicians work in an office-based setting to work on using medications developed to treat opioid addictions.15 Research shows that a combination of counseling, medication, and recovery services works best to ensure successful treatment.15

Research shows that a combination of counseling, medication, and recovery services works best to ensure successful treatment.

There are nationwide prevention programs that seek to reduce the number of prescription drug misuse and abuse incidents. Many of them focus on individuals who interact directly with prescription drugs, and the methods they can utilize to prevent misuse. Substance Abuse and Mental Health Services Administration (SAMHSA)15 outlines how physicians, family, friends, communities, and workplaces can identify potential signs of prescription drug abuse or misuse. Physicians play a critical role in preventing prescription drug misuse and abuse since they are often the first source of access to pharmaceuticals. Physicians may contribute to opioid abuse and overdoses due to a lack of awareness and education about appropriate prescription practices6, so continued education for prescribers is crucial.

SAMHSA15 recommends all physicians should have a serious conversation with patients about signs of drug dependence and abuse, as well as discuss the negative effects of misusing prescriptions. Physicians should also have open communication with pharmacies to note rapid increases of the amounts of medication requested and how often refills are being filled. Drastic increases in requests for medication strength and refills can signal “doctor shopping”. While prescribers need to be diligent in their allotment of prescriptions, individuals prescribing drugs need to be diligent in their use and storage of said drugs. Patients and families need to ensure that they are using the prescribed drugs appropriately, storing them in secure locations, and disposing them safely. These three simple steps can ensure that prescriptions are used appropriately and only by the individual with the prescription. Communities and workplaces can help encourage safe and secure drug-free environments by providing preventative aid and treatment for those struggling with prescription drug problems.

Conclusion

Educating teens and young adults about the dangers and consequences of misuse and abuse of prescription drugs, specifically, can prevent them from taking part in a dangerous trend.

Nationwide, prescription drug use is on the rise, leading to almost epidemic levels of misuse and abuse. The consequences of these have been vast and immediate, with deaths drastically increasing in the last two decades. Although prescription drugs are commonly being misused by teens and young adults across the country there are national level treatment and prevention methods that are offering promising results. Educating teens and young adults about the dangers and consequences of misuse and abuse of prescription drugs, specifically, can prevent them from taking part in a dangerous trend. Families, schools, and communities can come together to ensure that young adults are educated to help them make decisions about proper pharmaceutical consumption.``

References

1 National Institutes of Health. (2016). Abuse of Prescription (Rx) Drugs Affects Young Adults Most. National Institute on Drug Abuse. U.S. Department of Health and Human Services.

2 National Institutes of Health. (2017a). Drug Facts: Prescription Drugs. National Institute on Drug Abuse. U.S. Department of Health and Human Services

3 National Institutes of Health. (2017b). Overdose Death Rates. National Institute on Drug Abuse. U.S. Department of Health and Human Services.

4 National Institutes of Health. (2017c). Prescription Drug Information Sheet. National Institute on Drug Abuse. U.S. Department of Health and Human Services.

5 Centers for Disease Control and Prevention, & National Center for Health Statistics. (2015). Underlying cause of death 1999-2013 on CDC WONDER online database, released 2015. Data are from the multiple cause of death files, 2013.

6 Centers for Disease Control and Prevention. (2014). Emergency department visits involving nonmedical use of selected prescription drugs-United States, 2004-2011. MMWR: Morbidity and mortality weekly report, 59(23), 705-709.

7 Mental Health Services Administration (SAMHSA). (2016). Treatment Episode Data Set (TEDS): 2004–2014. National Admissions to Substance Abuse Treatment Services. BHSIS Series S-84, HHS Publication No.(SMA) 16–4986. Rockville: Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality.

8 Pollini, R. A., Banta-Green, C. J., Cuevas-Mota, J., Metzner, M., Teshale, E., & Garfein, R. S. (2011). Problematic use of prescription-type opioids prior to heroin use among young heroin injectors. Substance abuse and rehabilitation, 2, 173.

9 National Institute on Drug Abuse. (2012). Epidemiologic trends in drug abuse. Proceedings of the community epidemiology work group, 66.

10 Florence, C. S., Zhou, C., Luo, F., & Xu, L. (2016). The economic burden of prescription opioid overdose, abuse, and dependence in the United States, 2013. Medical care, 54(10), 901-906.

11 Doup, L. (2006). Teens Swapping Legal Drugs at Pharming Parties. South Florida Sun Sentinel, May, 5, 2006.

12 O'Neil, M., & Hannah, K. L. (2010). Understanding the cultures of prescription drug abuse, misuse, addiction, and diversion. West Virginia Medical Journal, 106(4), 64-71.

13 Sham, M. K. (2010). Down on the pharm: The juvenile prescription drug abuse epidemic and the necessity of holding parents criminally liable for making drugs accessible in their homes. J. Contemp. Health L. & Pol'y, 27, 426.

14 Morris, M. C., Cline, R. J. W., Weiler, R. M., & Broadway, S. C. (2006). Prescription drug abuse information in DARE. Journal of drug education, 36(1), 33-45.

15 Mental Health Services Administration (SAMHSA). (2016). SAMHSA’s Efforts to Fight Prescription Drug Misuse and Abuse.