AODS 152 (85792)

MichaelLong

Fall 2009
11/16/2009

Prescription Drug Abuse: Opioids

 A tractor trailer filled with more than 16 million doses of hydrocodone

products was hijacked on June 17, 2007 in Gurnee, Ill. Even though these

drugs probably went to dealers, 60% of users of illegal prescription drugs

receive them free from friends or relatives. The Center for Substance Abuse

Treatment (CSAT), of the federal Substance Abuse and Mental Health

Services Administration (SAMHSA) reports that according to a household

survey in held by (SAMHSA) in 2005, 17% also receive their drugs by going

to different physicians, or doctor shopping; 0.8% get their meds online; and

4.3% buy them on the streets from dealers.(3)

In government hearings on the growing problem of OxyContin abuse in

this country it was reported that robberies and employee thefts involving

opioids, (analgesics, narcotics and painkillers i.e. Oxy), were minimal until

2001 with 8 out of 59 robberies armed. After this it shot up to 87 out of 105

armed with 13 in one month alone (Jan. to Feb, 2002 ). (7)

As early as between the years 1992-1997 narcotic painkiller admissions

to treatment facilities increased 129%. During this same time period

oxycodone admissions, (OxyContin was put on the market in 1996), rose to

1,267%.(4) In 2002, about 29.6 million Americans reported using prescription

opioids for non-medical/recreational uses in their lifetime. In 2005, about

600,000 of the 1.4 million people treated in hospital emergency rooms for

substance use and abuse were for non-medical use of prescription products

and 200,000 of those involved opioids. This was a 24% increase from 2004.
From 2002-2005 13,500 licensed treatment programs indicated a 45%

increase in opioid admissions from the previous reporting period.(3)

Jane Maxwell, PhD, director of the Center for Excellence in Epidemiology,

Gulf Coast Addiction Technology Transfer Center in Austin Tex., says that

men aged 18-25 are the largest demographic group to abuse opioids

followed by girls 12-17. According to Maxwell “It’s a young population, and if

they’re using as teenagers and young adults, we’re going to see them

continue to use-just like we saw the kids who started on marijuana 30 years

ago continuing, a lot of them, as older adults.”(4) SAMHSA reports that the

abuse of prescription drugs is exceeded only by the abuse of alcohol and

marijuana in the United States and we are not unique in the world. The

United Nations-affiliated International Narcotics Control Board estimates that

the number of individuals abusing prescription drugs worldwide is close to

equal with the number using illegal substances.(3)

Simply, patients use prescription drugs correctly or not. Isaacson (2005),

outlined 4 common levels of use and misuse regarding prescription

opioids(1)

1) Appropriate Use: using the medication as prescribed.

2) Inappropriate Use: use of a higher dose than prescribed or for other

than it was called for.

3) Abuse: using a drug solely for euphoria or recreation.

And the most severe:

4) Catastrophic Use: use of a drug in immediately harmful ways or

commits illegal acts surrounding the use of the drug.

Recently OxyContin has been the opioid of media interest especially in

the light of actor Keith Ledger’s death. It tends to show users as just naïve

innocent medication users who became accidentally “hooked” while using

the drugs for legitimate medical reasons totally ignoring the disease of

addiction and throwing a bad light on the beneficial aspects of the

substance. A drug such as Oxycontin’s abuse on a percentage basis is not

that serious. What is serious is the inappropriate use of all prescriptions.

Law enforcement complained that manufacturers, such as Purdue

Pharma (i.e. OxyContin), ignored abuse reports first coming out of Maine in

2000 about the misuse and abuse of medications such as OxyContin and

continued highly aggressive marketing campaigns. They were urging doctors

to switch patients already on least addictive painkillers to drugs such as

“Oxy”. This sparked numerous investigations by the Congress and others.(5)

(6)(7)

Overall, the problem of prescription drug abuse, especially opioids, exists

amid a unique set of circumstances. Mainly such abuse and dependence is

shrouded by legitimate personal, industry, and medical practices. It’s

maintained by a well-meaning system of care. Medical and mental health

professionals need to work together and be equipped with a greater

knowledge not only in the scope of the issue but also in terminology, tactics

users engage in to obtain the drugs, and the signs of misuse and

dependence. In this way they (we) will be better prepared to help

government, pharmaceutical manufacturers, educators, law enforcement,

and society at large address this monumental problem. Once the problems

are identified and brought into the open, appropriate preventions,

interventions, and referrals of those individual clients can be implemented.

Bibliography/Citatations

Article

1) Isaacson, J.H., Hopper, J.A., Alford, D.P., & Parran, T. (2005) Prescription

drug use and abuse: Risk factors, red flags, and prevention

strategies. Postgraduate Medicine, 118(1), 19-26.

2) Katz, D. A., & Hays, L. R. (2004). Adolescent OxyContin abuse. Journal

of the American Academy of Child and Adolescent Psychiatry, 43, 231-234.

Electronic Databases

3) Bender, K.J., PharmD, MA,(2007) Abuse of Prescription Drugs Close

Behind Alcohol, Marijuana. Psychiatric Times 24.10 Retrieved Nov. 8,

2009 from Academic OneFile.

4) Weigel, D.J., Donovan, K.A., Krug, K.S., Dixon, W.A., Prescription opioid

abuse and dependence: assessment strategies for counselors.

(Trends) Journal of Counseling and Development, 85.2(Spring 2007):

211(5), Retrieved Sept. 28, 2008. from Military Intelligence Database. Gale.

5) Van Zee, A., (2009) The Promotion and Marketing of OxyContin:

Commercial Triumph, Public Health Tradegy. American Journal of Public

Health, 99(2), 221-7 Retrieved Oct. 22, 2009, from ProQuest Health and

Medical Complete. (Document ID: 1630875471)

Website

6) United States Government Printing Office via GPO Access 107th Congress

House Hearings (Aug. 8, 2001). Retrieved Sept. 28, 2008 from

http://www.access.gpo.gov/congress/house
7) United States Government Printing Office via GPO Access 107th Congress

House Hearings Second Session (Feb.12, 2002). Retrieved Nov. 8, 2009 from

http://www.access.gpo.gov/congress/house