Why Are Prescription Drugs So Commonly Abused?

Understanding Prescription Drug Misuse

Prescription drug misuse is a growing problem worldwide, with serious implications for public health, social economic dynamics, and individual health. Understanding the nature and scope of this issue is crucial for devising effective prevention strategies and interventions.

Definition and Overview

Prescription drug misuse involves taking a prescription medication in a way or dose other than prescribed by a healthcare provider, or for a purpose that differs from what the healthcare provider intended. This could mean taking more than the prescribed dosage, using a drug prescribed to someone else, or using the medication to get high.

Such misuse is not limited to a specific demographic or age group. In fact, misuse of prescription drugs among adults aged 18-25 has increased by 8% from 2002 to 2017, with an 18.5% increase observed in male adults compared to 10.5% in female adults.

Commonly Misused Medications

There are several types of prescription drugs that are commonly misused. These include opioids, central nervous system depressants, and stimulants. Each of these drug classes has different effects, and their misuse can lead to different health risks.

According to the National Survey on Drug Use and Health (NSDUH), in 2017, 18% of students in college aged 18-22 engaged in nonmedical use of prescription stimulants in the past year.

Understanding the nature and extent of prescription drug misuse is the first step towards developing effective prevention and treatment strategies. This awareness can help healthcare providers, policymakers, and communities work together to address this critical issue.

The Prevalence of Prescription Drug Misuse

Unpacking the prevalence of prescription drug misuse allows for a clearer understanding of the scope of this problem. This section will explore how misuse varies among different age groups and the overall impact of misuse on public health.

Misuse Among Different Age Groups

Prescription drug misuse is a concern across all age groups, but certain demographics show alarming trends. According to the Santa Barbara Treatment Center, misuse among adults aged 18-25 increased by 8% from 2002 to 2017. This increase is even more pronounced in male adults (18.5%) compared to female adults (10.5%).

The National Survey on Drug Use and Health (NSDUH) reported that 18% of college students aged 18-22 engaged in nonmedical use of prescription stimulants in the past year. It's clear that prescription drug misuse is a significant issue among young adults.

Impact of Misuse on Public Health

Prescription drug misuse has escalated over the past two decades, becoming a serious public health issue in the United States. In fact, prescription drug misuse is second only to marijuana use as the nation's most commonly used illicit drug [3].

The Preventing Prescription Drug Misuse Overview reports that nearly 18 million people misused prescription drugs at least once in the past year. The opioid epidemic, fueled by prescription and illegal opioids, has led to a sharp increase in overdose deaths.

The economic burden of prescription drug misuse in the United States is estimated to be $78.5 billion annually, with costs stemming from healthcare, treatment for substance use disorders, criminal justice involvement, and lost productivity. In 2012, the rate of emergency department visits involving the nonmedical use of pharmaceuticals was highest among those aged 21 to 34 years old, emphasizing the impact on young adults in terms of healthcare utilization and potential harm.

These statistics highlight the urgent need for a multifaceted approach involving healthcare providers, policymakers, educators, law enforcement, and community organizations to address the crisis of prescription drug misuse.

Reasons Behind Prescription Drug Misuse

Understanding the reasons behind prescription drug misuse is crucial to addressing this growing public health issue. The motivations behind misuse often stem from misconceptions about prescription drugs and their accessibility and availability.

Misconceptions About Prescription Drugs

Misconceptions about prescription drugs play a significant role in their misuse. Some individuals abuse prescription drugs because they believe these substances will help them have more fun, lose weight, fit in, or study more effectively [4].

However, these beliefs overlook the fact that prescription drugs are only safe for individuals who have valid prescriptions for them. A doctor has examined these individuals, prescribed the right dose, and provided instructions on how to take the medicine, including potential side effects to watch for.

The most commonly misused prescription drugs fall into three classes: opioids, central nervous system (CNS) depressants, and stimulants. Misuse of these drugs can lead to severe health problems. For instance, misuse of opioids can lead to mood changes, trouble thinking clearly, breathing problems, coma, or death. The risk is higher when opioids are combined with substances like alcohol, antihistamines, or CNS depressants.

Similarly, stimulant misuse, such as with some ADHD medications, can result in heart problems, seizures, panic attacks, paranoia, and violent behavior. Risks increase when stimulants are mixed with other medications, even common over-the-counter drugs.

Accessibility and Availability of Drugs

The accessibility and availability of prescription drugs also contribute to their misuse. Prescription drugs are often easily accessible, with people having them in their medicine cabinets or sharing them with others [1]. Additionally, they may be available from family or friends, and are sometimes sold illegally on the street.

The ease of access to these drugs often leads individuals to underestimate their potential harm, resulting in misuse. This, coupled with misconceptions about the supposed benefits of prescription drugs, underscores the need for education and prevention efforts to address and curb prescription drug misuse.

Consequences of Prescription Drug Misuse

As the prevalence of prescription drug misuse continues to rise, it becomes crucial to understand the potential consequences. The effects of this issue extend beyond the individual misusing the medication and can have significant health, social, and economic impacts.

Health Risks

Misusing prescription drugs can lead to a host of health risks. Physical dependence, addiction, and overdose are often the most severe outcomes. The misuse of prescription opioids, for instance, is a significant contributor to the opioid epidemic in the United States, with 21-29% of patients prescribed opioids for chronic pain misusing them.

Prescription drugs are only safe for the individuals who have prescriptions for them from a doctor, who chooses the appropriate dose and provides instructions on how to take the medicine, including potential side effects to watch for [4]. The most commonly misused prescription drugs fall into three classes: opioids, central nervous system (CNS) depressants, and stimulants.

Some of the potential health risks associated with misuse include:

• Opioids: addiction, overdose, respiratory distress
• CNS depressants: memory problems, low blood pressure, respiratory distress
• Stimulants: high body temperature, irregular heartbeat, heart failure

Social and Economic Impact

Prescription drug misuse doesn't just affect an individual's health; it also has considerable social and economic repercussions. This misuse has escalated over the past two decades, becoming a severe public health issue in the United States [1].

The economic burden of prescription drug misuse in the United States is estimated to be $78.5 billion annually. These costs stem from healthcare, treatment for substance use disorders, involvement with the criminal justice system, and lost productivity.

Socially, prescription drug misuse can lead to strained relationships, job loss, legal issues, and other personal problems that can significantly impact an individual's quality of life. Understanding these consequences is essential in breaking the cycle of misuse and creating strategies to address this critical public health issue.

Prevention and Treatment Strategies

Addressing the issue of prescription drug misuse requires a multi-faceted approach encompassing both prevention and treatment strategies. These strategies involve the role of healthcare providers, community efforts, and policy interventions.

Role of Healthcare Providers

Healthcare providers play a critical role in preventing prescription drug misuse. One key measure in place is the use of Prescription Drug Monitoring Programs (PDMPs). These state-run electronic databases track the prescribing and dispensing of controlled prescription drugs, and are associated with lower rates of opioid prescribing and overdose in some states. However, there are still unresolved issues, including determining best practices, improving ease of use, and enhancing interoperability.

In 2016, the Centers for Disease Control and Prevention (CDC) issued the CDC Guideline for Prescribing Opioids for Chronic Pain, providing healthcare providers with evidence-based recommendations. In 2019, the CDC further provided guidance on opioid tapering for clinicians considering reducing opioid therapy for chronic pain patients.

Another strategy involves the development of abuse-deterrent formulations (ADF) of opioid medications, aimed at preventing misuse by making it more difficult to snort or inject the drugs.

Community and Policy Interventions

Policy interventions are crucial in addressing prescription drug misuse. In 2015, a federal government initiative was launched to reduce overdoses and prevent opioid use disorders, spearheaded by the National Institutes of Health's Helping End Addiction Long-term (HEAL) Initiative. This initiative is focused on managing and treating pain, as well as preventing addiction.

Regulation of medication has also shown to be effective, with the reclassification of hydrocodone products to a more restrictive schedule in 2014 leading to a decrease in opioid prescribing [6].

At the community level, researchers are prioritizing the development of non-addictive pain medications and alternative treatments. This is particularly important given the growing number of older adults and injured military service members who need pain management. More research is needed in this area to enhance chronic pain management, identify factors leading to substance use disorders, and prevent the nonmedical use of prescription medications.

These combined efforts of healthcare providers, community initiatives, and policy interventions form a comprehensive approach to preventing and addressing prescription drug misuse.

The Role of Education in Preventing Misuse

Education plays a pivotal role in the prevention of prescription drug misuse. Through awareness and effective prevention programs, the cycle of misuse can be broken and the associated risks minimized.

Importance of Awareness

The misuse of prescription drugs often starts at a young age, particularly during adolescence. This is a phase of life characterized by significant changes and challenges such as moving, family divorce, or changing schools. These events, combined with the availability of drugs in social settings, can lead to experimentation with drugs.

Furthermore, the desire for independence and novelty during adolescence coincides with the ongoing development of the brain. The parts of the brain that control judgment and decision-making do not fully develop until the early or mid-20s, limiting a teen's ability to accurately assess the risks associated with drug experimentation. This makes them more vulnerable to peer pressure and the allure of drugs.

Therefore, raising awareness about the dangers of prescription drug misuse is crucial. Educating young people on the risks associated with drug misuse can help them make informed decisions, reducing the likelihood of experimentation and subsequent misuse.

Effective Prevention Programs

Research-based prevention programs have proven effective in reducing early use of tobacco, alcohol, and other drugs among youth. These programs, based on scientific evidence, aim to balance the risk and protective factors for drug use in various settings like families, schools, and communities.

Such programs work by enhancing protective factors and reducing risk factors associated with drug use. They are tailored to different ages and settings, allowing for a comprehensive and targeted approach to prevention.

Moreover, these prevention efforts can lead to substantial cost savings in terms of medical expenses. They also aid in keeping individuals productive members of society. For every dollar invested in prevention programs, the return can be up to $65 [7].

Educational initiatives play a vital role in combating prescription drug misuse. By raising awareness and implementing effective prevention programs, it's possible to break the cycle of misuse, safeguard public health, and ensure a healthier future for all.

References

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

‍[2]: https://sbtreatment.com/addiction-and-age-groups-guide/

‍[3]: https://www.samhsa.gov/data/sites/default/files/report_3210/ShortReport-3210.html

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

‍[5]: https://solutions.edc.org/sites/default/files/Preventing-Prescription-Drug-Misuse-Overview-Factors-Strategies_0.pdf

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

‍[7]: https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-misuse-addiction-best-strategy