Prescription drug abuse has become an important public health issue in the past decade. The United States has 5% of the world population, but consumes 75% of the world’s prescription drugs. The majority of these prescription drugs are pain killers called opioids. Besides pain relief, opioids cause slower breathing, decreased bone density, decreased levels of certain hormones, and drowsiness. They can also be very addictive and cause physical dependence and withdrawal symptoms. The body adapts to long-term use and therefore requires an increased dose to obtain the same relief from chronic pain. At their worst, prescription opioids cause death by overdose because of this highly addictive characteristic.
How did we get to this point of widespread addiction and overuse? Modern day prescription opioids have been in healthcare since the 1830’s when Codeine was synthesized as a convenient painkiller. In the 20th century, more synthetic opioids were created including Methodone, Vicodin, OxyContin, and Percocet. In the early 1990’s, drug companies took advantage of new and controversial evidence that opioids had no addictive dose. One study performed with a very limited patient population claimed to show no evidence of addiction regardless of dose or length of treatment. This perception was sold by the drug companies to the prescribing physicians and the public.
Fast-forward two and a half decades later and we are now in a prescription drug epidemic. Unintentional overdose deaths have increased by four times since 1999. A lot has been learned about prescription drug abuse and public education about the dangers of opioid overuse has increased.
For example, a Stanford study published in 2016 sought to identify risk factors that may lead to a susceptibility to opioid addiction after surgery. They found that certain surgeries that have painful recovery periods put the patients at twice the risk of opioid addiction than other surgeries. The high risk surgeries were: knee replacements, hip replacements, breast surgeries, and open gallbladder surgeries. Awareness of a patient’s predisposition to addiction by the physician and patient can help to prevent addiction from occurring post-operationally.
Image Source: Tom Merton
There have also been innovative approaches to fighting against prescription drug abuse. A recent study showed that state-run Prescription Drug Monitoring Programs (PDMP) decrease opioid overdose death rates. PDMPs are electronic databases that track prescriptions of addictive drugs. They can identify patients who may be at risk for drug misuse or addiction and allow help to be offered to those patients.
In 2010, enough painkillers were prescribed to give to every American every four hours for one month. A considerable effort has been made to educate physicians on the addictions risks of these prescriptions. Prescription painkillers do have a useful place in healthcare, but they should be prescribed only when necessary and effective. Overprescription of these highly addictive drugs just puts more drugs on the streets to be bought, sold, and abused on the black market.
It is going to take a considerable effort to combat addiction to these highly potent drugs and it starts with prevention. We must educate physicians and patients about the risks of addiction. Continued use of PDMPs can help identify signs of misuse and hopefully allow early interventions for addicted patients. If you have unused prescription medication, visit this website to find a sponsored location to safely discard your medications.
Feature Image Source: Pills / Tablets by Global Panorama
