Prescription and Non-Prescription Drug Abuse

A patient was taking pain medication because of the arthritis in his knee.
Repeated requests for more medication led his orthopedic doctor to refuse to continue to prescribe

narcotics because there was a surgical treatment that could correct the problem and eliminate the need for pain medicine.

Dr. J, internal medicine, had another story to share about prescription drug abuse.

A patient sent his wife to the doctor’s office with a request for more pain medicine, before the pills ran out. “We told her that he needs to wait until it’s time for his regular refills,” Dr. J. said.
People who abuse prescription drugs and become addicted, will say that they lost their medicine, or maybe it was stolen. They will avoid their appointments. They will ask for higher dosages. They’ll ask for more.

Prescription drug abuse occurs when prescription medication is taken that’s not prescribed for the patient, or it’s taken for reasons or in dosages other than those prescribed.
Statistics show that in 2009, 16 million Americans age 12 and older had taken a prescription pain reliever, tranquilizer, stimulant, or sedative for nonmedical purposes at least once in the year before being surveyed.

Also the National Institute on Drug Abuse (NIDA) funded the 2010 Monitoring the Future Study that showed 2.7 percent of eighth graders, 7.7 percent of tenth graders, and 8.0 percent of twelfth graders had abused the pain reliever Vicodin, and 2.1 percent of eighth graders, 4.6 percent of tenth graders, and 5.1 percent of twelfth graders had abused the pain reliever OxyContin for nonmedical purposes at least once in the year before being surveyed.

What some of us may not know, or want to acknowledge, is that abuse of prescription drugs can produce serious health effects, including addiction and death from overdose.
Commonly abused classes of prescription medications include opioids for pain, central-nervous-system depressants for anxiety and sleep disorders, and stimulants for ADHD (attention deficit/hyperactivity disorder) and narcolepsy (extreme daytime sleepiness).

One way physicians try to minimize prescription drug abuse is to require patients to sign a medication contract in which the patient agrees how the narcotics will be administered. This also includes obtaining monthly or random drug screenings within 24 hours when requested by the doctor’s office.

FROM ABUSE TO ADDICTION

The National Institute of Drug Abuse defines drug addiction as a chronic, relapsing brain disease characterized by compulsive drug seeking and use, despite harmful consequences. It’s considered a brain disease because drugs change the brain. They change its structure and how it works. These brain changes can be long lasting and can lead to harmful behaviors as seen in people who abuse drugs.

Interestingly enough, for most people the initial decision to take drugs is voluntary. However, the brain changes that occur over time challenge a person’s self-control and ability to resist intense impulses that urge them to take drugs.

We don’t want to leave out over-the-counter (OTC) medicines, as they too can be abused and can cause serious consequences if used incorrectly.

OTCs are the drugs that you can buy without a prescription at a grocery store, pharmacy, or convenience store. They are used to relieve headaches, toothaches, indigestion, itching, etc. The Food and Drug Administration has determined that these medications have medical benefits for common ailments and are safe for general consumption, if taken exactly as prescribed by the packaging.

As with any medicine, it’s important to take OTC drugs correctly.

While we’re tempted to think that more may be better, it isn’t necessarily so. You should never take OTC medicines longer, or in higher doses, than the label recommends. If symptoms don’t go away (as usually indicated on the OTC packaging), take the advice it offers and check with your doctor.

Overdoses can occur, even with OTC drugs. Every year approximately 200,000 Americans wind up in the hospital because they use OTC drugs incorrectly.
NSAIDs (non steroidal anti-inflammatory drugs), pain relievers such as Advil, Aleve, and Motrin, are the most misused drugs in America. Many times consumers use NSAIDs for longer than needed at too high a dosage that can thin the stomach lining and cause ulcers. Misuse can also cause rebound headaches and kidney problems, as well as an increased risk of heart attacks and stroke.

Too much of a drug can cause unwanted side effects and potentially dangerous drug interactions.

To be safe, Dr. Oz recommends remembering a simple acronym: OTC.

• Obey directions by reading drug labels.
• Talk to your pharmacist. It’s a free consultation with an expert.
• Choose the lowest dose first. For example, if the suggested dose is one or two pills, take one pill first to see how you feel before taking the full dose.