Isprescription Medication Abuse Increasing in America?
Isprescription medication Abuse Increasing in America?
Theprescription medication misuse is a critical global challenge withdire consequences on one’s health, social, and economic position.At the global domain, approximately 26.4 to 36 million individualsare involved in the misuse of prescription drugs such as the opioidpain relievers (Kirschner, Ginsburg & Sulmasy, 2014). Thereckoning by the “Centers for Disease Control and Prevention-CDC”in 2012 depicted that roughly 2.1 million citizens suffered from drugmisuse ailments associated with opioid pain reliever prescription inthe year 2012, the same period when only 467,000 individual becameaddicted to heroin in the United States-U.S. The outcomes of theabuse have been upsetting, as well as on the rise in the U.S.Therefore, the research paper examines the issue of prescription drugabuse in the U.S. to ascertain if the problem has been on the rise.
TheU.S. faces a situation of an unparalleled prescription medicationmisuse and overdose epidemic. Deaths related to drug overdose havebeen on the rise since the year 1980. As at the year 2009, the numberof those who lost their lives as a result of drug overdose surpassedmotor vehicle crash deaths in the U.S. for the first time.Prescription drugs, particularly opioid pain relievers, have beenassociated with deaths due to the overdose of the drug, which isoccurring with increasing prevalence (Kirschner et al., 2014).Specifically, CDC (2012) estimated that about 30 percent of deathsresulting from drug overdose involved opioids in the year 1999, aproportion than is less than the 2010 death toll of 60%. Put anotherway, deaths related to overdose or misuse of opioids currentlysurpass those of prohibited drugs like cocaine and heroin puttogether. Apart from the overdose deaths, there has been anincreasing frequency of emergency visitation of health carefacilities, admission of patients for treatment, and economic costsas a result of prescription drug abuse. The results of abusing suchdrugs are severe the victims suffer from the central nervous systemdisorders, addiction, and even death under severe conditions.Unfortunately, the research by Dart et al. (2015) determinedadolescents to face the greatest danger of prescription drug misuse,with the number of teens and youths aged between 12 and 25 abusingthe drugs rising from 400,000 during the 1980s to about 2 million by2000. The future progress of the nation relies on this age group,thus, the necessity to save the teens and youths from the consequenceof drug overdose and abuse. Therefore, the issue of prescriptionmedication abuse is an important research area that experts shouldexploit to appreciate the rising trends of the challenge, itsconsequences, and the necessary interventions to deter the problem.
Thestudy uses the literature review approach as a secondary researchtool to determine the trend of prescription medication abuse in theU.S. and draw a conclusion if the problem is on the rise. A total offive studies were reviewed to generate the report. The key words usedto identify the electronic sources were prescription drugs, drugabuse, and addiction. A total of eight sources were identified, andthree eliminated because they were not published within five years.According to Fink (2013), literature review is an important tool forobtaining secondary data from a wide array of sources, including theinternet and physical libraries. The method helps in assessing thefindings of other researchers and coming up with up-to-dateconclusions about the topic of study.
Typesof Prescription Drugs Abused
Thereare three groups of the most frequently misused prescriptionmedications. These are stimulants, depressants, and opioid painrelievers. Under normal medication procedures, opioids areadministered to alleviate chronic or short-lived pains from aprevious or contemporary medical process or sickness. Opioids are themost abused among teenagers and youths who settle for its utilizationnonmedically. Among the most misused opioids are Vicodin, Demerol,OxyContin, and Morphine. People opt for the nonmedical use of thesepainkillers because of the feeling of pleasure that follows onceconsumed as the drugs can arouse the pleasure circuits of the brain.Opioids are common drugs of abuse in the streets and learninginstitutions (Dart et al., 2015).
Thenext group of prescription drugs people abuse is the central nervoussystem-CNS stimulants. Just like cocaine, these drugs, if usednonmedically, culminate in a rush of euphoria or pleasure related tothe release of dopamine in the CNS. Examples of prescription drugsunder this category are Ritalin, Concerta, Adderall, and Dexedrine.Ritalin is the most misused of the stimulants among the youths andadolescents, and is highly available in the market. If it is takenutilized systematically, the resulting mortality incidences arehigher than those reported in cocaine users (Paulozzi, 2012). Thefinal class of prescription drugs, the CNS depressants, oftenadministered to remedy panic attacks, anxiety, and disorders relatedto sleep, are also in the list of misused medications. Examples areXanax and Valium. These depressants are very addictive if misusedcontinually, with the abusers always indicated to consume alcohol andother drugs besides the prescription depressants (Kirschner et al.,2014). According to CDC (2012), each day, about 100 million U.S.nationals make use of stimulants, tranquilizers, painkillers, orstimulants. There is a serious concern as such abusers, especiallythose who use alcohol, mix it with depressants, and the outcome issevere when overdosed.
PrescriptionDrug Abuse Epidemiology
Dartet al. (2015), in their study, found out that the death ratesresulting from prescription medication overdose have risen five-foldcompared to the situation as it was in the year 1980. This strikingrise in death incidences branded poisoning deaths, whereby about 90percent are prescription drug overdoses, the number one cause ofinjury loss of life in the U.S. by 2008. By the year 2008, deathsfrom the misuse of prescription medication in the U.S. surpassedthose caused by motor vehicle crashes for the initial time in thehistory of the region (figure 1) a trend that Dart et al. (2015)pointed out to have persisted through 2009 and 2010.
Figure1: Death trend due to prescription medication overdose compared totraffic crash deaths (CDC,2012).
Kirschneret al. (2014) verified that in the year 2008, more than 41,000 peopledied due to poisoning associated with drug overdose, a period whenabout 38,000 deaths resulted from motor vehicle crushes. 89 percentof all the poisoning deaths was due to the overdose of prescriptionmedication. Over the last thirty years, the rate of poisoning deathsfor every 100,000 citizens triple-folded to 13.5 in 2008 from 4.8 in1980. Specifically, the proportion of poisoning deaths due toprescription drugs catapulted to 89 percent from 56 percent between1980 and 2008 (CDC, 2012). The year 2008 reported 77 percentunintentional drug poisoning deaths, 13 percent suicidal, and 9percent of undetermined intention.
Throughthe last ten years, prescription medication, particularly the opioidanalgesics, were the major cause of overdose deaths. Used alone, oras a constituent mixture in alcohol and other drugs, Dart et al.(2015) concluded that opioids contributed to 30 percent drug overdosedeaths in the year 1999 in instances where a drug was specified, incomparison to the 60 percent cases in 2010 (figure 2). For instance,a total of 16,651 individuals lost their lives in 2010 as a result ofopioid analgesics misuse, a figure that outnumbered deaths from theuse of illegal drugs such as cocaine and marijuana. Apart from opioidanalgesics, Kirschner et al. (2014) argued that such prescriptionmedication as benzodiazepines and antidepressants also caused 6,497and 3,889 deaths (in 2010) respectively, and were often used incombination with opioids.
Figure2: Opioid and other drugs in poisoning deaths, 1999 to 2008 (CDC,2012).
McHugh,Nielsen & Weiss (2015) found out that morbidity due toprescription medication misuse has also shown a rising trend over theyears. Incidences of visitations to the emergency department-EDrelated with the abuse of the drugs rose by 114 percent between theyear 2004 and 2011. Mainly, in 2011, no less than 1.4 million visitsto the ED were associated with the abuse of prescription drugs, anumber in which opioid abuse cases constituted 420,000 casualtieswhile benzodiazepine visits amounted to 425,000 cases. In about 18percent of the pharmaceutical abuse ED visits, there was aninvolvement of alcohol. The rates of substance misuse treatmentadmissions due to opioid analgesics abuse rose six times between theyear 1999 and 2010 (CDC, 2012).
Causalto the mortality and morbidity is a large population of individualsreporting nonmedical utilization of prescription drugs peopleconsume the medicines without prescription for such reasons aspleasure and sleep induction. The review by Paulozzi (2012)determined that in the year 2011, about 14 million U.S. nationalswere involved in the non-prescribed use of pharmaceuticals, with atleast 11 million citizens involved in opioid abuse. Sad to note,Kirschner et al. (2014) identified that chronic nonmedicalutilization of opioids rose by 75 percent between the periods2002/2003 and 2009/2010. The increase can be inferred to mean thataveragely 1 million individuals reported nonmedical opioid use duringthe 2009/2010 period. The frequency of chronic opioid abuse is higher(twice) in men than women. However, the incidences of ED visitationsdue to abuse compare across gender, but with more men succumbing todrug poisoning than women. In the year 2010, for instance, menrepresented a higher proportion of opioid-associated substance misusetreatment admissions, accounting for a percentage of 54 compared to46 for women (Dart et al., 2015).
Regardingage, McHugh et al. (2015) ascertained that prescription drug overdoserate is highest among adolescents and youths aged 18 to 25, followedby those aged 26 to 34, and 35 to 49 years of age. Those aged 21 to29 reports the highest ED rates, followed by age group 30 to 44 and45 to 54. Concerning admissions related to substance abuse foropioids, those aged 25 to 34 lead, followed by age group 18 to 24 and35 to 44 (McHugh et al., 2015). For opioids, overdose death rates(figure 3) are worst for ages 45 to 54, trailed by those aging 33 to44, 25 to 34 years, 55 to 64 years of age, 15 to 24, and over 65years of age such drug poisoning deaths due have shown a risingtrend since 1999 (CDC, 2012).
Figure3: Drug poisoning death rates with age, 1999 to 2008 (CDC, 2012).
Theprescription medication misuse and overdose death incidences differacross the ethnic and racial groups in the U.S. It is suggested thatNative Americans and Caucasians exhibit the uppermost prevalence ofnonmedical utilization of prescription medications, as well as thehighest death incidences. Whites also report high frequency EDvisitations and admissions related to opioid analgesics (McHugh etal., 2015).
PrescriptionDrug Abuse Drivers
Severalfactors have been attributed to the increasing trends of prescriptionmedication abuse in the U.S. First, there has been the need toincrease prescription of pain relievers to alleviate the growingincidences of cancer pains. That has resulted in an increase inopioid sales by four-folds between 1999 and 2000, a trend that wentside by side with worsening cases of overdose and misuse deaths(Kirschner et al., 2014). Second, the general administration ofprescription drugs by primary care experts and internists continuallycause overdoses and abuse due to the lack of knowledge by theprescribers. Third, there have been a growing number of “pillmills” or unethical pain clinics involved in the prescription ofopioids and other pharmaceuticals. Paulozzi (2012) argued that theaim of such clinics is to generate more revenue hence, they oftenprescribed larger doses than required, causing drug poisoning deaths.Forth, patients who are prescribed to particular drugs, for instance,pain relievers, often share the medicines for free with relatives atthe time of need, resulting in the abuse of the medications (Dart etal., 2015). The study by McHugh et al. (2015) determined that aboutroughly 70 percent of those who previously used prescription drugsobtained them from relatives and friends. Finally, policies in placedo not cover the use of prescription drugs, and have failed toreimburse for screening and risk alleviation actions, therebyfacilitating abuse and overdose (Kirschner et al., 2014).
Fromthe review, it is evident that prescription medication abuse is onthe rise in the U.S., and affects all ages, gender, ethnic and racialgroups. Amidst the growing cases of cancer, pill mills, sharing ordrugs among friends and relatives, drug administration by those wholack adequate knowledge and experience, and inadequate policies, moreprescription drugs get to the public, and what follows is medicationmisuse and overdose, resulting in death and other mental challenges.Arguably, prescription drug misuse keeps on exerting a considerablehealth cost due to the increasing rates of drug poisoning deaths andsubstance disorder treatment. The paper recommends the need forprescriber training and the monitoring of prescription and policyshifts, for example, drug buy-backs, to prevent unintended release ofprescription medication to the public. Otherwise, the growing trendof prescription drugs, which has been increasing since 1980, isprojected to continue in the future.
Centersfor Disease Control and Prevention, CDC. (2012). CDC grand rounds:prescription drug overdoses-a US epidemic. MMWR.Morbidity and mortality weekly report, 61(1),10.
Dart,R. C., Surratt, H. L., Cicero, T. J., Parrino, M. W., Severtson, S.G., Bucher-Bartelson, B., & Green, J. L. (2015). Trends in opioidanalgesic abuse and mortality in the United States. NEngl J Med, 2015(372),241-248.
Fink,A. (2013). Conductingresearch literature reviews: From the Internet to paper.Washington, D.C.: Sage Publications.
Kirschner,N., Ginsburg, J., & Sulmasy, L. S. (2014). Prescription drugabuse: executive summary of a policy position paper from the AmericanCollege of Physicians. Annalsof internal medicine, 160(3),198-200.
McHugh,R. K., Nielsen, S., & Weiss, R. D. (2015). Prescription drugabuse: from epidemiology to public policy. Journalof substance abuse treatment, 48(1),1-7.
Paulozzi,L. J. (2012). Prescription drug overdoses: a review. Journalof safety research, 43(4),283-289.