Is Over-Prescribing to Blame for Prescription Drug Abuse?

Is Over-Prescribing to Blame for Prescription Drug Abuse?

One in five Americans report misusing a prescription drug at least once in their lifetime. The abuse of prescription drugs such as Xanax and OxyContin is arguably the most serious drug-related problems in the country today. The issue is made much more complex because painkillers and anti-anxiety medicines obviously have legitimate uses, and doctors can’t stop prescribing them altogether. Many people have argued that the reason more and more people are becoming addicted to prescription drugs is because doctors are too ready to dish out pills. If this is true, harsher prescribing practices might be the only way to rectify the issue, but the problem isn’t as simple as it might seem at first glance.

Which Prescription Drugs Have the Potential for Abuse?

There are numerous prescription drugs that can be abused, but generally speaking there are two major groups of commonly abused ones. The first group is sedative medications, generally benzodiazepines such as Valium and Xanax. These are prescribed to help people overcome anxiety issues, but they have the potential for abuse and can be dangerous during detoxification. The other main group is opiate painkillers such as OxyContin and Vicodin. These drugs are prescribed for moderate to severe pain, and essentially have the same effects as heroin. As would be expected, withdrawal from these drugs is extremely uncomfortable and overdose is an unfortunate possibility. It’s important to note that both of these types of drug have valid, legitimate uses.

Are More People Using Prescription Painkillers?

The first step to determining whether doctors are prescribing these medications too freely is looking at the numbers of people taking them. A study conducted throughout 2011 on America’s workforce revealed that from 2007 to 2011, positivity rates increased by 25 percent, and increased 10 percent from 2010 to 2011 alone. The same study showed an increase in opiate use altogether of 20 percent from 2007 to 2011. Benzodiazepine positivity rates have stayed relatively stable, aside from a brief increase in 2009. However, non-negative results for benzodiazepines (ones which are indefinite or hard to determine) increased by 21 percent over the five-year period studied.

Do Doctors Prescribe too Much?

It’s not particularly easy to determine whether doctors prescribe a certain type of drug “too much.” After all, if somebody is in chronic pain, for example, it would virtually be a breach of the Hippocratic oath to deny them effective medication. However, numerous individuals do raise concerns about over-prescribing. It’s been argued that doctors are becoming less restrictive in their prescriptions of opiate painkillers, and that this leads more people to become addicted. Dr. Nick Carr, a general practitioner from Australia, believes that this is the case, and consequently never prescribes addictive anti-anxiety or painkiller medications to new patients. The drugs have also increased in availability, so this could lead to more people taking them, rather than lax medical practice.

This year, 35 physicians petitioned the FDA to change the prescribing guidelines on narcotic painkillers to address the perceived issue. As things currently stand, opiate painkillers like OxyContin and Vicodin are prescribed for “moderate to severe” pain, meaning that many patients are given repeat prescriptions for them. The petition called for the guidelines to be changed so that the drugs were only available for severe pain, thus reducing the number of individuals who are given potentially addictive drugs.

Addiction isn’t Just About Availability

Whilst it is true that if doctors are prescribing potentially addictive medicines too readily then they will increase the number of people who develop addictions, there is obviously more to the issue than that. Not everybody who takes an addictive drug will develop an addiction, and whether it’s because of a genetic pre-disposition, a brain disease or learned behaviors, there is no way that doctors are solely causing the issue by prescribing medicines. It isn’t good that people are granted access to potentially life-destroying substances, but if the pain is sufficiently intense, there is no other option. It isn’t ideal, but it is surely better than debilitating pain or crippling anxiety.

Anybody over the age of 21 can go out without a prescription and buy addictive and harmful substances like alcohol or tobacco, and those who are pre-disposed to addiction in whatever way have several ways to develop a problem. Unfortunately, even if doctors were extremely careful about whom they prescribe addictive medicines to (for example, if in the future susceptibility could be predicted with genetic screening), some people would still fall prey to addiction. There isn’t much that can be done to stop it, so outright denying people medication they can benefit from is unnecessary.

Although changing the guidelines for medicines like OxyContin may help to reduce the rates of addiction, doctors would still be free to prescribe the drug however they choose. The guidelines are just that, so “off-label” prescriptions by medical professionals are absolutely allowed. The only small benefit it would have is stopping the pharmaceutical company from marketing them for moderate pain, but realistically the problem isn’t going to disappear. Addiction, as most people accept, is a serious problem that some people are more likely to develop than others, and needs intensive treatment to overcome. Some patients will always need addictive prescription medications, so there is little that can be done about it aside from educating patients about the risks.

Sources: http://www.bloomberg.com/news/2012-06-25/prescription-painkiller-abuse-surged-in-u-s-study-finds.html
http://www.drugfreeworld.org/drugfacts/painkillers/international-statistics.html
http://www.webmd.com/pain-management/features/prescription-drug-abuse-who-gets-addicted-and-why
http://www.sbs.com.au/insight/episode/overview/488/Accidental-Addicts
http://www.nytimes.com/2012/07/26/business/doctors-petition-fda-for-painkiller-limits.html?_r=0 http://www.questdiagnostics.com/home/physicians/health-trends/drug-testing

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