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PRESCRIPTION DRUG ABUSE The recent tragic death of a central Wisconsin 14-year-old boy, due to prescription medicine and alcohol abuse, brought to the fore a harsh reality – small communities are not immune to such events. A growing national concern. In fact, prescription drug abuse has become a national problem. An estimated 20 percent of our population, aged 12 and older, have abused prescription medications for non-medical reasons. In 2004, a national study evaluated prescription drug abuse by eighth, tenth and twelfth graders. The results revealed that by the twelfth grade, 10 percent of the population had abused Vicodin –a painkiller composed of hydrocodone and acetaminophen - and 5 percent had abused Oxycontin, an opiate commonly used to treat the pain of cancer patients. Both of these medications are controlled narcotic substances that are very potent and highly addictive. Other medications that are frequently abused include the benzodiazepines such as Valium, Ativan, or Xanax. Effects of drug abuse. The aforementioned medications alter brain chemistries, can lead to addiction, and depress the body’s functions. When used therapeutically to treat medical conditions and in accordance with professionally recommended dosage, side effects are limited. However, when the narcotic medications are used in excess, a variety of complications may occur, including respiratory depression – in which the body does not receive enough oxygen - and an irregular heart beat (heart arrhythmias). In addition, a person may become nauseated and vomit. This is especially a problem when the person is unconscious and unable to protect their airway because the person can choke. Witnessing abuse first-hand. During the past 20 years working in the Emergency Department, I have seen a significant increase in people seeking narcotic prescriptions under false pretenses. These individuals report a variety of false pain conditions and will even specifically ask for Vicodin or Oxycontin. Many times, they have been to a dozen Emergency Departments during the same day throughout the state. People such as this are dangerous not only to themselves, but to those to whom they may potentially sell the medications. As an Emergency Physician, I must be astute to their complaints, but I have no obligation to provide a prescription to address their alleged concerns. It is my obligation to protect the patient and the public from narcotic and other prescription drug abuse. I must be prudent in my prescribing practice and be certain to maintain thorough follow up examinations and documentation of patients to monitor the pain, as well as the drugs prescribed. As a parent, vigilant control of prescription medications within the household is essential as well. Keep all medications in a locked cabinet and monitor the stock. It is best to dispose of unused medications. Most communities have disposal programs in place through a variety of service organizations that ensure the drugs are properly handled. Parents must also talk to their children about drug abuse. The discussion should include the immediate dangers as well as the long-term consequences. We can also take part in national campaigns – such as Red Ribbon Week held annually during the last week in October – that unite communities and present a visible stand against drugs. All of us –physicians, pharmacists, parents, teachers, community members – must assume responsibility and protect our youth from the non-medical abuse of prescription pain medications by educating, talking, and listening to them. |
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