Despite years of research and advocacy, prescription drug abuse remains an epidemic in the United States. Every single day, 44 people die from prescription drug overdoses, and drug-related poisonings are now the leading cause of death due to unintentional injuries. The National Survey on Drug Use and Health reports that 15 million people over the age of 12 have abused prescription drugs in the past year, and 6.5 million people did so just in the last month.
Keep in mind, these drug statistics are specific to prescription drugs ONLY. These stats don’t even consider alcohol or illegal drugs. When you consider that these numbers are for drugs that people are obtaining legally, from a doctor, they are even more staggering!
Americans are facing down a significant problem when it comes to the misuse of prescription drugs – and unfortunately, it’s not a problem with an easy way out. 37% of Americans believe that we are actually losing ground on the problems associated with drug abuse.
To bring some clarity to the abuse and misuse of prescription drugs, it is important to consider three key questions:
- What counts as prescription drug abuse?
- What is the scope of the problem?
- Where do we focus our solutions?
Here we explore the answers to these very important questions and leave the floor open to you to add your thoughts in the comments as well.
What Counts As Prescription Drug Abuse?
50% of all Americans have used at least one prescription drug in the last 30 days. Prescriptions are pervasive, and the majority of drugs available to us do what they’re prescribed to do and are not addictive. As such, before we outline the scope of the problem and its potential pathways, we must clarify exactly what types of drugs we’re talking about.
At the federal level, the Centers for Disease Control and Prevention (CDC) and the Department of Health and Human Services (DHHS) are among the agencies that track and monitor drug use in the United States. Their most recent research puts the focus on two major classifications of drugs – opioids and stimulants. The following table outlines the major labels and uses associated with these drugs:
Table 1: Primary Drugs Associated With Prescription Drug Abuse
To understand what makes prescription drug abuse and misuse an epidemic, it is important to specify the types of drugs that make up the problem. We are talking about a very specific set of drugs that have specific functions and side effects that make them desirable for non-medical uses. That kind of understanding is key to outlining the scope of the problem.
What Is The Scope Of The Problem?
In 2011, the CDC and DHHS painted a pretty grim picture about prescription drug abuse rates in the United States. Using data from the 2010 census in combination with other tracking and monitoring data from their respective departments, these federal agencies noted a significant surge in the number of cases of prescription drug abuse and overdose between 1999 and 2011. The scope of the problem involves two primary points – exactly where we are seeing increases, as well as the causes associated with our current numbers.
When it comes to the most current data on prescription drug abuse and overdose, there is both good news and bad news. The good news is, the general rates of prescription drug abuse have stayed relatively flat since 2010, meaning we have not seen an increase in the percentage of people either abusing or overdosing on prescription medications. If we dig down deeper into that data, however, we do see some areas that raise concern.
Historically, the greatest concern has focused on opioid abuse – the painkiller category from Table 1, which includes oxycodone and morphine. Opioids are highly addictive and can sometimes lead to dependence on illegal narcotics, namely heroin. Research from 1999-2010 saw the most alarming increases in this particular class of drugs; however, those increases have slowed in the last five years. More recent data points our attention in a different direction – stimulant use among high school and college students. While the numbers for prescription painkillers have remained fairly flat, the numbers for stimulants have continued to increase, especially in the form of AD/HD drugs used for non-medical purposes.
While the numbers for both opioid and stimulant use are both cause for concern, the increases in the abuse of stimulants among high school and college students force us to realize that this issue is very complex. As such, the causes of the prescription drug epidemic are best considered across different age groups.
For the general population, as well as adults 26-65, we find some common culprits for prescription drug abuse and misuse. Many studies tie the continued prevalence of abuse to both mental health issues, as well as increased access to highly addictive prescription drugs. Part of the prescription drug epidemic can be attributed simply to the growing number and availability of drugs from a variety of sources. Between 1999 and 2009, the number of prescriptions increased 39% (from 2.8 billion to 3.9 billion). Compare that to a 9% increase in the U.S. population, and we see that the number of available drugs is growing at a faster rate than the number of consumers.
From that consumer perspective, abuse is closely linked to mental health concerns, including depression, anxiety, or to manage pain and sleep problems. Americans are facing a growing amount of stress and anxiety, particularly in the wake of economic recession and recovery starting in 2008. A shrinking middle class, mounting stress on old infrastructure, and persisting financial uncertainties have placed many Americans in need of support. With those increased needs for support often comes an increased dependence on prescriptions to manage the anxiety.
When we look at two different age groups, young people and the elderly, we see a slightly different picture in terms of causes. For younger populations, the dependence on prescription drugs is also related to stress and anxiety; however, the source of that stress is associated more with the pressure to succeed. Many high school and college students experience great pressure from their family members to succeed. Students are expected to participate in athletics and extra-curricular activities, internships, volunteer work, and other activities, all while maintaining a top grade point average.
For middle class and wealthier families, that pressure comes from a need to communicate a certain social standing or “good parenting.” For working class and poor families, that pressure for success is often tied to more material needs, including generating money for the family and lifting them out of poverty. Schools have seen a dramatic increase in the number of students who are using or trading drugs like Adderall® and Ritalin® in order to stay up late studying, maintain a social life, and often work their way through school.
Elderly populations face a different set of challenges. Nine million Medicare-age people receive opioids every year. Many elderly face problems with prescription drug misuse as opposed to abuse. Due largely to the realities of aging, older populations can experience difficulties in reading and understanding prescriptions, remembering to take their medication, or taking the wrong dosage. At the same time, they also face some of the same mental health concerns as the general population.
These specific needs of both the elderly and younger generations point to the complexities of prescription drug abuse and misuse. As such, we must focus our solutions on both evidence-based and innovative ideas.
Where Do We Focus Our Solutions?
Federal agencies like the CDC and DHHS have spent a great deal of effort researching and developing solutions to the prescription drug epidemic. The CDC has advocated for solutions including safer and more effective pain management, improved state policies that address prescription drugs and mental health initiatives, and the development of prescription drug monitoring programs. These institutional solutions have helped create infrastructure that reduce abuse through better tracking and monitoring. At the same time, these solutions have sometimes been criticized because they rely primarily on infringing upon consumer privacy in order to control behaviors and choices.
In addition to institutional solutions, we also need to focus on some individually-oriented solutions. Much federal research focuses on the causes of prescription drug abuse; however, the public does not always think about these causes alongside the reasons people are experiencing the anxiety or stress in the first place. Future research needs to examine the intersections between the sources of stress and anxiety in conjunction with the likelihood to abuse prescription drugs. Moreover, these individual-level experiences do not exist in a vacuum. The only way for us to truly grasp the solutions to our prescription drug crisis is to also examine how economic downturns, natural disasters, job loss, and other events in our cultural history drive some people to use and abuse illicit drugs.
The U.S. Healthcare System relies on the balance of two approaches to health – prevention and treatment. Whenever possible, we focus on prevention. We try to eat better, drink more water, take our vitamins, exercise regularly, sleep for 8 hours, and visit our doctors. At the same time, the majority of our health needs require more than making sure we eat our vegetables. That’s where treatment comes in. In most cases, treatment is a fairly seamless process. We take a medication and we get better.
However, that is not always the case, and seemingly simple pain or AD/HD treatments can spin out of control. We now have more access to prescription drugs than ever before, and with that access comes a great responsibility to how these drugs are used and shared.
What’s Next In Overcoming This Epidemic?
Here at Summit Behavioral Health we are committed to making a difference. While our treatment services are intended to help individuals overcome all types of chemical and substance addictions, we can see that often times addiction starts with prescription abuse. We know that in order to help individuals and families in our community avoid and overcome addiction they must first understand the dangers in taking prescription drugs. Proper education is the first step in this fight, but we must take that step together if we are going to see some real change.
Please take a moment to share this post with anyone you feel can act as a voice to help raise awareness for this epidemic that affects us all.