Prescription Drug Abuse: Introduction | General Issues | Opioids (Analgesics) | Stimulants | Sedatives and Tranquilizers | Conclusion | Key Points | References | Suggested Reading
Pharmaceutical products have been abused throughout
the ages, and the current epidemic of prescription drug abuse in the
United States represents the newest wave of a long-standing problem
(Compton and Volkow 2006a). The extent of the problem
is staggering, with national surveys showing that in 2004, approximately
15 million Americans, age 12 years and older, used a psychotherapeutic
drug for a purpose other than medical use (Colliver et al. 2006). Past-year prevalence rates among twelfth grade students documented that prescription drugs were among the most abused
illicit substances: 9%–10% reported Vicodin
abuse, 4%–5% reported OxyContin abuse,
8%–9% reported amphetamine abuse, 6%–8% reported
sedative abuse, and 5%–7% reported Ritalin
abuse in each of the past several years (Johnston et al. 2007).
Thus, prescription drug abuse has reemerged recently as a major
and costly public health threat (Birnbaum et al. 2006).
Furthermore, prescription drug abuse presents unusual difficulties
for clinicians for two reasons: first, the medical system is the
origin of the substances in many cases; and second, the boundary
between therapeutic use, misuse, and addiction can be quite vague.
Overall, physicians are in a unique situation of having to prescribe
the optimal medication dosage to minimize the symptoms of the disease,
such as when treating pain with opioids, hyperactivity with stimulants,
or anxiety with sedatives. Simultaneously, physicians must monitor
their prescribing practices to reduce the risk of substance abuse