Over the years, I have met many people who had a severe prescription drug addiction or illicit drug addiction that began with prescription medication that affected their ability to function as human beings. Some of these people have died and others are in a basic survival mode, feeling unhealthy and depressed most of the time, physically dependent on drugs and unable to do anything constructive. Their futures look very dim unless they get the medical and psychological attention needed to get them through their addiction challenges. Prescription drug abuse is the overuse or intentional use of prescription drugs (painkillers in particular) for non-medical purposes. Common street drugs like heroin, cocaine, methamphetamine, crack and the like are fully criminalized and yet quite easy to obtain. So it goes for prescription drugs as well. The difference is that prescription drug users are in legal jeopardy only if they commit a crime where intoxication is a factor, like driving under the influence of drugs.
So the big threat to the prescription drug addict is primarily an issue of health, quality of life, loss of job productivity or loss of employment altogether, destruction of the family unit, eventual homelessness and other unfortunate outcomes. It is for the above reasons that I am pleased to see the California State Legislature attempting to address the issue by making it more difficult for abusers to "shop for doctors" to get multiple prescriptions to feed their addictions.
I realize that there will be some unintended consequences to the extent that people may turn to the streets and illegal drug dealers to meet their needs. Senate Bill 809, according to sources "will provide the funding needed to not only save, but strengthen and modernize, the Department of Justice's Controlled Substance Utilization Review and Evaluation System (CURES) program and the Prescription Drug Monitoring Program (PDMP) that exists within CURES. CURES allows authorized prescribers and pharmacists to quickly review controlled substance information and patient prescription history in an effort to identify and deter drug abuse and diversion."
According to the bill's authors, it is estimated that SB 809 will "save around $52 million in workers' compensation costs alone." Furthermore, "with an increased prescribing of narcotics there has been a parallel increase in deaths, now four times what it was in 1999. Prescription drug overdoses now cause more deaths than cocaine and heroin combined....In 2011, sales of painkillers in the United States reached $8.5 billion. Sales of the nation's two most popular prescription painkillers, oxycodone and hydrocodone, have skyrocketed over the last decade. In California, between 2000 and 2010, the per capita sales of oxycodone increased 372 percent and the per capita sales of hydrocodone increased 123 percent."
According to a report released by the U.S. Centers for Disease Control and Prevention (CDC) in November of 2011, the problem of prescription drug abuse has increased "four-fold," which, according to CDC Director Dr. Thomas Freidan, amounts to an "epidemic." Aside from the fact than many people die daily from prescription drug overdoses, and that scores of others end up requiring emergency medical treatment for drug misuse or abuse, there are many other adverse consequences to our society as a whole. People who use narcotic-based painkillers or mood altering drugs routinely drive vehicles or operate heavy equipment and machinery. The dangers they pose to themselves and others is very significant, and because prescription drugs generally do not reveal themselves as readily as alcohol, their presence in a person's system is more difficult to detect. Many abusers, when confronted about their apparent stupor or being "off," simply assert that they suffer from lack of sleep or that they do not feel well. Drug abuse has a huge financial impact on the individual, their loved ones, and it leads to lower productivity, job loss and worse. It is interesting that legitimately-manufactured prescriptions pain medications, stimulants, sedatives and psychotropic drugs are relatively easy to obtain, whether from legitimate physicians or through other means such as the Internet via foreign countries and even from within the United States. These same drugs are also readily available on the streets, or from people who have stockpiled them from their various physician visits. That these drugs kill and incapacitate is not subject to argument, and it is also known that prescription medication use does not carry the same stigma with it as using such substances as crack cocaine, methamphetamine or heroin. Oftentimes, patients prescribed medication to treat pain that are either synthetic opiates or opiate derivatives such as codeine, morphine, and dilaudid, become addicted to them. These drugs can be expensive and difficult to obtain so some people turn to heroin, a cheaper opiate narcotic that is easily accessible on the street.
Physicians have a significant role in helping to curtail the problem, although it is obvious that that they control only a portion of the prescription drugs that are used by members of the public. Nevertheless, we are seeing signs that the dispensation of prescription drugs by physicians is being done using a higher threshold and a greater reliance on other methods to help with pain control. Physicians are also doing more to educate their patients about the vagaries of prescription drug use and abuse. They are right to do so, and while these kinds of abuses are law violations, treating them as such appears to do little good. It is a health problem and the major emphasis for bringing the problem under control should fall on the medical community, parents and educators.
The government also has its role in terms of prescription drug regulations and as appropriate, to enforce criminal violations on the manufacturing and distribution side of the drug abuse milieu. New laws always have unintended consequences, but doing nothing about the problem of prescription drug abuse is not an acceptable course of action. There is too much suffering by not just those who are addicted, but by their families and friends who have to deal with the behaviors and sorrows that accompany these situations. Making improvements with this problem will reduce the human suffering and the economic losses associated with prescription drug abuse. And if these drugs become harder to get, there may well be fewer people who begin the abuse cycle in the first place.