Prescription drug abuse is typically associated with celebrity overdoses, but the epidemic goes beyond Hollywood. According to the Office of National Drug Control Policy, prescription drugs are the second most abused category of drugs, behind marijuana. A new study found that hospitalizations for unintentional overdoses of prescription opioids, sedatives and tranquilizers increased 37 percent from 1999 to 2006. Hospitalizations from intentional overdoses skyrocketed by 130 percent. The three most commonly abused classes of prescription drugs are painkillers, depressants such as sedatives or tranquilizers, and stimulants.
Why the epidemic? Prescription drugs are generally viewed as “safer” than illegal substances such as heroin or cocaine. The availability of prescription drugs is also part of the problem. Doctors are writing more prescriptions than ever. Patients may hop from doctor to doctor, collecting prescriptions. Unethical physicians may be willing to write unnecessary prescriptions or even sell drugs directly to patients, as did a California doctor who was recently sentenced to four years in prison for peddling painkillers. (Prosecutors called him “a drug dealer in a lab coat.”) Similarly, online pharmacies don’t always require a prescription.
The concern surrounding prescription drug abuse is having a negative effect on patient care, Medical News Today reported in January. Many patients are now being under-treated due in part to physician worries about prescription drug abuse.
Devices such as the RxLocker and the PillSafety Device aim to prevent prescription drug abuse by physically restricting access to medications. In addition, some pharmaceutical companies offer prescription drugs that are formulated with a lower abuse potential. The FDA recently approved a less-addictive formulation of the popular painkiller OxyContin. Manufacturer Purdue Pharma designed the pill to be harder to crush, cut, chew or dissolve for a greater high. In August, we reported that the FDA approved the painkiller Embeda by King Pharmaceuticals. Embeda consists of a morphine capsule with a core of naltrexone, an opioid antagonist. If the patient takes the capsule as directed, the core passes through the body. If the patient crushes or chews the capsule, the core breaks open and the antagonist reverses the effects of the morphine.
The FDA also recently approved Somaxon’s Silenor, the only sleep aid on the market that is not deemed a controlled substance. Silenor acts to block histamine, one of seven neurotransmitters in the brain that promote wakefulness. No abuse or withdrawal effects were observed in a clinical trial.
Prescription drug abuse has reached crisis levels in America. Do pharmaceutical companies have a responsibility to reduce the addictive potential of their products, or do patients need to take responsibility for their own healthcare? How can healthcare organizations and health insurance providers help prevent prescription drug abuse?