Cedarville Magazine, Fall 2013

18 | Cedarville Magazine number of deaths from prescription drug abuse each year is more than the number of deaths from heroin and cocaine combined. The accessibility of prescription drugs is a major contributor to the epidemic. More than 50 percent, perhaps as high as 70 percent, of abused drugs come from family and friends, either offered or stolen. Although the highest rates of death have been in the 45–54-year-old category, this problem reaches all age groups, including teenagers. Perhaps you have heard about a new style of party that is popular with teens — called “skittling” or “pharma,” among other names —where participants simply bring whatever pills they can find, add them to a bowl, and consume a handful of the colorful drugs. It doesn’t take long to understand these parties are dangerous. Easy Availability The epidemic had noble beginnings. Throughout recent decades, pain management — especially among individuals experiencing some sort of chronic pain syndrome —was suboptimal at best. Physicians shied away from aggressive therapy for fear of overdosing a patient and being sued. In the mid-1990s, a variety of good things occurred that set change in motion. State governments addressed physicians’ concerns regarding the link between aggressive pain management, unintended outcomes, and malpractice litigation. Changes in malpractice laws were accompanied by improved pain management education for health care professionals during and following their medical training. Pharmaceutical manufacturing companies studied and produced improved (more effective and, supposedly, less addictive) pain medications. At the same time, public awareness was growing about the physical and emotional benefits of controlling chronic pain, easing patient concerns regarding the risk of addiction in favor of good pain control. But, it didn’t take long for the pendulum to swing the other direction. Pain is certainly more effectively treated now, and for that we can be truly grateful; however, as the medical community and patients became more comfortable with treating (and, being treated for) pain, the number of pain medicines being stored in home medicine cabinets grew to an all-time high, introducing a whole new problem. Today, addiction to prescription medications, primarily due to misuse and abuse (not legitimate treatment managed by a health care provider) is at a greater level than ever before. And, so are the tragic outcomes of that misuse and abuse, namely, accidental deaths. Supply and Demand The increased demand for prescription medications on the street — sustaining and creating new addicts — has resulted in the proliferation of illegitimate pain management clinics. The scourge of so- called “pill mills” (providing phony care and prescribing and/or providing narcotics — usually as a low-overhead, cash-only business) has magnified the problem in many U.S. cities. Further complicating the situation, treatment options for addiction are incredibly limited. Current medical treatment includes the prescription medications methadone (distributed only by a limited number of specialized clinics) and buprenorphine (Suboxone). Much study is presently underway in an effort to identify newer, more effective options; however, we are likely months to years away from such products being tested and marketed for public use. In response to the epidemic, state and federal governments have aggressively pursued legislation aimed at curbing access to medications, including shutting down “pill mills.” In addition, prevention efforts have been aimed at educating the public about the problem, including reducing the most common mode of medication access: the home medicine cabinet. These initiatives have achieved some success; the most recent annual report from the White House Office of National Drug Control Policy notes the number of people abusing prescription drugs decreased by nearly 13 percent between 2010 and 2011 (the most recent years for which data is available), although there is clearly more that we all can do to protect our families and communities. Safety Precautions Awareness of the problem is key to curbing it. Even if you haven’t already been affected by this epidemic, you are now aware. Tell others. Contact your local pharmacist, health department, or hospital to request additional education for your church, school, or community group. If you happen to live near a university with a pharmacy or medical school, contact them for the same. Be aware of the types ofmedications that are most commonly abused. Frequently abused medications include prescription pain killers (e.g., OxyContin, Vicodin, oxycodone, hydrocodone), sedatives or tranquilizers (e.g., Valium, Xanax, diazepam, alprazolam), and stimulants (e.g., Adderall, amphetamines, Cercerta, methylphenidate, Ritalin). Recognize your own unwitting contribution. As noted above, as much as 70 percent of all abused prescription drugs are coming from our medicine cabinets. Keep your medications out of the reach of others (even other adults), using locks if necessary. Discard any unused medications. The U.S. Drug Enforcement Agency (DEA) has sponsored Drug Take Back Days for the past couple of years. In cooperation with local and state law enforcement, public health organizations and other institutions, events have been staged to receive any and all unneeded medications from the public. More than 1,000 tons have been collected to date. The medications are securely received and then incinerated. Some communities have secure drop-off boxes located at police stations, and states