| PRESCRIPTION DRUG ABUSE |
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| The Nation's Most Rapidly Growing Drug Problem
Prescription drugs help millions of people live healthier, longer and more productive lives. While most prescription medicines are of no interest to drug abusers, those referred to as "controlled substances" can be used in ways not intended by the prescribing physicians. Abusing them can be dangerous and even lethal.
The most commonly abused classes of controlled substances are:
Prescription drugs account for the second-most commonly abused category of drugs, behind marijuana but ahead of cocaine, heroin, methamphetamine and other individual illegal drugs.
In 2008, over 6 million persons or 2.5% of the U.S. population, ages 12 and older currently used psychotherapeutic drugs for non-medical purposes (NSDUH, 2008). In addition, of the estimated 2.9 million persons who used an illicit drug for the first time in 2008, 29.6% initiated illegal drug use by using psychotherapeutics. As the table below shows, the highest rate of abuse of psychotherapeutics occurred among young adults ages18 to 25, with nearly one third (29.2%) reporting lifetime use.
In 2004, 2.4 million persons ages 12 or older initiated non-medical use of prescription pain relievers during the past year, surpassing for the first time since the National Survey on Drug Use and Health began, those who initiated abuse of marijuana (2.1 million). In 2008, the same number of individuals initiated use of pain relievers (2.2 million) as use of marijuana. The non-medical use of prescription drugs is a problem that cannot be ignored. In the United States, there are more unintentional overdose drug deaths due to prescription drugs than those for heroin or cocaine (CDC, 2008). However, non-medical use of prescription drugs is not only a problem in the United States. The United Nations International Narcotics Control Board confirms that world-wide more people abuse legal narcotics than cocaine, heroin and ecstasy combined (INCD, 2010). IBH Initiatives Through its Independent Advisory Committee on Prescription Stimulant Abuse, from 2004 to 2010 IBH focused on the nonmedical use of stimulants, the class of prescription drugs that include such widely used medicines as Ritalin, Adderall, Concerta and others.
IBH encourages better education for the general public, patients and physicians about the prescription and use of medicines that are subject to illegal abuse. Patients need to understand that such medications are to be used only for the problems for which they are prescribed and only in the prescribed doses and routes of administration. Further, patients receiving prescription controlled substances are responsible to see that no one else uses their medicines. Use by anyone other than the person for whom they were prescribed is illegal and potentially dangerous to the point of being not only addictive but life-threatening. | ||||||||||||||||||||||||||||||
A topic that IBH has been investigating is the development of unique abuse-resistant delivery systems as a promising new strategy to reduce prescription drug abuse while protecting legitimate medical use of controlled substances. The most effective of these new formulations modulate the rate at which brain rewarding substances enter the body. Ensuring the relatively steady release of medicine into the bloodstream instead of the rapid surge preferred by abusers, achieves treatment goals while foiling attempts at getting high. Several medicines containing controlled substances are now available in abuse-resistant formulations and many new abuse-resistant strategies are being studied. The early experiences provide encouraging evidence that this strategy is gaining momentum although many earlier efforts to produce abuse-resistant formulations were thwarted by the ingenuity of drug abusers who found ways to overcome the protections. For this reason careful post-marketing monitoring of abuse is essential to protect the public health.
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