| PRESCRIPTION DRUG ABUSE |
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| A Rapidly Growing Epidemic 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. Nonmedical use is dangerous and can be fatal.
The most commonly abused classes of controlled substances are:
Prescription drugs account for the second-most commonly abused category of drugs, behind only marijuana but ahead of cocaine, heroin, methamphetamine and other individual illegal drugs.
An estimated 7 million persons or 2.8% of the U.S. population aged 12 and older used prescription-type psychotherapeutic drugs for non-medical purposes in the past month. Of the estimated 3.1 million persons who used an illicit drug for the first time in the past year, 28.6% used prescription drugs.I As the table below shows, the highest rate of prescription drug abuse occurred among young adults ages18 to 25, with nearly one third (29.2%) reporting lifetime use.
In 2004 the number of people aged 12 and older who initiated nonmedical prescription drug use surpassed the number who began marijuana use. Since that time, prescription drug initiates have been higher than or equal to the number of marijuana initiates. In 2009, 2.6 million persons initiated nonmedical prescription drug use while 2.4 million initiated marijuana use. In 2007, there were over 27,000 unintentional drug overdose deaths; the majority of these deaths were related to prescription drugs. Opioid analgesics accounted for nearly 11,500 unintentional overdose deaths, more than the total of deaths attributed to cocaine and heroin use combined: The Centers for Disease Control report that most of these overdose deaths are due to nonmedical use of prescription painkillers.II The number of prescriptions filled for prescription drugs have increased dramatically in recent years. Opioids, powerful pain relievers, are the most prescribed class of medications in the United States. These increases in the availability of prescription drugs that are subject to use by drug addicts and alcoholics -- especially medicines used to treat pain -- have drastic consequences. During the last ten years there has been fivefold increase in admissions to substance abuse programs for opioid addiction.III IV Hospital emergency room visits involving the misuse or abuse of pharmaceutical drugs have nearly doubled over the past five years.V Prescription drug abuse 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.VI
IBH Activities From 2004 to 2010 an IBH Independent Advisory Committee on Prescription Stimulant Abuse was convened to study 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 must guard these medications to ensure that others do not have access to them. 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.
I Substance Abuse and Mental Health Services Administration. (2010). Results from the 2009 National Survey on Drug Use and Health: Volume I. Summary of National Findings (Office of Applied Studies, NSDUH Series H-38A, HHS Publication No. SMA 10-4586Findings). Rockville, MD. | ||||||||||||||||||||||||||||||
Expanding on the 
IBH also has been promoting 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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