Prescription Drug Abuse

Background. In the United States, the leading cause of injury death is from prescription drug overdose. The most commonly abused prescription medications are (a) pain relievers (opioids), (b) CNS depressants (tranquilizers, sedatives, hypnotics), and (c) stimulants. Opioids are a class of drugs that includes both heroin and prescription pain relievers. CNS depressants are for managing anxiety and stimulates are used in ADHD. A consequence of abuse is drug overdose death, with opioids being the leading cause. Opioids are safe for short term use but have a strong potential to be abused resulting in addiction. In order to understand this crisis, it is critical to examine: (a) demographics, (b) reasons for abuse, and (c) the provider of drugs for targeted prevention. Methodology. Information was gathered utilizing the search engines (a) Journal of the American Medical Association, (b) EBSCO host, (c) Google Scholar, and (d) the LIU library database. Search terms included: (a) prescription drug abuse, (b) prescription drug overdose, (c) United States, and (d) demographics. All publications were from 2010 to 2018 and in English. Results. Mental health disorders put an individual at greater risk for abuse, especially when an opioid is prescribed in conjunction with: (a) an antidepressant, (b) antipsychotic, or (c) benzodiazepine. In examining specific demographics, (a) non-Hispanic males are more likely to abuse prescription stimulants and tranquilizers, (b) Hispanic males are more likely to abuse prescription painkillers, and (c) non-Hispanic females are more at risk to abuse prescription sedatives. Young adults from the age 18 to 25 years old were found to be the largest population that abuses (a) opioid pain relievers, (b) ADHD stimulants and (c) anti-anxiety drugs. From 2004-2011 emergency department visits related to prescription drug abuse rose 114%. Prescription drug abuse (28%) outpaces illicit drug (25%) use in emergency department visits. Among the prescription medicines, pain relievers have shown to be the most problematic with 75.2% of all pharmaceutical overdose deaths being from opioids. Prescription pain relievers are frequently abused to (a) alleviate pain inappropriately (62.3%), (b) feel good or get high (12.9%), (c) relax or relieve tension (10.8%), (d) as a coping mechanism (3.9%), and (f) aid in sleep (3.3%). Prescription pain relievers are typically received from (a) a friend/relative (53%), (b) a healthcare provider (37.5%), or (c) bought from a stranger (6%). Conclusions. Over 80% of Americans will see a healthcare provider within the year which provides them with the opportunity to screen for prescription drug abuse at the bedside. Patients must be counseled on the use and storage of their prescriptions to prevent redistribution to unintended audiences. Health practitioners should utilize the electronic prescription drug monitoring program before prescribing scheduled drugs and evaluate the patient’s medication history to prevent dangerous drug interactions. If prescription pain relievers are indicated, then it should be prescribed for short term use at a low dose without refills. Prescribers should offer close follow up and consider alternative methods for chronic pain relief such as acupuncture and physical therapy