Running Head: Medicine and its Backlashes

Social Overdependence on Medical Drugs: A Review of Literature on Medicine and its

Backlashes
Luisa Gonzlez
The University of Texas at El Paso
Abstract
The progress of medicine and public health has been of significant subject to recognition
as people get to live longer, healthier, and more productive lives than ever before. Modern
scientific capabilities have forever altered the course of humanity, yet with an overflowing
increase in benefits come a series of failures and backlashes. Over the course of the last century,
the misuse and abuse of prescribed medications have been under a shadow of the ethical issues
that arise within the medical industry. Possible solutions and techniques to end the epidemic
disease may only be attainable with a deep knowledge and comprehension of the factors
surrounding and leading to this issue. In is in our best interest as individuals and as a society to
work towards the development towards the solutions and techniques of a problem that demands
out attention despite of the difficulties to attain them.

Social Overdependence on Medical Drugs: A Review of Literature on Medicine and its

Backlashes
Modern scientific capability has profoundly altered the course of human life. The majority of
the population now lives longer and better lives than any other time in history, yet scientific
advances have turned two of the natural processes of life, aging and dying into medical
experiences. We have allowed our fates to be controlled by the imperatives of medicine and
technology forever changing the trajectory of our lives. This not necessarily either right or wrong
but unfortunately medicine, just like anything else, has its backlashes and various ethical issues
arise debating the limitations that medical advancements should either surpass or stick to
(Gawande, 2014).
A very strong issue that has caught the attention of many professionals in the field is the
abuse of prescribed drugs. Prescribed drug abuse has been around for some time now, yet it has
fallen into an ambiguous gray area that makes it extremely complex to fully comprehend all the
factors that contribute to such. For this reasons, the following questions must be considered for
research and review:

What is the purpose of medicine and which ethical issues come attached with medical

advancements?
When does the use of prescribed drugs become an addiction and which are the factors or

reasons that lead to such?

Which are the consequences that result from a misuse of prescribed drugs?

The misuse of prescribed drugs is a very complex issue that can only be successfully treated with
throughout knowledge and understanding of all the surrounding factors that lead to such. This
research intends to further examine and explain those factors with the purpose of offering a
glimpse into the dangers of prescribed drug abuse.

What is the purpose of medicine and which ethical issues come attached with medical
advancements?
Life sciences have enhanced the quality of life almost reaching utopian sensations where
diseases have been drastically reduced and even eliminated in the last century. A few medical
schools offer courses in ethics yet the purpose of medical schooling, as described by Atul
Gawande, is to teach students how to save lives, not how to tend to their demise and to learn
about the inner process of the body, the intricate mechanisms of its pathologies, and the vast
trove of discoveries that have accumulated to stop them (Gawande, 2014). Indeed, American
medical schools have no requirements on minimum knowledge on medical ethics.
As described in a Thesaurus, medicine it is the art or science of treating disease with
drugs or curative substances, as distinguished from surgery and obstetrics; meaning its purpose,
by definition, is to treat patients physical malfunctioning with no required focus on their mental
and emotional state in the reality of such. This is the reason why, even with a conscious
knowledge on the need for an ethical approach of medical care, the medical profession still fails
to effectively approach the issue that constantly orbits around it (Martinez, 2002). In his article,
Ethics and Medicine: The Challenge of Technological Evolution, Musajo-Somma describes the
issue as follows:
The ever increasing ramification of scientific knowledge, and especially technology, is
also the result of an almost natural process whereby every solution to a specific problem
generates a chain of other problems in search of specific solution. Many of the most
intractable health problems that we confront today are neither technical nor scientific, but
social, ethical, behavioral or moral (Musajo-Somma, 2007)

In the past 20 years, medical discoveries have given a rise to important ethical and
societal issues, facing issues that had never been thought of in past years where in many cases
decision-making in based on ethical principles. To function effectively in the health care
systemto navigate in a trillion dollar industry, we need a compass: medical ethics- R. Scott
Jones. Medical ethics is more than just an honorable code of conduct; it incorporates moral,
legal, economic, and charitable considerations (Martinez, 2002).
When does the use of prescribed drugs become an addiction and which are the factors or
reasons that lead to such?
The majority of people are able to manage using prescribed drugs without disrupting our
lives, but some others develop a certain dependence or addiction to them, which ultimately leads
to a substance use disorder. According to the American Psychiatric Association a person may be
diagnosed with substance use disorder when drug use continues despite significant life disruption
and/or physical risk. Resulting brain changes may persist after quitting use of the substance thus,
leading to strong cravings when exposed to people and situations that trigger memories of drug
use (Meyers & Dewall, 2015). There are three identified influences that lead to disordered drug
use, the first one being biological influences, the second being social-cultural influences and the
last one being psychological influences. Within the category of biological influences exist
genetic predispositions and variations in neurotransmitter systems; in the social-cultural
influences fall the aspects of difficult environments, cultural acceptance of drug use, and
negative peer influences. Lastly, the psychological influences category is characterized by
lacking a sense of purpose, significant stress and psychological disorders such as stress (Meyers
& Dewall, 2015).

An example of a cultural influence is discussed in the popular documentary series of This

is Life with Lisa Ling her second aired episode called Unholy Addiction focuses on the
unspoken addiction to prescribed drugs and its crossroad relationship with religion. The episode
takes place in Salt Lake City, Utah, a city characterized mostly for being located in one of the
safest states in the United States to live in along with its Mormon conservative values, yet known
to be one with the highest mortality rates in the country. In her quest to investigate the
relationship between a city with such positive characteristics and a 400% increase in deaths over
the last years due prescribed drug addiction, Ling discovered several factors that lead to such.
With the help of a mother and her daughter, both addicts to the prescribed painkiller Oxycodone,
Ling learned that most of Salt Lake Citys addicts have been victims of a pressure to be perfect
imposed by their own religion and eventually felt that Oxycodone was the only way to get
through this everyday pressure, without being held responsible for the misuse of the drug. Unlike
the use of alcohol or tobacco, the use of prescribed medication (usually painkillers) falls into a
gray area since the use of it is often justified by medical reasons and validation from their
doctors meaning that its possible side effects are not subject to immoral behavior, making it
Figure 1: Where are prescription drugs
easier for individuals to quickly get addicted to obtained?
it with a valid justification. Of course, no one is
0.3%: Bought on the internet
Moreseeking
than oneexperiences,
doctor
limited to this factor and other reasons such1.9%:
as thrill
curiosity, peer
2.2%: Other
Drug more
dealermight
or stranger
pressure, eased accessibility to prescribed drugs3.9%:
and many
be the behind the initial
16.6% Bought/took from friend or relative
engage in such behaviors in Salt Lake City (Ling,18.1%:
2014).One doctor
54.2%: FREE from friend or relative
A second example regarding biological and psychological influences of addictions to
prescribed medical drugs is presented in Venlafaxine Addiction without a History of Alcohol and
Substance Abuse: A Case Report. In this report, the individual is subject to a dependence on
Venlafaxine despite of not having previous history of alcohol and/or substance abuse. The patient

suffered from chronic headaches, sleeplessness, nightmares, malaise, and muscle pain. She was
started on venlafaxine with 75mg/day and within 8 months of treatment, she increased the dose
to 2100 mg/day because this is the dose that would now provide alleviation to her symptoms. In
an attempt to lower her dependence, venlafaxine dose would be lowered by 75mg/day and
milnacipran was added to the treatment when venlafaxine dose was lowered to 1050mg/day. Her
headache and insistence on receiving high dose venlafaxine gradually decreased and the patient
was discharged with the treatment of milnacipran 100mg/day. In substance abuse, there are
cognitive, behavioral and physiologic signs that indicate continuous abuse of substance, as well
as a continuous self-medication resulting in tolerance, abstinence and compulsive behavior. In
this case, previous history of alcohol and/or substance abuse was not the reason for raising the
dose of venlafaxine by the patient, but the recurrence of somatic or physical symptoms.
Venlafaxine withdrawal symptoms may include several somatic as well as psychiatric symptoms
that may lead to the development of dependence in patients, which in this case did (Esizolu,
A., Yaan, A., Blbl, ., Karabulut, E., & Grgen, F., 2012).
Which are the dangers and consequences that result from an addiction?
In a previously held interview with Dr. Leah Whigham, the executive director of the El
Paso del Norte Institute for Healthy Living, it was concluded that daily events, habits and
activities in our lives determine many factors in our health; and that the consequences of
becoming dependent on a single method (i.e., diet, exercise, medicine, etc.) to attain such would
be reflected in our well-being (Whigham, 2016). The book All Is Well by Louise Hay, a
metaphysical lecturer and teacher, and Mona Lisa Schulz, a practicing neuropsychiatric,
emphasizes the importance of maintaining a balance between emotions, intuitions, logic and
facts; in other words, a balance between medical health, holistic health, nutritional health, and

emotional health. A failure to find a balance between all these factors typically results in an
imbalance within our system that leads to, in some cases even unconsciously, an irresistible and
never ending addictive cycle whether it be a psychological, biological or behavioral (Hay &
Schulz, 2013).
Over the years, the concept of addiction has been extended to cover many behaviors
formerly considered as bad habits. Addictions can be powerful, yet psychologists debate whether
addictions are really as irresistible as commonly believed. Despite of this, viewing addictions as
uncontrollable diseases is proved to have an influence in undermining peoples self-confidence
and their belief that they can reverse their condition. Another important psychological
consequence of this condition, is the addiction-as-disease-needing-treatment idea that has been
offered for a host of driven, excessive behaviors meaning that addiction can become an allpurpose excuse (Meyers & Dewall, 2015).

The

most

commonly

identified

consequences

of

substance

use

include

diminished

disorder

control,

diminished

social functioning, hazardous use,

and drug action and death. Some of
the problems that these concepts
cover

are the

increase

of the

substance needed for desired effect, a

failure to regulate the use of the
substance; the frequent acquisition, use
of and increase in recovery time from

Figure 2: National Overdose DeathsNumber of

Deaths from Prescription Drugs. The figure above
is a bar chart showing the total number of U.S.
overdose deaths involving prescription drugs from
2001 to 2014. The chart is overlaid by a line graph
showing the number of deaths by females and
males. From 2001 to 2014 there was a 2.8-fold
increase in the total number of deaths.

effects; the craving of the substance;

disruptions in commitment to work, school or home; a continuation of abuse despite social
problems, physical and psychological problems and hazards involved; reduced social,
recreational and work activities; tolerance to the drug, and withdrawal experiences. These
problems that arise from substance use disorders are the most accurate explanations of why
addiction to prescribed medication is often the first step that individuals take towards more
complex addictions to harder drugs such as heroin, methamphetamine, cocaine, LSD, etc.
(Meyers & Dewall, 2015).

Conclusion
The misuse and abuse of prescription medications in the United States and elsewhere
remains high, yet only a few people are truly aware of the seriousness and colossal of the issue.
This literary review has analyzed several ethical, medical, cultural, social and behavioral factors;
approaches and techniques used to address the issue, real-life examples and known facts
surrounding the unspoken realities of the addiction to prescribed drugs. Medical advances have
most definitely proved to be beneficial to our modern society by improving the quality of lives,
yet it is those same advances are the ones that have unfortunately caused many people to fall,
consciously or unconsciously, into an epidemic disease. There are still a great number of
questions left unanswered regarding this issue, as well as many opinions, facts and information
not stated in this research. An in-depth comprehension and effective solutions regarding this
issue can only be attained by further extensive research but as long as this is discussed and
advocated for even in small proportions it will ensure that a difference towards improvement is
being made even if it is at a slow rate.

Esizolu, A., Yaan, A., Blbl, ., Karabulut, E., & Grgen, F. (2012). Venlafaxine
Addiction without a History of Alcohol and Substance Abuse: A Case Report.
Dusunen Adam: Journal Of Psychiatry & Neurological Sciences, 25(4), 376-378.
Gawande, A. (2014). Being Mortal. New York, NY: Henry Hold and Company, LLC.
Hay, L.L., Schulz, M.L. (2013) All Is Well. United States: Hay House, Inc.
Image 1 Retrieved on April 02, 2016 from https://www.drugabuse.gov/related-topics/trendsstatistics/infographics/popping-pills-prescription-drug-abuse-in-america
Image 2 Retrieved on April 02, 2016 from https://www.drugabuse.gov/related-topics/trendsstatistics/overdose-death-rates
Ling, L. (2014) This is Life with Lisa Ling. United States: CNN.
Martinez, S. A. (2002). Currents in Contemporary Ethics. Journal Of Law, Medicine &
Ethics, 30(3), 452.
Medicine. (N.d.). The American Heritage Dictionary of Idioms by Christine Ammer.
Retrieved on April 02, 2016 from http://www.dictionary.com/browse/medicine
Musajo-Somma, A. (2007). Ethics and Medicine: The Challenge of Technological
Evolution. Acta Medico-Historica Adriatica, 5(1), 117-124.
Myers, D.G., Dewall, C.N. (2015) Psychology 11 Ed. New York, NY: Worth Publishers.
Whigham, L., interview, March 17, 2016