A Look at Prescription Drug Abuse

Health Science 460 Section

Drug Use and Abuse
Brother Yearsley

Name:
Date:

OUTLINE
THESIS STATEMENT:

Prescription drugs can cause negative effects such as

addiction, tolerance, physical dependence, and death, thus,
anyone taking medication needs to be aware of these
hazards.

I.

A Modern-Day Disease

II.

Pain Medications and Addiction

III.

Prescription Drug Abuse

A. Barbiturates
B. Benzodiazepines
C. Amphetamines
D. Appetite Suppressants

IV.

Commonly Abused Prescriptions

A. Opioids
B. Depressants
C. Stimulants

V.

Prescription Drug Abuse Trends

VI.

Abuse and Misuse of Medications in the Elderly

A. Prescription and OTC Drug Use
B. Minimizing OTC Misuse/Abuse
C. Future Increase?

VII.

Summary

I.

A Modern-Day Disease - INTRODUCTION

Prescription drug abuse is a modern-day disease. In an estimate, over six million

American have abused prescription medication. However, there is no completely accurate

way to measure prescription drug abuse. The number is not that important, but the fact
that many people suffer from addiction to prescription drugs is. Torn apart families,
destroyed lives, and deaths are some of the negative effects. Some people think that by
focusing on prescription drug abuse, we may scare physicians away from reasonably
prescribing helpful medications for patients who really need them (Prescription Drug
Abuse, 2002).
II.

Pain Medications and Addiction

What is the most common reason people go to the doctor? It is pain. Doctors all

over the country wonder how they can prescribe accurate medications so the patient is
relieved of pain without becoming addicted to that medication. Many doctors underprescribe powerful painkillers. They overestimate the potential for patients becoming
addicted to painkillers such as morphine and codeine. When doctors limit pain
medication, thousands of patients suffer needlessly. Doctors' fear that patients will
become addicted to pain medication is known as "opiophobia".

"Opiates, including morphine and codeine, and synthetic opioids, such as

Demerol and fentanyl, work by mimicking the endogenous opioid peptides, painrelieving chemicals produced in the body. These peptides bind chemically to
opiate receptors, activating pain-relieving systems in the brain and spinal cord.
But opioids can cause undesirable side-effects such as nausea, sedation,
confusion, and constipation. With prolonged use of opiates and opioids,
individuals become tolerant to the drugs, required larger doses, and can become
physically dependent on the drugs" (Bellenir, 2000, P. 120).

III.

Prescription Drug Abuse (Reference to Lader)

Addiction to prescribed drugs or to those used in treatment is term iatrogenic. The

most common drugs susceptible to addiction are those prescribed for psychological
problems. Some act on the mind, having low potential for abuse and dependence.
Examples are anti-psychotics, anti-depressants, and lithium salts. Other, like barbiturates
and amphetamines, have high potential.
A.

Barbiturates
"Tolerance and physical dependence can rapidly occur during therapy - and
abrupt withdrawal can result in a severe and life-threatening withdrawal state.
Large quantities can be injected into a vein or muscle, often producing abscess
formation. Other users take large amounts by mouth, on a binge or spree bais.
Some users become permanently intoxicated and totally engrossed in maintaining
their supply. Withdrawal can be hazardous, with the risk of seizures or psychotic
features, when discontinuing chronic usage of 500 milligrams a day or more"
(Lader, 1995, P. 844).

B.

Benzodiazepines
The benzodiazepines replaced the barbiturates because they appeared to be at

least as effective, with few side effects, and a less chance of causing addiction.
Benzodiazepines have been abused all around the world during different periods of time.
They have been used as the main drug of abuse as well as part of a polydrug-abuse
pattern. Alcohol abusers also abuse benzodiazepines. When combined, the drug
interaction that occurs is particularly powerful. Most benzodiazepine abuse is with legally
obtained drugs. About half of benzodiazepine abusers were introduced to the drug
through medical context.
C.

Amphetamines
Amphetamines raise mood, increase the sense of energy and alertness, and

decrease appetite. A few users react oppositely, becoming drowsy, anxious, and irritable.

Some people feel the need to stay awake for long periods of time. Medical interns and
long-distance truck drivers sometimes use amphetamines for this cause. The effects wear
off after a couple of hours, leaving the abuser exhausted, drowsy, and depressed.
Methamphetamine can be synthesized easily. Intravenous use of
methamphetamine is usual and tolerance occurs quickly. Larger and more frequent doses
become required to achieve the desired effect. A very negative outcome could be that a
paranoid type of psychosis would develop. This would cause a loss of reality and
delusions of persecution.
D.

Appetite Suppressants
Most appetite suppressants are stimulants. Patters of use and abuse vary greatly. A

therapeutic dose may result in chronic daily ingestion, while use of larger quantities may
cause an individual to binge or spree. The more amphetamine, like the appetite
suppressant, the greater the chance is of abuse. Stopping the use of appetite suppressants
can be difficult for abusers because of withdrawal symptoms like tiredness, discomfort,
or depression. These problems have caused many doctors to stop prescribing them.
IV.

Common Abused Prescription Drugs

Prescription drugs help patients manage pain, restore balance, control sleep

disorders, and fight obesity. However, when abused they can be incredibly dangerous.
Three commonly abused prescription drugs are opioids, depressants, and stimulants.
Opioids, including morphine and codeine, as well as other related drugs such as
Vicodin and Demerol are generally given to relieve pain. When taken correctly, opioids
can be used to manage pain without unpleasant side effects. Chronic use can result in
tolerance. Long-term use can also be dependence and addiction. Withdrawal can occur

when someone stops using the drugs. Symptoms may include restlessness, muscle and
bone pain, insomnia, diarrhea, and vomiting. Those addicted to opioids are more likely to
overdose, which could be fatal.
Barbiturates are some of the mostly commonly prescribed CNS depressants.
Some like Mebaral and Nembutal are prescribed to treat anxiety, tension, and sleep
disorders. Benzodiazepines like Valium and Xanax are prescribed to treat anxiety, acute
stress reactions, and panic attacks. Other benzodiazepines like Halcion and ProSom are
used for short-term treatment of sleep disorders. All of these depressants produce a
beneficial drowsy or calming effect. Use over a long period of time will result in
tolerance. Larger doses will then be needed to attain the original effects. Continued use
can also lead to physical dependence and withdrawal. Both barbiturates and
benzodiazepines have the chance of being abused and should be used only as directed. As
with opioids, overdose can be fatal.
Stimulants enhance brain activity, increase alertness and energy, raise blood
pressure, and elevate heart rate and respiration. Stimulants like Ritalin and Dexedrine are
prescribed to treat narcolepsy, attention-deficit/hyperactivity disorder, and depression.
They may also be used for short-term weight management. Some become addicted to the
sense of comfort and improved energy that stimulants produce. However, using high
doses frequently over a short time can lead to feelings of hostility or paranoia. Very high
body temperatures and an irregular heartbeat can also result from an uptake of stimulants.
(Petracca, 2002).

V.

Prescription Drug Abuse Trends

Every year millions of prescription pills enter the illicit drug market. In 1993

prescription drugs were sold for about $25 billion in the illegal drug market. Enormous
amounts of people in the U.S. use prescription drugs for the wrong reasons. Nationally,
the federal government spends about $13.5 billion on the drug war, but only $70 million
goes to investigate prescription drug offenses.
By having an accurate dosage, a high purity level, and a lower price, prescription
pills have established a place next to regular street drugs. Medical offices and pharmacies
help supply a large amount of these drugs. "Doctor shoppers," lie to doctors by claiming
to have injuries or ailments to get prescriptions. A woman by the name of Vicki J.
Renalso tricked 42 doctors and 26 pharmacies into giving her codeine tablets during an
eight-month period.
There is no glory in catching doctors and pharmaceutical companies involved in
this illegal drug trafficking. Media coverage is small due to the fact there are no guns and
no bundles of case for the world to see. Sometimes action is taken, but the results are
usually small. Very few doctors, dentists, and pharmacists are prosecuted annually for
prescription fraud.
Doctors, even when convicted, have very small sentences compared to those
caught selling cocaine or marijuana. A certain Dr. eric C. Tucker issued more than 7,000
questionable prescriptions for the stimulant Preludin and other 7,600 for Dilaudid. More
Dilaudid, also known as "drugstore heroin," was distributed from Tucker's office per year
than from the LAC-USC Medical Center, the West Coast's largest public hospital. Tucker
pleaded guilty and lost his medical license, but only served eight days in jail. On the other

hand, Daniel G. Siemianowski was prosecuted in Los Angeles at about the same time as
Tucker. He was arrested with four ounces of crack and was sentenced to a year in prison.
Don Simpson, a Hollywood producer, died from a mix of cocaine and 20
prescription drugs. Since then, prescription abuse has received more attention in Los
Angeles. "Abuse of prescription drugs is a serious problem in our society, but nobody pay
attention until somebody big and powerful like Don Simpson drops dead," said Steve
Simmons, the California Medical Board's senior investigator on the case.
In a research of an estimated 10 prescription frauds, one doctor received a short
sentence; the other nice pleased guilty and were put on probation. Part of the problem is
that medical practitioners are usually charged under laws carrying low prison penalties.
The laws are written allowing health car professionals to escape serious drug trafficking
charges, no matter how fraudulent. About 75% of physicians convicted of prescription
drug crimes got to keep their license. Medical and pharmacy board investigators are
seeking more court orders to suspend licenses after someone is arrested (Bellenir, 2000,
P. 19, 20, 21).
VI.

Abuse and Misuse of Medications in the Elderly

A.

Prescription and OTC Drug Use

The elderly use prescription drugs about three times as often as the general

population, and they use over-the-counter (OTC) medications even more extensively.
Medication misuse occurs when patients consume medications in a way that
deviates from the recommended prescribed dose. Misuse may include overuse as well as
underuse. A patient can abuse a drug intentionally or misuse a drug unintentionally.

B.

Minimizing OTC Misuse/Abuse

There are many reasons why the elderly misuse prescription or OTC medications.

Medication misuse can occur when someone starts losing sight, hearing, and strength. As
someone gets older, they may become forgetful and take their medication more than
once. Some might not be able to read the directions. Other, when told the amount they
should take, just don't hear very well and then have to guess. Finally, an older person who
is weak or has arthritis may overuse the medication to feel better.
The elderly should avoid polypharmacy. When there is lack of communication, it
is possible that the patience will get medications from more than one source. It has been
recommended that the elderly get their medication from only one pharmacy.
C.

Future Increase?
The greater exposure to medications by the elderly, along with age-related

changed and problems, puts them at a greater risk of medication misuse. As we begin to
love longer, there may be an increased use and abuse/misuse of prescription and OTC
medications (Patterson, 1999).

SUMMARY

Prescription drug abuse is a modern-day disease that affects millions of

Americans. Sometimes people become addicted to painkillers and then start abusing
them. Some even lie to their doctors to get more medication. A few of the drugs being
abused are barbiturates, benzodiazepines, amphetamines, and appetite suppressants. If
people are not careful, overdose of these drugs could kill them.
Even though there is little coverage of prescription drug abuse, it is continually
happening. It can and does affect many in various ways. Sometimes doctors, dentists, or
pharmacists are involved in illegal drug trafficking. However, if caught they receive small
sentences. The elderly are also involved in medication misuse. When they take the
medicine, they don't always take the right amount at the right time due to loss of sight,
hearing, and strength. As we begin to live longer, we need to be careful so we don't abuse
or misuse prescription medication.

REFERENCES

1.

Bellenir, Karen, ed. Drug Abuse SOURCEBOOK. Detroit: Omnigraphics, Inc.,

2000.

2.

Lader, M. A. "Prescription Drug Abuse." Encyclopedia of Drugs and Alcohol. Ed.

Jerome H. Jaffe. 4 vols. New York: Macmillan-Simon, 1995.

3.

Patterson, Lacro, and Dilip V. Jeste. "Abuse and Misuse of Medications in the
Elderly." Psychiatric Times. 16.4 (1999): 5 pp. 22 Jan. 2002

<http://
substanceabuse.about.com/gi/dynamic/offsite.htm?site=http%3A%2F%
2Fwww.mhsourse.com%2Fpt%2Fp990454.html>.
4.

Petracca, Michael. Prescription Drug Abuse: a Report 22 Jan 2002 <http://sub

stanceabuse.about.com/library/blrx100601.htm?terms=prescription+drug+
abuse>.

5.

Prescription Drug Abuse 22 Jan. 2002 <http://www.prescriptiondrugabuse.org/

pda.html>.