Prescription drug abuse kills: action in 4 areas to lower abuse

There has been growing awareness of the power of prescription medications to kill. The problem is so serious it should be ranked alongside illicit drug abuse and alcohol abuse as primary critical health hazards in the United States and elsewhere across the world. High profile deaths from prescription drugs, such as that of Michael Jackson, helps to highlight how serious this problem is. Many other people are also dead and dying from prescription drugs. The time to act on this problem is now.

Prescription drug abuse has been labelled as an epidemic by the Centers for Disease Control and Prevention, reports The White House Office of National Drug Control Policy. There has been a marked decrease in the use of some illegal drugs such as cocaine, according to data from the National Survey on Drug Use and Health (NSDUH). However, nearly one-third of people who are aged 12 and over who have used drugs for the first time in 2009 started by using a prescription drug non-medically.

It is often believed by prescription drug abusers that these substances are safer than illicit drugs because after all they are prescribed by healthcare professionals and dispensed by pharmacists. This appears to be a critical problem of misperception in teens. Teens are responsible for much prescription drug abuse, reports EmaxHealth reporter Robin Wulffson, MD. Addressing the critical problem of the prescription drug abuse epidemic is a top priority for public health.

The 2011 Prescription Drug Abuse Prevention Plan has expanded upon the Obama Administration's National Drug Control Strategy. This initiative now includes action in four major areas to lower prescription drug abuse, including:

1: Education. In order to effectively tackle the problem of prescription drug abuse it is essential to educate parents, youth, and patients about the dangers of abusing prescription drugs. Prescribers should be required to receive education dealing with the appropriate and safe use, and proper storage and disposal of prescription drugs.

2: Monitoring. Prescription drug monitoring programs (PDMPs) should be implemented in every state to lower “doctor shopping” and diversion. PDMPs should be enhanced to make certain they can share data across states and are used by healthcare providers.

3: Proper Medication Disposal. Convenient and environmentally responsible prescription drug disposal programs should be developed to help lower the supply of unused prescription drugs in the home.

4: Enforcement. Law enforcement needs the tools necessary to eliminate improper prescribing practices and to put a stop to pill mills.

Prescription drug abuse and doctors who prescribe them have been on the rise, according to EmaxHealth reporter Tyler Woods, Ph.D.

It has been observed that prescription drugs are actually the second-most abused category of drugs after marijuana. Furthermore, the most recent National Survey on Drug Use and Health shows that greater than 70 percent of people who abused prescription pain relievers got them from friends or relatives, while about 5 percent got them from a drug dealer or over the Internet. Also, opiate overdoses, which was once almost always due to heroin use, are now increasingly surfacing as being due to abuse of prescription painkillers. In the U.S. military alone, illicit drug use increased from 5% to 12% among active duty service members between 2005 to 2008. This was primarily due to the non-medical use of prescription drugs.

In recent years the number of prescriptions filled for opioid pain relievers, which are some of the most powerful medications available, has increased dramatically. There was a 402 percent increase in the milligram-per-person use of prescription opioids in the U.S. from 1997 to 2007. Furthermore, in 2000 retail pharmacies dispensed 174 million prescriptions for opioids.

A wave of cautionary drug stories this year was lead by GlaxoSmithKline’s penalty. In the largest pharmaceutical settlement to date, in July 2012 pharmaceutical giant GlaxoSmithKline (GSK) pleaded guilty to a three-part criminal indictment. The firm agreed to pay $3 billion in fines and civil penalties, which is the largest pharmaceutical settlement to date. The crime was promoting its drugs for unapproved uses while also failing to report drug-related health hazards.

U.S. Justice Department prosecutors said GSK endorsed Paxil for use by patients under 18 years old, even though there was lack of approval. The firm was also charged with withholding research which was related to a possible increase in suicide risk when taken by adolescents. GSK was also charged with failing to disclose health hazards which are associated with the diabetes drug Avandia. And doctors are said to have been given illegal kickbacks by GSK.

Abbott Laboratories settled for $1.6 billion over a lawsuit involving its anti-seizure drug Depakote in 2012. Abbott was charged with illegally marketing the drug for schizophrenia and agitated dementia, even though it was approved only for treatment of seizure disorders, or mania which is associated with bipolar disorder and migraines. Although doctors may prescribe drugs for any purpose, pharmaceutical companies are prohibited from promoting drugs for conditions which are not approved by the Food and Drug Administration.

Johnson & Johnson's Janssen Pharmaceuticals agreed to pay $181 million in order resolve claims made by 35 states and the District of Columbia that the firm had defrauded state Medicaid agencies by promoting the antipsychotic drugs Risperdal and Invega for unapproved uses. This was the largest multi-state health care fraud settlement ever.

The shooting massacres in 2012 in Aurora, Colorado and Newtown, Connecticut have sparked renewed interest in the association between violence and prescription psychiatric drugs in teens and young adults. This disturbing pattern was evidenced in the 25-year list of school shootings which was compiled by the Citizens Commission on Human Rights International (CCHR). The CCHR has long been blasting the psychiatrists for using dangerous drugs which can set off suicidal and homicidal ideation and intent, along with many other painful and sometimes lethal side effects.

Older patients are also put at risk by prescription drugs. A Vanderbilt University study has found that about 50 percent of all heart patients make medication errors. Two percent of these medication errors are life threatening. It has been found that one in five medications which are prescribed to people older than 65 are either wrongly prescribed or prescribed at the wrong dosage. This study also uncovered several drugs that are routinely prescribed for seniors, despite knowledge of their being inappropriate for that age group. These drugs include:

Kristaps Paddock, ND, has commented in regard to the position of naturopaths on the prescription drug abuse problem, "The issue is not that drugs don't work, nor that as a naturopathic physician I'm 'opposed' to drugs, but rather that when the lives and health of patients is on the line, we should have access to accurate, unbiased information, be it about pharmaceutical drugs, herbs, supplements or other treatments." Dr. Paddock's insightful comment is right on target.

It has been my impression that the abuse of both illicit and prescribed drugs has been epidemic for decades, if not longer. These drugs have flooded the market to such a degree it appears organized crime must have infiltrated the entire American society, including the high school and university campuses. It also appears a disregard for the seriousness of this problem by many medical doctors highlights a catastrophic lack of commitment to dealing with these problems by medical educators and an arrogant desire to place quick profits ahead of patients lives by too many medical doctors.

It's been sad to witness that the practice of good general health care and good mental health care is far too often equated with how many prescription drugs are written. If a cup of green tea and exercise works better than pills, pills and more pills for some conditions such as weakness of an unclear etiology, than the pills simply should not be prescribed even if they are cleared by the FDA for such uses. Making up diagnoses to legitimize the prescribing of drugs which are often dangerous, as psychiatrists always do, can be lethal.

Ok thanks now I understand. I stopped taking antidepressants 5 times. Finally the shrink I had from India insisted I had to take them. Me and her had some heated words needless to say. Same doc my sister saw later and we got her away from her as well.

She wasn't a bad doctor because she was from India {so is my nieces husband} she was a bad doctor because she didn't have a earthly clue as to why she was there for LOL. Next shrink took me off antidepressant I was taking and fixed my Xanax prescription to one that stays low strength in the bloodstream 24/7. My medical charts now have No antidepressants adverse reaction on them.

It was a couple years after that my wife had Serotonin Syndrome and I realized from symptoms I was having while taking them I was right on the edge of it. Wellburtin for example made flush, nausiated, and a head ache within minutes of taking it.

Paxil locked up my blader and I had to go to the ER for a Cathater. Thanks to my training for my wifes care I understood what was happening to me and got to the ER before I went into shock. I asked the nurse what was wrong with me and he said Paxil caused it. We see a few cases a month of this. I had the folley for two weeks till the Paxil left my bloodstream.

My wife wasn't so lucky. For nearly a week she thought she was Della Reese aka Tess on Touched by an angel. 28 years ago she was being treated for anxiety & placed on Xanax by her cardiologist to control heart spasms that was closing down a valve in her heart. About 13 years later she was taking antidepressants for PTSD and clinical depression when she had the reaction to them.

When a person isn't getting enough Serotonin and to the brain it can cause depression or the brain lacks a chemical and the type of antidepressants enhances the neurotransmitters. That is well and good if that is the actual problem. But if the system which processes the sensory impulses is damaged it can cause major issues.I am not anti antidepressants I am anti prescribing the wrong medication because of political pressures or media hysteria which in the case of this article is likely both. Antidepressants for those in true need are a blessing. I have family members who have to take them.

I learned what I did from some basic detective work and a book Phobia Free written by a Neurologist back in the late 1970's IIRC and he linked Anxiety Disorders to Inner Ear/Vestibular. Cerebellar disorders or damage. This gave me the info I needed to get on the right track for treatment. I was born with some damage including one eye functional vision and some screwed up responses to auditory and visual stimulation. Sinus allergies all throughout my childhood increased that damaged. So can chronic ear infections.

I had to take Occupational Therapy two years at about age 13 just to be able to walk straight. My feet because of this and Club feet break my shoes over to the side. I can destroy any quality shoe in less than a month without insoles to prevent it. Trying to play baseball I'd swing early, late, or duck away. I was also misdiagnosed as ADD ADHD. I took the therapy which taught me adaption even to the point I passed both my Navy and Army physicals.

At about age 36 I started having severe startle reactions to certain noises. I lost my ability to concentrate on work and things at home. I would go through episodes of what many call a brain fog. Out of the blue you have no idea where you are, why you are there, how you got there, where you are going, etc and it can be in a place you frequent like driving down the road like I was first episode of it. This is a sensory processing system crash and can be mistaken for several things including a nervous breakdown, stroke, etc. That part I learned to head off finally. But I have upper torso spasms triggered by auditory and visual stimulation.

My wifes condition her quadriplegia also helped me put the pieces together. Besides motor function the first thing quads loose is their Inner Ear function which must be regained on what is called a Tilt Table. My wife like myself is a vestibular patient.

My sister {my only sibbling} is a stroke, mental health issues, and Dementia patient. I am the first one one the notification list as the Memory Care unit. Last year in the early spring I sometimes got two calls a day telling me she had fallen. Now I can understand that sometimes happen but I began to notice it was happening especially when a major weather front was coming through. I documented it then talked to my niece and the facility nursing director. The nurse thankfully understood what I was telling her so we took sis to a doctor she had been seeing. Thankfully again he listened especially when I said that Inner Ear issues runs in the family & understood what I was saying and tried her on Valium. Her fall rate went to less than once a month immediately. She was falling because balance was made worse and because of the fact she had less tolerance for being in noise which when she fell she was trying to get away from and go to her room.

Here is another interesting event that helped me understand it better later on. My last night at work I got a trouble call to a residents apartment in the retirement home. I was a maintenance mechanic. I went to the apartment and the woman was in the hallway crying. I knew her and knew this wasn't her usual self. I asked her what was wrong? She said Oh the noise please make it stop. I could not hear any unusual noise so i said OK take me to the noise. She took me to her A/C unit at the wall. I turned it off and she was fine. Was she nuts? No! I told the nurse and she said yea she came home from the hospital like that.

I left and returned to the main building to my shop to eat supper. I was sitting down propped up in a chair when someone behind the double door yelled at somebody down the hall. I was like the cartoon cat that the dog sneaks up behind and barks. Then it started. The crash. I called a relief in because by law due to boilers we had to have someone there. I called my wife and by that time I could barely speak. I was aware very aware of what was around me. and what was otherwise going on. She called my dad to come and get me. That was my last night at work ever.

I had MRI, CAT Scans, and EEG of my brainwaves done all negative. That is common in Vestibular disorders for those test to be normal. At that point the doctor said OK it's Shrink time. What did this have to do with that laddie I mentioned? Everything. She likely had a basic good old fashioned Inner Ear infection and noises were driving her nuts.

I have a cousin with this as well but not to the extent of seizures. He spent tens of thousands on trying to get help. I told him have the doctor look into your Ear Infections as a kid. Finally a semi retired GP asked all the right questions. He asked him I see you were in Nam did you wear hearing protection? Did you have ear infections as a kid? He had tubes in his ears. he asked a few more questions and said you have Vestibular Damage and it is triggering anxiety. Here take this medication and it was a Benzo.

In the case of my wife her Shrink saw her about an hour before I took her too the ER and said up the Zoloft and see you in three months. The hospital had a Shrink come in whole had never seen her. In less than 5 minutes he also said up the Zoloft. When he saw her she was back to normal because they had discontinued the Trazodone and Zoloft for almost 72 hours and was treating her with Ativan which was the only thing they did right. Next day at noon in walks nurse with Zoloft. In one hours time she was out of it thrashing and hallucinating, That was when I went home and got on line and searched Trazodone +Zoloft +adverse reactions. I credit GOD for fast answers. I found an article written by a University of Tennessee Pharmacology professor warning about Serotonin Syndrome. The hospital was associated with that same university.

None of what I posted is fabricated. It is true life experiences. Worst part of it was in the ER because she was not mentally competent to sign for treatment I could not sign for her. Strangers did and this was about 13 yearss ago. This involved two ER's. The first one we left after I found her unconscious in her wheelchair and curtains drawn closed so no one could see her. I found her and said she needs help Stat. The ER doctor came in and looked and shrugged. I said you Stupid {word I never use} do something. We took her out and to another ER. At first they helped till I was honest and said we had left a previous ER. They made a call and lost interest fast calling in Mobile crisis instead. In that time no testing was done.

When her primary care doctor finally saw her after the hospital release she was shocked and said Oh My God because she had thrashed herself against the bed and was black and blue. Antidepressants are a medication not to be taken likely by doctor or patient nor is Benzos. A doctor should not be in fear of prescribing either one if it is what the patient needs.

Both doctor and patient need to be educated as to all possible side effects and possible adverse reactions. Antidepressants are acceptable by society, media, and politicians, because everyone knows someone taking them. But Woe unto Patient Jones taking a needed Benzo and the prescribing phyisican.

Thank you for the input, cva.

The use of anxiolytics is VERY complex, as is the use of pain medicine (opiates).

In my experience, Xanax is not a great medicine for a couple of reasons.

First, it gets into the system fast, which is good, when you have a patient with say anxiety over flying in an airplane.

The big problem is it hits the same brain receptors as alcohol does, so you can figure that a person can easily get "hooked".

Its half-life is 3-5 hours, so once the effect has worn off, you're back to square one. An anxious patient who now has to deal with "rebound anxiety".

It ends up becoming a self-feeding addiction.

A patient is literally dependent on it. I rarely use it for this reason.

For truly anxious patients I go for something that lasts longer, like valium.

Low dose, and slow.

But it stays in the system longer.

For a person with generalized anxiety disorder, this is the way to go.

Not so many addiction problems.

The gold standard is some kind of anti-depressant with rare use of benzodiazepines.

Emphasis on rare.

All benzos are addictive. So use with great caution.

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