Pregnant women are often scrupulous about what they put in their bodies, avoiding alcohol, caffeine, processed meats and mercury-laced fish in an effort to protect their developing child. But if they go to their doctor for pain, about one in five will leave with a prescription for a narcotic painkiller such as codeine, hydrocodone or oxycodone, according to a recent study published in the journal Obstetrics & Gynecology. That’s a record number.
What’s wrong with this picture? Maybe nothing. Maybe a lot. The problem is we just don’t know for sure.
The face of drug addiction has changed dramatically in the past decade. Gone are the days when the “typical” drug addict was a junkie shooting heroin on the street. The widespread abuse of prescription drugs, which are easily accessible and presumed “safe,” has meant that addiction is plaguing some unexpected populations. Three unsuspecting groups have been hit particularly hard:
A new generation of addicts is making its way into drug rehab centers. Many Baby Boomers, who grew up in the 60s and 70s in a culture that romanticized drug abuse as consciousness-raising, are now retiring. Free from the responsibilities of work and raising children, some are using their extra time and money to return to the drugs of their youth or to experiment with newer drugs, including prescription medications.
As awareness grows about the dangers of prescription drug abuse, the government is following through on its promise to address the “nation’s fastest-growing drug problem.” The Food and Drug Administration (FDA) recently revealed its risk evaluation and mitigation strategy for extended-release and long-acting opioids to prevent misuse and abuse, starting with education for doctors who prescribe highly addictive painkillers as well as the patients who take them.
Prescription drug abuse is finally showing signs of stabilizing. Some believe this gradual decline is the result of government efforts to crack down on the abuse of prescribed medications. At first glance, this may seem to be so. It appears that the war against prescription drugs is heating up but so far, all it has done is punish those who legitimately need medication and drive addicts to riskier drugs like heroin. The following examples suggest that, as a nation, we still do not have the right attitude about addiction that will enable us to develop effective treatments and policies:
#1 Prescription Drug Monitoring Programs
Most states have a prescription drug monitoring program, a registry of every individual prescribed a controlled substance, which generates reports of suspicious behavior when a patient obtains prescriptions from multiple doctors or multiple pharmacies in a given month. These efforts, while well-intentioned, may deter doctors from prescribing medications for legitimate uses to treat people with chronic or severe pain. Fearful of a time-consuming investigation that could jeopardize their professional license and reputation, many doctors are no longer willing to prescribe painkillers even when there is clear medical necessity.
Teenagers are natural experimenters, but there are some drugs that put them at grave risk even if they try them just once. Although grisly media reports of psychotic episodes and gruesome acts of violence have made it difficult to differentiate horror from hysteria, in the case of “designer drugs” much of the hype is worth heeding.
What Are ‘Designer’ Drugs?
Chemists are always engineering new drugs, some of which are used to save lives by treating cancer and other illnesses; others are designed for less savory purposes, namely to get high. In this context, so-called “designer drugs” are concocted in underground labs to mimic the effects of controlled substances. Consumers of these specially designed drugs are typically youth in their teens to early thirties, who purchase them at raves, clubs, head shops and convenience stores, as well as online.
Methamphetamine is a synthetic compound that stimulates the release of dopamine and norepinephrine, a neurotransmitter closely related to adrenaline. The effects of meth are much more prolonged than the short burst of dopamine and norepinephrine that is released when neurons fire on their own.
Like all amphetamines (“speed” drugs), meth creates feelings of euphoria, intensity, and power, along with the drive to do whatever activity the user wishes to engage in. If going to clubs and dancing is your thing, then while you’re high on meth you’re up all night, feeling energized by every thump of music—at least until you start coming down.
Meth is sold legally (with a prescription) in tablet form as Desoxyn, FDA approved for the treatment of ADHD and exogenous obesity. More often, though, it’s cooked in makeshift labs and sold illegally as a powder or rock. The powder form can be snorted, smoked, eaten, dissolved in a drink, or heated and injected. The rock form is usually smoked, though it can also be heated and injected. Widely available in the 1960s, meth faded in the 1970s as controls were tightened on legal production, and cocaine took its place as the new party drug of choice. Crack cocaine dominated the 1980s, along with designer drugs like MDMA (Ecstasy), but in the early 1990s meth made a comeback, and it seems to be here to stay. According to the World Health Organization, meth is now the second most widely abused illicit drug worldwide, trailing only marijuana.
Despite warning labels on prescription pill bottles and frequent news reports of celebrity overdoses, people are not taking the risks of fatal drug combinations seriously. Prescription drugs and alcohol are legal, so they must be safe, right? Few people even consider them “drugs,” yet together they are responsible for thousands of preventable deaths each year.
While alcohol and prescription drugs are among the most common and dangerous, other types of interactions also can be life-threatening, including interactions between herbal or dietary supplements, illegal drugs, over-the-counter medications, and even some foods.
Certain medications have a similar function and can increase each other’s effects, risking severe side effects or overdose, whereas others decrease or block another drug’s effects, causing one or both drugs not to work as intended.
Dangerous drug combinations are of particular concern among adults ages 50 and older, who are more likely to take a variety of medications for different ailments and whose bodies are more sensitive to the drugs’ effects. Given that more than half of older adults take five or more prescription drugs, over-the-counter medications or dietary supplements every day, the risk of an adverse drug interaction is high.
The latest example making news is war veterans suffering from pain and co-occurring post-traumatic stress disorder who are being prescribed potent opiate painkillers. Even though it’s widely known that veterans with PTSD are at high risk for drug and alcohol abuse, a recent study in the Journal of the American Medical Association shows they’re twice as likely to get prescriptions for addictive painkillers as veterans with only physical pain.
Even more concerning, vets with active substance abuse problems were four times more likely to get addictive drugs than those without mental health issues.
Vets with PTSD who are prescribed these drugs are more likely to suffer drug overdoses, self-inflicted injuries and suicides, according to the study. In addition to their addictive potential, opiate drugs can actually exacerbate certain emotional problems and only slightly reduce or even worsen pain.
Side effects, tolerance and withdrawal symptoms can compromise the drugs’ pain-relieving effects. In a 2009 study of 1,843 workers with back injuries, researchers found that only 26 percent of the patients on opioid painkillers experienced pain relief, and only 16 percent experienced improvement in physical function.
Happiness is a feeling most of us are quick to embrace. But when feelings of sadness, anger, stress or frustration arise, it can be tempting to believe that feeling nothing would be better than feeling down. Whether it’s the laws of nature or the age-old principle of yin and yang, it seems that we are required to experience both extremes on the emotional spectrum.
Human beings are social creatures that need feelings to survive. Emotions connect us to other people and help us interpret, respond to and learn from our environment. It is our emotions that compel us to be in relationships, raise families and escape from danger.
When difficulties arise in our relationships, or memories of a painful childhood or troubling experience surface, it is understandable to think that numbing those feelings would bring relief. When someone is pushed to the edge of what they can tolerate, the choice may come down to suicide or emotional escape. And drugs are a quick, powerful way to disappear.
But numbing painful feelings with drugs comes at a price. In addition to drowning the difficult emotions, the positive ones begin to fade. An even greater risk is addiction, which comes with its own artificially manufactured highs and lows. Over time, drug users lose touch with their emotions and, in doing so, destroy their relationships with others and themselves.
The easy accessibility and perceived safety of prescription drugs have intensified the risks of addiction. Ordinary people with families and jobs are finding themselves hooked on medications. In some cases, the pills were originally prescribed for a legitimate medical purpose, such as to treat the pain of an injury or accident, and the individual became dependent over time. There is also a growing population that sets out to abuse prescription medications for their euphoric, stimulating or relaxing effects.