Prescription Drug Abuse Facts
Although most patients use medications
as directed, abuse of and addiction to prescription
drugs are public health problems for many
Americans. However, addiction rarely occurs
among those who use pain relievers, CNS depressants,
or stimulants as prescribed; the risk for
addiction exists when these medications are
used in ways other than as prescribed. Health
care providers such as primary care physicians,
nurse practitioners, and pharmacists as well
as patients can all play a role in preventing
and detecting prescription drug abuse.
Role of health care providers
About 70 percent of Americans - approximately
191 million people - visit a health care
provider, such as a primary care physician,
at least once every 2 years. Thus, health
care providers are in a unique position not
only to prescribe needed medications appropriately,
but also to identify prescription drug abuse
when it exists and help the patient recognize
the problem, set goals for recovery, and
seek appropriate treatment when necessary.
Screening for any type of substance abuse
can be incorporated into routine history
taking with questions about what prescriptions
and over-the-counter medicines the patient
is taking and why. Screening also can be
performed if a patient presents with specific
symptoms associated with problem use of a
substance.
Over time, providers should note any rapid increases
in the amount of a medication needed - which
may indicate the development of tolerance
- or frequent requests for refills before
the quantity prescribed should have been
used. They should also be alert to the fact
that those addicted to prescription medications
may engage in "doctor shopping," moving from
provider to provider in an effort to get
multiple prescriptions for the drug they
abuse.
Preventing or stopping prescription drug
abuse is an important part of patient care.
However, health care providers should not
avoid prescribing or administering strong
CNS depressants and painkillers, if they
are needed. (See box on pain and opiophobia.)
Role of pharmacists
Pharmacists can play a key role in preventing
prescription drug misuse and abuse by providing
clear information and advice about how to
take a medication appropriately, about the
effects the medication may have, and about
any possible drug interactions. Pharmacists
can help prevent prescription fraud or diversion
by looking for false or altered prescription
forms. Many pharmacies have developed "hotlines" to
alert other pharmacies in the region when
a fraud is detected.
Role of patients
There are several ways that patients can
prevent prescription drug abuse. When visiting
the doctor, provide a complete medical history
and a description of the reason for the visit
to ensure that the doctor understands the
complaint and can prescribe appropriate medication.
If a doctor prescribes a pain medication,
stimulant, or CNS depressant, follow the
directions for use carefully and learn about
the effects that the drug could have, especially
during the first few days during which the
body is adapting to the medication. Also
be aware of potential interactions with other
drugs by reading all information provided
by the pharmacist. Do not increase or decrease
doses or abruptly stop taking a prescription
without consulting a health care provider
first. For example, if you are taking a pain
reliever for chronic pain and the medication
no longer seems to be effectively controlling
the pain, speak with your physician; do not
increase the dose on your own. Finally, never
use another person's prescription.
Source: National Institute on Drug Addiction |
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