Prescription Drugs and Pain Medications

Prescription drugs make complex surgery possible, relieve pain for millions of people, and enable many individuals with chronic medical conditions to control their symptoms and lead productive lives. Most people who take prescription medications use them responsibly. However, the non-medical use of prescription drugs is a serious public health concern. Nonmedical use of prescription drugs like opioids, central nervous system (CNS) depressants, and stimulants can lead to abuse and addiction, characterized by compulsive drug seeking and use.

Addiction rarely occurs among people who use a pain reliever, CNS depressant, or stimulant as prescribed; however, inappropriate use of prescription drugs can lead to addiction in some cases. Patients, healthcare professionals, and pharmacists all have roles in preventing misuse and addiction. For example, if a doctor prescribes a pain medication, CNS depressant, or stimulant, the patient should follow the directions for use carefully, and also learn what effects the drug could have and potential interactions with other drugs by reading all information provided by the pharmacist. Physicians and other health care providers should screen for any type of substance abuse during routine history-taking with questions about what prescriptions and over-the-counter medicines the patient is taking and why.

Trends in Prescription Drug Abuse

In 1999, an estimated 4 million people, about 2 percent of the population age 12 and older, were currently (use in past month) using prescription drugs non-medically. Of these, 2.6 million misused pain relievers, 1.3 million misused sedatives and tranquilizers, and 0.9 million misused stimulants.1 While prescription drug abuse affects many Americans, some trends of particular concern can be seen among older adults, adolescents, and women.

The misuse of prescribed medications may be the most common form of drug abuse among the elderly. Older people are prescribed medications about three times more frequently than the general population, and have poorer compliance with directions for use.

The National Household Survey on Drug Abuse1 numbers indicate that the sharpest increases in new users of prescription drugs for non-medical purposes occur in 12 to 17 and 18 to 25 year-olds. Among 12 to 14 year-olds, psychotherapeutics (e.g., pain killers, tranquilizers, sedatives, and stimulants) were reported to be one of two primary drugs used.

The 1999 Monitoring the Future Survey₂ of 8th, 10th, and 12th graders nationwide, showed that for barbiturates, tranquilizers, and narcotics other than heroin, general long-term declines in use in the 1980s leveled-off in the early 1990s, with modest increases again in the mid-1990s.

Overall, men and women have roughly similar rates of nonmedical use of prescription drugs, with the exception of 12 to 17 year olds. In this age group, young women are more likely than young men to use psychotherapeutic drugs nonmedically. Also, among women and men who use either a sedative, anti-anxiety drug, or hypnotic, women are almost twice as likely to become addicted.₃

The Drug Abuse Warning Network,₄ which collects data on drug-related hospital emergency room episodes, reported that mentions of hydrocodone as a cause for visiting an emergency room increased 37 percent among all age groups from 1997 to 1999. Also, mentions of clonazepam increased 102 percent since 1992.