America’s Drugs: From Prescription to Addiction | February Editor’s Choice

VIVEK TRIVEDI | Senior Editor

The United States has been facing a drug epidemic for the larger part of the last decade, with more Americans using illicit substances now than ever before 1. A more subtle issue that we have been facing is the rise of addictions to prescription drugs, as Shoshana First described in her 2014 article entitled “The Contemporary Amphetamine Epidemic.” Her article highlights the prevalence of Adderall abuse, as a way for college students to study for longer hours. This is only symptomatic of a larger trend, the overprescription of Schedule II substances, which indubitably contributed to the widespread addiction we see today.

Across the country there have been dramatic increases in the illicit use and sale of prescription drugs. The situation has become critical in states like Florida, where doctors prescribe ten times as many oxycodone pills as the rest of America’s doctors combined 4. With an increased demand for opioids, Florida witnessed a concomitant increase in the number of pain clinics. Dubbed “pill mills,” one sheriff has said that the number of pain clinics has exceeded the number of McDonald’s restaurants 2. This is because until 2011, Florida was one of the few states without a prescription drug monitoring program (PDMP). Potential abusers would go “doctor shopping” from clinic to clinic, receiving multiple prescriptions for the same ailment. These pills were then sold on the black market for hefty profits. Although a PDMP has been implemented in most states, they have not managed to dissuade more ambitious drug dealers, who are willing to cross multiple state lines to obtain pills.

The ready availability of these controlled substances has fueled an ongoing epidemic. The demand mostly comes from patients who developed addictions to their prescribed pain medications. Once their prescriptions expire, they turn to the black market, often paying a premium to get their fix. Those who cannot afford to turn to non-pharmaceutical grade derivatives of opioids such as heroin. These drugs are generally manufactured clandestinely, have indeterminate compositions and potencies, and are more likely to lead to addiction or an overdose. To make matters worse, as drug addicts become physiologically and mentally tolerant of heroin, the need for a more powerful drug arises. The DEA reports an increase in the past decade in the illicit sale of fentanyl, which is 100 times more potent than morphine and many more times that of heroine. Very recently, law enforcement officials have discovered that drug dealers are now selling carfentanil, which is commercially used as elephant tranquilizer. The drug is 10,000 times more potent than morphine and 100 times more potent than fentanyl. These drugs are prone to misuse and incorrect dosing, often lethally 3.

Despite motions by the new administration to deregulate the pharmaceutical industry, it appears that a national prescription monitoring program is very much needed. The media often understates the epidemic that has swept the nation, with disjointed, sparse reporting of singular overdoses without addressing the root of the problem. A national discussion on the prescription and sale of pharmaceutical drugs is simply essential to begin reversing this insidious trend.

References:
[1] Awad, Susan. “American Society of Addiction Medicine.” Increased Marijuana, Heroin Use Contribute to Highest Reported Illicit Drug Use in More than a Decade. ASAM, 10 Sept. 2015. Web. 31 Jan. 2017.
[2] Lainie Rutkow JD. “Florida Prescription Drug Monitoring Program, Pill Mill Laws, and Opioids.” Florida Prescription Drug Monitoring Program, Pill Mill Laws, and Opioids | Law and Medicine | JAMA Internal Medicine | The JAMA Network. N.p., 01 Oct. 2015. Web. 31 Jan. 2017.
[3] “Fargo Police Warn of Powerful, Deadly Drug Reaching Area.” Grand Forks Herald. N.p., 23 Jan. 2017. Web. 31 Jan. 2017.
[4] “Nationwide Trends.” DrugFacts: Nationwide Trends | National Institute on Drug Abuse (NIDA). NIH, June 2015. Web. 31 Jan. 2017.

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