Prescription Drug Abuse
Original Editors - Lauren Cotton & Erin Smith from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description[edit | edit source]
Prescription drug abuse occurs when someone uses a prescribed medication for purposes other than what it was intended for, use more than the dose prescribed by the physician, or continue prolonged use after the amount prescribed by the physician was taken[1]. Abuse of prescription medications can produce serious adverse health effects, including addiction[2].
Prescribed drugs that are commonly abused in the healthcare system are narcotic painkillers. Narcotics are natural opioid drugs that can help to reduce pain, and can also promote drowsiness. Physicians commonly use narcotics to reduce a patient’s post-operative pain or to reduce anxiety and induce anesthesia prior to an operation (2). These drugs are also commonly prescribed to “enable individuals with chronic pain to lead productive lives[2].”
“Opioids are analgesic, or pain-relieving, medications. Studies have shown that properly managed medical use (taken exactly as prescribed) of opioid analgesics is safe, can manage pain effectively, and rarely causes addiction (3).” However, many people who are prescribed and taking opioids for a period of time may develop a physical dependence on the drug which could lead to abuse of the painkiller and will require medical supervision (3). Some examples of opioids that you may see commonly abused in the healthcare system are (3):
• Hydrocodone (e.g., Vicodin)
• Oxycodone (e.g., OxyContin)
• Codeine
• Propoxyphene (Darvon)
• Meperidine (Demerol)
• Lortab (5)
• Dilaudid (5)
• Lorcet (5)
• Tylox (5)
• Percocet (5)
• Percodan (5)
Prevalence[edit | edit source]
The prevalence of prescription drug abuse is at a dangerously high level. According to the Centers for Disease Control, “In 2010, about 12 million Americans (age 12 or older) reported nonmedical use of prescription painkillers in the past year”. (3) The results of the National Survey on Drug Use and Health (2010) showed that “an estimated 2.4 million Americans used prescription drugs non-medically for the first time within the past year” (1). These numbers show that this problem is one that deserves the attention of the healthcare community.
The Drug Abuse Warning Network, which monitors emergency department visits across the country, stated that “an estimated 1,079,683 ED visits in 2009 involved the nonmedical use of prescription drugs, over-the-counter medicines, or other types of pharmaceuticals“ (2). Prescription pain relievers were the drugs used most commonly, with oxycodone, hydrocodone, and methadone rating the highest amongs the drugs used (2).
The population affected the most by prescription drug abuse includes those ages 18-25, with a percentage of prescription drug use non-medically at 5.9% (4). However, another age group at a higher risk for prescription drug abuse is the older adult group (65+). More than 1/3 of the total dollars spent on outpatient prescription medications in the US come from this population. Due to the prevalence of co-morbidities and chronic disease, the older population is more likely to be prescribed long term medications as well as multiple medications, which leads to a greater chance for improper use (4).
Characteristics/Clinical Presentation[edit | edit source]
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Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports/ Case Studies[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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- ↑ Mayo Clinic. Prescription Drug Abuse. http://www.mayoclinic.com/print/prescription-drug-abuse/DS01079/METHOD=print&DSECTION=all (accessed 15 March 2012).
- ↑ 2.0 2.1 The Free Dictionary. Narcotics. http://medical-dictionary.thefreedictionary.com/Narcotics (accessed 19 March 2012).