Why We Should Worry About Prescription Drug Abuse

Are we the Nation of the Dolls? Science Photo Library-Corbis

It's been an exciting summer what with the largest oil spill in history, the battle over regulating Wall Street, the overturning of Prop 8, and Chelsea Clinton's wedding. It's a lot, I know, but I want to revisit something else that happened right around the time the whole Shirley Sherrod disaster hit the front page. About two weeks ago, the U.S. Department of Health's Substance Abuse and Mental Health Services Administration (SAMHSA), reported that abuse of opioid painkillers has risen more than 400 percent over the last decade. And, while it was dutifully reported here and here, there was no real outcry.

Which indicates to me that somehow we in the media didn't explain this well enough. Because this a big deal. After marijuana, pain pills are now the second-most-popular way to get high in America. Gil Kerlikowske, the national drug-policy director, called opioid abuse a serious threat to public health. "These findings should serve as exclamation points to punctuate what we already know—abuse of prescription drugs is our country's fastest-growing drug problem, the source of which lurks far too often in our home medicine cabinets," he said about the new report.

But beyond the policy wonks, nobody seems to get how awful and scary this is. This isn't about taking one of your friend's Vicodins when your back goes out. This is about millions of young people who think that because painkillers are prescribed, they're safe. And if they're safe, adolescent minds reason, they're safe in any quantity or combination. What that shocking 400 percent statistic doesn't begin to tell you are the rising numbers of addictions, overdoses and deaths that result from opioid abuse—all of which have risen exponentially over the same 10 years. According to the Centers for Disease Control and Prevention (CDC), overdose deaths involving prescription drugs increased more than 200 percent from 2001 to 2007, and the number of treatment admissions for prescription opioids increased nearly 300 percent over the same time, according to the SAMHSA. In cities, the most common cause of drug-related deaths is opioids, including prescription drugs and their illegal sibling, heroin.

The old "just say no" approach won't work here. Prescription drugs, like alcohol, aren't illegal—millions of them are lawfully prescribed and appropriately and gratefully used to relieve pain every year. So law enforcement can't solve this problem alone. It's going to take the wholesale retraining of the medical establishment in pain protocols—the Food and Drug Administration is now debating whether training in pain management for medical professionals should be mandatory or voluntary. But it's also going to take a new evaluation of the role of painkillers in medical treatment. That's happening, too—the National Institute on Drug Abuse recently held a conference to address how to get less abusable drugs into the pipeline, how to recognize substance abusers, and how to properly prescribe opioids. And, oh yeah, it's going to take a level of monitoring of both doctors and their patients. Some charge that this is a violation of privacy: in Georgia, a statewide drug-monitoring program is struggling to pass with critics worried that law enforcement should not access patient information while supporters say it's the only way to cut down on doctor shopping. More than anything, though, it's going to take a rethinking of the nature of addiction, and this one might be the hardest of them all.

I talked with Dr. Marvin D. Seppala, chief medical officer of Hazelden, the nationally renowned addiction-treatment center, about why that is. "Opioids are really dangerous, and the data and our experience shows that youths and baby boomers who are the most vulnerable to addiction are also the least likely to understand the risk," he said. "Young people are naive. They take them [opioids] consecutively for a week or two [for fun] and get caught up in an addiction fast." Boomers, of course, are entering their 60s, and with age comes all kinds of pain problems. "If boomers aren't treated properly, they, too, go overboard. And of course, the access is incredible with most doctors untrained in how to properly prescribe these pills," Seppala added. And here's the really scary thing that Seppala told me. Because prescription opioids such as OxyContin, Percocet, and morphine are chemical siblings to heroin, abusing these drugs often serves as a gateway to heroin itself. And thus the rates for heroin use have also risen exponentially over the last ten years. "People don't realize the magnitude of this problem," Seppela continued. "Opioid abuse cuts across all socioeconomic levels and just about anybody can get their hands on it."

And there's no evidence this is going to get any better anytime soon. We are awash in prescription drugs. The U.S. Department of Health estimates that more than 50 percent of Americans take at least one prescribed pill a day. We are inundated by prescription commercials for ailments as varied as fibromialgia, erectile dysfunction, and depression. And no one seems to remember that the deaths of Heath Ledger and Anna Nicole Smith were hastened by a nasty cocktails of pharmaceuticals, with opiates found in both of their bloodstreams after death. "I haven't seen an adequate response yet," Seppala said. "Sadly it may take more celebrity overdoses before the country finally gets the message." That is why I'm reminding us about this statistic now, off the news cycle, because it shouldn't take the deaths of famous people to get our attention.

Kelley is a staff writer covering society and cultural affairs. Find her on Twitter.