Prescription drug abuse tragedies impact many as epidemic continues

Advocates call for better education, legislation

Published: Wednesday, Aug. 15 2012 8:00 p.m. MDT

"If parents don't get it, how can we expect kids to get it?" Bauer said. "Sometimes we need to shock parents. They need to wake up and realize that sometimes they are the drug dealers."

If a teen is prescribed a prescription such as Ritalin or even a sleep aid, the parents must monitor the use of the drug closely, said Leonard Paulozzi, a medical epidemiologist in the Division of Unintentional Injury Prevention of the National Center for Injury Prevention and Control and a Center for Disease Control expert on drug overdoses.

"Know how many pills are in the vial and make sure they take it on schedule," he said. "Don't get prescriptions and fill them just in case. Minimize the amount of drugs used in the home in the first place."

Doctors who over-prescribe patients with larger quantities than necessary is a central concern for experts like Pasierb. He described the ease of accessibility and relatively lax attitude about prescription medications as gateways to abuse.

"Someone who goes to the dentist for a tooth extraction might need two or three hydrocodone tablets to get them through the next 24 hours, but instead they go home with 30," Pasierb said. "Well you know where the other 27 go, on the shelf in the bathroom. So we still have prescribers putting a huge volume of these products into American homes."

Pasierb agrees that parents must recognize the dangers of leaving medicines unsecured as well as working to dispose of medications that are no longer needed.

"The one key word is responsibility," he said. "Parents need to safeguard their medicines by locking them up and educating their family about the risks."

Taking action

In terms of laws regulating prescription drugs, most of the control is at the state level, Paulozzi said.

"There has been an explosion in legislation on state levels in recent years," he said. "These are intuitive approaches that make sense, but there is no quantitative evidence yet of what works."

Recent legislation was introduced by Sen. Bob Casey of Pennsylvania and Sen. Lisa Murkowski of Alaska aimed at stopping the abuse of prescription cough medicine. The legislation would prohibit the sale of over-the-counter cough medicines containing dextromethorphan to teens under 18. Despite this progress, more needs to be done, Pasierb said.

"Doctors need to make sure their patient understands exactly what the prescription is and that the patients gets the appropriate prescription in the appropriate quantity," Pasierb said. "It begins with prescribers and it begins with patients."

Prescription monitoring is something that has been implemented in states like Kentucky, but in many states it is not fully funded or implemented, Pasierb said. Prescription monitoring allows doctors to keep an accurate database of patients and their prescriptions so that patients can no longer "doctor shop" or go around to various doctors looking for more and more prescription drugs.

Most states now have laws against doctor shopping, but they are not enforced uniformly, according to the CDC. For-profit clinics that distribute controlled substances with minimal medical evaluation, often called "pill mills," have few state laws regulating their activity. According to the National Alliance for Model State Drug Laws and the CDC, only 15 states required or permitted pharmacists to request identification from persons obtaining controlled substances as of March 2009.

"There are states, such as Utah and North Carolina, that have shown some progress," Paulozzi said. "But I wouldn't want to declare victory prematurely. Mortality rates have risen steadily for a decade, and we still have millions of people who are physically dependent on these drugs."

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