The abuse of prescription drugs, from stimulant medication to painkillers, has emerged as a central issue in the battle to curb drug abuse and addiction. But a new study released this week suggests that efforts to educate consumers and tighten prescribing practices over the past few years may be having an impact.
A survey recently released by the U.S. Substance Abuse and Mental Health Services Administration found that the number of people ages 18 to 25 who said they used prescription drugs for non-medical purposes in the past month fell 14 percent between 2010 and 2011, dropping from an estimated 2 million down to 1.7 million. The data come from the 23rd annual National Survey on Drug Use and Health which questions about 70,000 people ages 12 and older in order to make national projections.
Overall, 3.1 percent of those surveyed said they were current users (which is defined as taking an illicit substance other than marijuana within the past month). That's about eight million Americans. About 7 percent of people say they are marijuana users. But the next-highest category of abuse belonged to prescription drugs with 6.1 million people -- 2.4 percent of those surveyed -- using prescription drugs for nonmedical purposes. That rate was down from 2.7 percent in 2010 and 2.8 percent in 2009.
Despite the drop, prescription drug abuse is a major public-health problem resulting in a huge surge in people seeking treatment for addictions and costing the healthcare system and law-enforcement agencies billions of dollars. In the past five years, there has been a four-fold increase in emergency-room visits related to illicit use of prescription drugs and nearly a four-fold rise in the number of people seeking treatment due to dependence on prescription drugs.
It's unclear what accounts for this new decline among young adults, but Peter J. Delany, director of SAMHSA's Center for Substance Abuse Treatment, told TakePart he has some theories. For several years, there has been a dip in illicit prescription drug use among the youngest age bracket, people ages 12 to 17. That trend may now be showing up in the age 18 to 25 group.
"This is a significant decrease; 14 percent is a pretty good drop," Delany says. "We think it's probably due in part to the aging of a cohort that was starting to use less. At the same time, we have been doing a better job for several years now of paying attention to this problem."
Parents and teachers appear to be heeding the message that unused prescription pain medications shouldn't be left in medicine cabinets or bathroom drawers, Delany says. Studies show most people who abuse prescription medications get the drugs from family members or friends -- not from dealers on the street.
"There has been a whole lot of evidence about the effectiveness of getting communities and parents to control these substances while they are in the house," he says. "You don't give someone your narcotic pain reliever if they have a problem. A doctor has to prescribe it."
The best thing parents and community leaders can do is talk to kids, from school-aged through college-aged, about drug abuse, he says.
"Be open and available to talk about these issues -- making them aware of your concerns and your disapproval of misusing drugs -- and giving them honest information about the impact," Delany says.
Don't use scare tactics. But tell kids: "There are some real consequences that can happen to you."
Doctors have also heeded advice from the federal government to use caution in prescribing medications that have the potential to cause dependence in patients. The prescription drug monitoring program is a statewide electronic database that collects data on substances dispensed in that state.
For example, the program can show, "Is this guy coming from across the state line doctor shopping?" Delany says. "We're doing a lot to work with our partners at the state level ... so states can talk to each other."
Several types of prescription drugs are subject to abuse, including pain relievers, stimulants, sedatives and tranquilizers. But opioid painkillers are of greatest concern to public health officials. The survey found that 3.6 percent of young adults said they were currently using pain relievers for nonmedical reasons. That compares to 4.4 percent in 2010.
Health officials walk a fine line of not making it harder for Americans who need opioids to get the medications and wanting to curb misuse and abuse. Two decades ago, there were far fewer effective options to help people with acute, chronic pain, Delany said.
"We don't want to throw the baby out with bathwater," he says. "These are very helpful medication for people with acute chronic pain. It's when they move from being used medically to non-medically that we see the problems."
Other key findings in the report:
Overall, 22.5 million Americans ages 12 and older -- 8.7 percent of the population -- used illicit drugs in 2011 compared to 8.9 percent in 2010. Marijuana is the most commonly used illicit drug. Seven percent of American were current users in 2011 -- an increase from 5.8 percent in 2007. Marijuana use in teens has remained relatively steady from 2009 to 2011 at 7.9 percent. Tobacco use in teens continues to drop, from a rate of 15.2 percent in 2002 to 10 percent in 2011. The number of Americans who used heroin grew from 373,000 in 2007 to 620,000 last year. An estimated 21.6 million American need treatment for drug or alcohol abuse but only about 11 percent of them get help in a specialized treatment setting.
Should doctors be more careful about prescribing opioid painkillers to their patients? Let us know in the comments.
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Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.