Last year the Obama administration launched the National Drug Control Strategy with a focus on drug prevention and recovery. According to its mission statement, drug addiction is ‘not a moral failing but rather a disease of the brain’. While the change of rhetoric dates to 2010, what is new is that a form of addiction previously sidelined in US drug policy is now taking centre stage: addiction to prescription drugs.
In the video message used to launch the Strategy, Michael Botticelli, the acting director of the National Drug Control Policy, calls on doctors to be more cautious when issuing prescriptions.
How widespread is prescription drug addiction?
The Center for Disease Control and Prevention classifies the widespread dependence on opioid medicine in the US as an epidemic. According to one of its reports there were 16,235 recorded deaths from prescription drugs in 2013. Compare this with the relatively lower figure of 8,257 deaths from heroin abuse for the same year and it quickly becomes apparent that prescription drug abuse is the most serious opioid addiction issue facing the US today.
The ready availability of these drugs is a major cause for concern. While some opiate-based painkillers are easily available online, around 53% of teenagers in the US procure prescription drugs through friends or family and 23% acquire them directly from doctors. (These figures are discussed in more detail in a previous post.)
American general practitioner Todd Jaffe says that many abuse cases result from ‘poorly educated physicians who misprescribed opiates and those who over prescribe for money’. So it is difficult to be sure opiate-based medicines are getting into the right hands.
What is being done to combat the epidemic?
The US authorities’ strategy to tackle prescription drug abuse is divided into four main areas: education, monitoring, access to medicine, and treatment and enforcement.
The main focus is monitoring access to medicine. Monitoring takes place through drug prevention initiatives set up across the US called Prescription Drug Monitoring Programs. According to a report by Forbes, this year 100 million dollars will be allocated to opioid addiction prevention alone, and this includes prescription drugs as well as heroin.
Will the plan work?
Reaction from the medical community has been mixed. Some, such as Dr Andrew Kolodny of the Phoenix House addiction treatment centre, have praised the allotment of new funds to the issue while pointing out the limited scope of the initiative. “I’m pleased to finally see this, but it’s very little, very late, and only a small portion of the $100 million is for expanding access to opioid treatment addiction,” Kolodny told Forbes.
On the other hand, Dr Todd Jaffe believes the bureaucracy in the system could counteract the positive effects of the investment. “The NIH [National Institutes of Health] claims 2.1 million people [are] addicted to prescription drugs… but ignores the excessive users, not yet addicted, which is much higher.’’ He also points out that many practices fail to charge the discounted rate: ‘’Any time you put a layer of bureaucracy between the patient and the doctor, health suffers.”
While the new policy initiatives are good at raising awareness on the alarming problem of prescription drugs addiction, time will tell if this will yield any clear results. In the meantime, it does serve as example and a possible course of action for other countries that are struggling with the problem of prescription drugs abuse.