09 Mar Prescription Drug Abuse Widely Misunderstood
Understanding the Misunderstood – About Prescription Drug Abuse
By Dr Ben Teoh, Medical Superintendent at South Pacific Private
In a recent interview with the Medical Observer Dr. Ben Teoh spoke of the wide misunderstanding surrounding prescription drugs. Read the article here.
Although most people use prescription drugs appropriately and effectively, there has been a significant increase in the number of cases where these drugs have been abused.
Recent reports have revealed a marked increase in the deaths of people who have abused prescribed opiates. Many of these deaths involved young people below the age of 25. Further, prescription drugs are now reported as the second most commonly abused category of drugs after cannabis; ahead of cocaine, heroin, and methamphetamine.
Prescription drug abuse (PDA) has a long history involving different classes of medication: opiates, CNS Depressants (benzodiazepines, hypnotics, barbiturates) and stimulants. Two of the most frequently reported prescription medications in drug abuse-related cases are benzodiazepines (e.g., diazepam, alprazolam, clonazepam, and lorazepam) and opioid analgesics, (e.g., oxycodone, hydrocodone, morphine, methadone).
In regard to opioid use, there has been a substantial increase in Australia and New Zealand in recent years. In Australia, there was a 40-fold increase in oral morphine supply between 1990 and 2006, and a nearly four-fold increase in oxycodone supply between 2009 and 2013.
These figures indicate the widespread misuse of prescription drugs and yet this addiction remains widely misunderstood. It is challenging for clinicians managing patients with chronic pain to decide on the provision of adequate analgesia, while also preventing abuse of the medication.
Where to draw the line between medication and addiction?
The question for many is: Where is the line between appropriate use and addiction to prescription pain medicines?
Signs of inappropriate use or abuse can include using the medications without consultation with a doctor and ‘doctor shopping’ e.g. visiting several doctors to get prescriptions without telling them about the prescriptions already acquired. In these situations it is likely that the drug misuse is causing problems for their physical and mental health, their relationships, and their ability to function with their everyday lives.
Other signs include excessive use and tolerance, aggression and irritability, hoarding and saving drugs, inappropriate use, e.g. for stress, concurrent use of illicit drugs, and complaints by family and friends.
Treating the addiction
Treating patients with an addiction to prescription drugs is challenging and involves working closely with mental health and pain specialists, GPs and other health professionals.
Successful treatment for addiction will likely also require a combination of components including detoxification, counselling, psychotherapy and sometimes inpatient admission.
When treating addiction it is important to understand the family and relational legacy with respect to the patient. A family history of alcohol, addiction, mood disorders or trauma is a mitigating factor to be taken into consideration.
When assessing the patient, it is important to take note of a history of addiction and or recovery from that addiction; both factors that need to be carefully considered as part of the story. That history would potentially place a patient at a higher risk of addiction (to any substance including prescription drugs) and may impact treatment options and decisions.
Addiction is a cunning, baffling and deadly disease. However, years of research have shown that addiction to any drug (illicit or prescribed) is a brain disease that can be arrested and an addict can move into recovery and go on to lead fulfilling and healthy life.
About South Pacific Private
South Pacific Private is Australia’s leading mental health and addiction treatment facility offering inpatient and day programs to treat anxiety disorders, mood disorders, post-traumatic stress disorder, behavioural addictions, alcohol addiction and substance abuse. Treatment at South Pacific Private offers the best possibility of recovery through its multidisciplinary, tailored programs which are designed to meet the individual needs of clients. www.southpacificprivate.com.au / firstname.lastname@example.org