I was just reading a statement from the Office of National Drug Control Policy (ONDCP) that abuse of prescription drugs to get high has become increasingly prevalent among teens and young adults. According to ONDCP, "Past year abuse of prescription pain killers now ranks second—only behind marijuana—as the Nation's most prevalent illegal drug problem." The DEA reports similar statistics.
Unfortunately, now that this surge in prescription drug abuse has replaced the "traditional" drugs of abuse (cocaine, heroin, hallucinogens, and inhalants) combined, I can only wonder how the magnitude of this "legal" drug abuse is affecting the already overburdened pharmacists' time and efforts to provide care to the legitimate patients. Not to mention the safety threat to pharmacists and their staff from the increased levels of pharmacy robberies resulting from prescription drug abuse.
I'm surprised that I haven't read more complaints about the rise in prescription abuse online or in the retail journals. Is this a taboo subject? I don't know, but if you've been reading this blog for a while then you're probably already aware of my complaints of having to deal with the manipulative schemes of drug abusers.
The actions of these individuals wreak havoc upon themselves, their families, and both the healthcare and legal systems. Personally, I don't like being what can essentially be considered, their "dealer". Having to deal with these people really gets on my nerves. I guess it could be said, that as a pharmacist, one should expect that it comes with the territory. But, it seems to be getting more dangerous and out of hand. Abusers are determined to get their drugs and they're not going to allow some pharmacist to stand in their way.
What also gets on my nerves is that, as a healthcare professional, I'm expected by some other healthcare professionals to buy into the theory that drug abusers aren't responsible for their own actions, and that their disease causes them to abuse drugs. Let me show you what I mean.
Here's a first paragraph excerpt from the National Institute on Drug Abuse, Addiction: "Drugs, Brains, and Behavior - The Science of Addiction" website:
How Science Has Revolutionized the Understanding of Drug Addiction -
Throughout much of the last century, scientists studying drug abuse labored in the shadows of powerful myths and misconceptions about the nature of addiction. When science began to study addictive behavior in the 1930s, people addicted to drugs were thought to be morally flawed and lacking in willpower. Those views shaped society's responses to drug abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punitive rather than preventative and therapeutic actions. Today, thanks to science, our views and our responses to drug abuse have changed dramatically. Groundbreaking discoveries about the brain have revolutionized our understanding of drug addiction, enabling us to respond effectively to the problem.
NIDA further writes that "As a result of scientific research, we know that addiction is a disease that affects both brain and behavior."
I don't fully agree with this statement. Of course, I'm not dissing the scientific studies and the fact that treatments for addiction should be designed based upon these scientific discoveries. I also agree that once addicted, an addict is at the mercy of his/her disease. What I'm dissing is the thought that drug addiction is fully a consequence of a disease, and not a personal failing. I believe that most people make an intentional choice to abuse drugs. The disease doesn't make them abuse drugs.
Sure, once addicted, I agree that it's very difficult for an abuser to stop taking drugs. But on the other hand, most addicts
initially decide to abuse drugs without already being exposed to those drugs beforehand. Therefore they make a conscious, intentional, and fully aware decision to accept the risks and consequences of their actions, unaltered by any chemical affects from those drugs on the brain. They are personally responsible for their own addiction.
It seems to me that, like some
newly created psychiatric disorders, the concept of science is being mis-used to shift blame away from personal responsibility for one's actions. In a way, it's almost like manufacturing victims. A disease is being used to justify illicit behavior. I've heard it all before, "It's not my fault, the disease made me do it".
Of course, there will always be legitimate patients who've become addicted only after being prescribed controlled-substances secondary to some type of trauma or medical condition. I also understand that the use these substances, not a moral flaw or lack of willpower, does affect one's ability to make rational decisions. But don't expect me to believe that this type of situation causes the majority of drug abuse. I don't buy it.
Now don't get me wrong, I know this is not a black and white topic. There's always going to be a gray area or an exception to the rule. I'm all for preventative measures and treatment of addiction, whether voluntary or imposed. I'm also for forgiving and supporting those who've accepted responsibility, cleaned up their act and sincerely turned their life around. It goes without saying that nobody's perfect, especially me.
But who are we kidding? Just like most smokers and drinkers, most drug abusers are well aware of the risks and consequences of their actions
before deciding to abuse drugs. Unfortunately, they choose to abuse those drugs regardless of those risks and consequences.
For example, what about the educated healthcare professional, without a legitimate prescription and fully aware of the potentially addictive properties of controlled-substances, but who decides to abuse those drugs anyway? Did the addiction make him/her do it, or are they responsible for their own decisions?
What about the person who decides to raid someone else's medicine cabinet because it's the weekend and he/she just wants to "get high"? Again, a personal decision made without having taken any drugs beforehand, and with full mental faculties.
Science shouldn't be used as an excuse for poor personal choices.
I'm not sure what to make of this rise in prescription abuse, and all of the potential problems it could cause in the workplace. I also don't propose to have an answer or a solution in dealing with it. I'm just ranting and putting this topic out for discussion. However, I do believe that finding excuses for intentional drug abusers or coddling them isn't the answer. What do you think?
Related Links -
AZBOP: Controlled Substances Prescription Monitoring Program
RxPatrol.org
National Institute on Drug Abuse
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