DRUG DEATHS OUTNUMBERED TRAFFIC FATALITIES

ticular medication does not work, the doctor may prescribe a different one. It becomes trial and error,” he says. “The thing is these patients are not returning or throwing away the medication that originally did not work. And once they become hooked, it becomes a no-holds-barred reaction. They will likely engage in criminal activity or do whatever is necessary to obtain this medication.”

Researchers believe the solution to overprescribing antidepressants could lie in training both the public and non-psychiatrist physicians regarding the proper use of these medications.

Most antidepressants are serotonin-specific reuptake inhibitors (SSRIs), which basically work by supplying more of the neurotransmitter serotonin to certain areas of the brain. This does not cause the user to get “high,” instead it gradually causes a change in mood and behavior over time.

SSRIs have been linked to increased suicidal tendencies in persons less than 25 years of age, but some research shows that for adults over age 25 the suicide rate has actually dropped, especially for women. SSRIs can be fatal in very large doses, but such deaths are relatively rare.

Presently more than three out of four prescription drug overdose deaths are from painkillers and one-half of those deaths involve at least one other drug… and many times that drug is alcohol. Both are central nervous system depressants, which slow breathing. When taken together, their overall potency is vastly increased and the person goes into respiratory arrest.

According to a recent report by the CDC, although men are still more likely to die from prescription painkiller overdoses, deaths among women have increased fivefold in the last 10 years. That is four times more than the number of overdose deaths from heroin and cocaine combined.

What makes the numbers for women even more disturbing is the fact the overwhelming majority of deaths came about through the combined use of painkillers and sedatives. The CDC says this is solid evidence that prescription drug monitoring programs are not working as well as they should.

CDC researchers also say physicians are prescribing painkillers more readily for patients who may not need them and states such as Washington have taken legislative steps to curb such practices. Recent legislation there requires physicians to refer patients who have been on painkillers for extended periods of time with no evident signs of relief to pain specialists for further evaluation.

Stimulants

Stimulants are amphetamines primarily used to treat ADHD. They increase the levels of the neurotransmitter dopamine in the brain. Dopamine is associated with the feeling of pleasure, movement, and awareness or attention. When the drugs are used according to a physician’s directions they increase dopamine levels in the brain gradually and help children and young adults overcome the symptoms of ADHD.

However, this class of drugs can easily be abused. When the pills are crushed and snorted or injected, they cause a drastic rise in dopamine levels and create a euphoric stimulant high.

This high is addictive. Once stimulant use becomes chronic, more of each drug is needed to attain the level of euphoria, and an endless cycle is born. When the person abusing the drug cannot attain adequate levels to maintain their high, they suffer symptoms of withdrawal.

According to Dr. Deas, stimulant use is on the rise among today’s youth. “Unfortunately, they use it for the effect of becoming high instead of what the medication is actually prescribed for. Stimulants become very dangerous when mixed with marijuana, pain medication, and alcohol. What I’m seeing is children ages 12 to 18 who are stealing stimulants from their parents or grandparents, taking them to school, and selling them. They can get anywhere from $5 to $18 just for one pill.”

Stimulants can cause heart arrhythmias, heart failure, high blood pressure, seizures, stroke, dangerously high body temperatures and psychosis that may lead to aggressive behavior. Some research is beginning to show that chronic stimulant abuse may cause permanent and irreparable damage to synaptic nerve endings in the brain, causing the abuser to have lifelong adverse neurological problems even after no longer taking the drugs.

Sedatives

Sedatives have two main classes: barbiturates and benzodiazepines. They are used to treat anxiety, stress, panic attacks, and disrupted sleep patterns. Sedatives are widely prescribed by primary care physicians and almost 2 million Americans abuse sedatives and tranquilizers each year.

They are central nervous system depressants and when combined with painkillers or alcohol, can cause respiratory failure and death. The vast majority of prescription drug overdose deaths come from the mixing of painkillers and sedatives.

If an abuser cannot find a source of sedatives, he or she will go through a severe and life-threatening withdrawal syndrome. Detoxification should take place in a highly trained, medically based rehab facility under close physician supervision.

A Nation Seeking Answers

Where does change begin? Do we enact stricter laws that include an increased focus on the physicians who are writing the prescriptions of controlled medications and the pharmacists who are indiscriminately filling the prescriptions? Do we seek stricter enforcement of the laws that are already in place? What role do the major pharmaceutical companies play and should they be held responsible for the overprescribing and overuse of the drugs they produce? Do we go all the way back to the medical schools and seek out the possible source of the problem that might include what tomorrow’s doctors are being taught concerning the prescribing of medications?

And what portion of the burden for drug management should fall to the government? As of March, 44 states have initiated programs to track the abuse of prescription medications. These programs were initially created for legal purposes but now are being utilized by health care professionals to help police their own policies of prescribing certain types of controlled medications.

So far, research has shown that although the programs show promise, there is much work to be done. Communication between states is poor and there is no real standardized method of reporting. If these problems can be solved and all states become involved, then possibly a union between the judiciary, law enforcement, and health care professionals can bring some relief to the problem.

So what is the answer to the overuse of prescription drugs in America? The CDC is pressing for standardized prescription drug monitoring programs; patient review and restriction programs; health care provider accountability; increased legislation prohibiting prescription drug abuse and diverting prescription drugs to those who they aren’t prescribed for; and better access to substance abuse programs.

Physicians should monitor patients for abuse and mental health issues and discuss treatment options that don’t include “at risk” prescription drugs.