Addictive Disorders

Opiates

Concern about the abuse of prescription painkillers has risen dramatically in the U.S. Of particular concern is the abuse of pain medications containing opiates (also known as narcotic analgesics), marketed under such brand names as Vicodin, OxyContin, Percocet, Demerol, and Darvon. According to the Drug Abuse Warning Network (DAWN), the incidence of emergency department (ED) visits related to narcotic analgesic abuse has been increasing in the U.S. since the mid-1990s, and more than doubled between 1994 and 2001.

• In 2001, there were an estimated 90,232 ED visits related to narcotic analgesic abuse, a 117 percent increase since 1994.
• Nationally, narcotic analgesics were involved in 14 percent of all drug abuse-related ED visits in 2001.
• In 2001, approximately one-third of the narcotic analgesics reported to DAWN were not specified by name (32,196 mentions). Among the named narcotic analgesics, hydrocodone led with 21,567 mentions, followed by oxycodone (18,409 mentions).
• Oxycodone mentions increased 70 percent from 2000 to 2001, compared to the 186 percent surge in mentions from 1999 to 2000. However, mentions of most narcotic analgesics did not increase from 2000 to 2001.
• From 1994 to 2001, the only narcotic analgesic that declined was codeine. Mentions decreased 61 percent, from 9,439 to 3,720.
• Dependence was the most frequently mentioned motive for narcotic analgesic abuse cases (38,941), followed by suicide (24,576), psychic effects (13,949), unknown motive (11,039), and other motives (1,727).
• In 2001, the average age was 37 for patients who attended the ED because of narcotic analgesic abuse.

MIS-USE, ABUSE, AND ADDICTION

Prescription drugs are medicines that are given to a patient by a doctor to treat a specific health condition. Prescription drugs make complex surgeries possible, relieve pain for millions of people, and enable individuals with certain medical conditions, like diabetes, to control their symptoms. Prescription drugs are not harmful if they are used properly and only under a doctor’s supervision. However, taking prescription drugs without a doctor’s approval and supervision can be a dangerous, even deadly, decision.

Using prescription drugs without a doctor’s approval (non-medical use) could lead to serious health problems. Data from the 2002 National Survey on Drug Use and Health show the second most common type of illegal drug use after marijuana is the non-medical use of prescription drugs. And it’s not just adults that are abusing these drugs. Another recent survey revealed that 10.5 percent of 12th-graders reported using Vicodin® (the brand name of the pain reliever hydrocodone) without a prescription in the 12 months prior to the survey and 4.5 percent said they had used OxyContin® (the brand name of the pain reliever oxycodone) in that time period.

The Difference between Mis-Use and Abuse

Prescription drugs can be both mis-used and abused. These two words have different meanings. A person with a valid drug prescription can mis-use it if he or she doesn’t follow the directions properly. For example, if a prescription says to take one pill every four hours and then the user takes three pills every four hours instead, he or she is mis-using the drug. Sometimes, people think that taking more of a drug will make its effect happen quicker. This is a mistake. Prescription drug instructions are carefully designed and serious consequences, like overdosing, can occur when these instructions are not followed.

Abuse means that a person, with or without a prescription, intentionally takes a prescription drug to get high or for some reason other than what the drug is intended to treat. The difference between mis-use and abuse is the person’s intention – is he or she using it inappropriately out of ignorance (mis-use) or is he or she intentionally using it for a non-medical purpose (abuse)?

Both mis-use and abuse of prescription drugs are very dangerous and can have the same dangerous consequences.