Emergency department 'mentions' for prescription narcotics like hydrocodone increased by 170% while oxycodone went up a staggering 450%, all in the space of eight years. This is just part of a general and disturbing upswing in prescription drug abuse exposed in recent statistics released by the NIDA (National Institute on Drug Abuse).



The NIDA records that: "Pain reliever incidence increased from 573,000 initiates in 1990 to 2.5 million initiates in 2000". This is a staggering thought especially when you consider that prescription drug use is supposed to be limited and monitored by stringent measures meant to keep exactly such use and abuse under control.

So what exactly is this prescription drug abuse that has been becoming increasingly popular among the populace?

Almost any prescription drug has the potential to be abused but certain classes of drug are more popular than others. These are the ones that yield a psychoactive effect that either slows the brain down or revs it up.

There are three main classes that are particularly prone to abuse. The Opioids which most of us know as the pain killers with analgesic properties. These prescription narcotics include morphine, codeine and oxycodone. When used in context they provide much needed relief for those in physical pain. Morphine is used for pain relief in surgical procedures while codeine is used for less severe pain.

Oxycodone is found in medications like Percocet and Percodan and it is these drugs that are gaining a powerful presence on our school campuses. It is this particular ingredient that swelled emergency room numbers by 450% in eight years.

Opioids act on the brain by attaching to opioid receptors. This action blocks the perception of pain and may lead to a feeling of euphoria. It is also capable of increasing the medical risk of severe respiratory depression. In simple language the breathing mechanism slows down and may stop completely causing death.

The second class of drug is the CNS depressants. These are subdivided into barbiturates like mephobarbital and benzodiazepines better known as Valium, Librium and Xanax.

CNS depressants effect a neurotransmittor called GABA (gammaaminobutyric acid) that typically slows down brain activity producing a drowsy, calming effect. These prescription drugs are legitimately used for treatment of anxiety, tension and sleep disorders.

Because the body develops a tolerance to these drugs larger and larger doses are needed to achieve the same initial effects. CNS depressants may also lead to heart and respiration complications that may lead to death.

Stimulants are the third class of drug favored by abusers. Stimulants like Dexedrine, Adderall and Ritalin enhance the euphoric effects of neurotransmittors like dopamine and norepinephrine on the brain. They also rev up blood pressure and heart rate, constricting the blood vessels and opening the pathways of the respiratory system.

Withdrawal induces the opposite symptoms like depression, fatigue and disturbed sleep patterns.

Most prescription drug abuse includes two important and dangerous elements. Typically alternative methods of administration like sniffing or injecting increase the risk of addiction along with the tendency of drug abusers to use the drug in a mix with other substances like alcohol or street drugs. Mixing the drugs has a synergistic effect that is not only dangerous but can be fatal.

The war against prescription drug abuse is fought on three main fronts:

1. The Family Doctor

This person is privy to personal information regarding the patient's use and possible abuse of medications. Most practices have screening questionnaires designed to uncover unhealthy drug use patterns though the typical drug addict is far to clever to be taken in by these simple questions.

The doctor may often have to play the subtle game of detective looking below the surface for certain signs that should ring alarm bells for the experienced practitioner.

Although medication prescriptions should not be withheld when they are needed they should be administered with caution. Most doctors have also become aware of the possibility that the patient is 'doctor shopping' for prescriptions.

2. The Pharmacist

He or she is often the first one to be alerted to furtive and frequent collections of prescriptions. It is the pharmacist whose duty it is to inform the patient of the side effects and proper usage of the medication though there would be a lot less drug addiction if this alone were all that was needed to stop drug abuse.

Some pharmacies have formed strategies whereby they can alert other pharmacies in an area of false prescriptions.

3. The Patient

Now typically candidates for drug abuse and addiction are the least likely ones to feel overly responsible about how and when to administer medication correctly. Despite this, it is imperative that each person take responsibility for their own medications and not leave that up to medical professionals who cannot know and monitor the inside story as well as the patient themselves can.

Many patients watch their relationship to prescription drugs and diligently consider terminating addictive ones as soon as the problem they were prescribed to treat is under control. They are normally the ones to suggest that reducing dosage has become appropriate.