Researchers Find Prescription Pills Are Gateway Drugs
Lead researcher Dr. Richard Blondell, professor of family medicine at UB, and colleagues sought to assess the prevalence of prescription drug use among opioid-dependent individuals who were hospitalized for opiate detoxification. Shockingly, more than half of the opioid-addicted patients reported that legal prescription drugs were their first drug of abuse.
The researchers’ study recruited 75 participating patients who were hospitalized for medical management of opioid withdrawal at the Erie County Medical Center in Buffalo. The patients’ opioid use ranged from derivatives of the opium poppy—including heroin, morphine, and codeine—to artificially produced medications such as methadone or fentanyl. The patients were interviewed regarding their drug use history—including patients’ age of first opioid use, preferred types of opioids, routes of administration, how their opioid abuse began, and how their addictions progressed overtime. Researchers also gathered data regarding the patients’ socioeconomic and demographic backgrounds.
In their responses, 31 patients (41%) reported that their addictions began with legal prescription drugs that were legitimately prescribed to them. Another 24 patients (32%) reported that their addictions began with the use of diverted prescription drugs that they either received or confiscated from a friend or family member.
Only 20 of the 75 patients (27%) reported that their opioid addictions began with illicit street drugs. However, an overwhelming 92% of patients (69 patients) admitted to having purchased a type of opioid drug illicitly ‘off the street’ at some point in time. Heroin was the most commonly purchased street drug among the patients, mostly because heroin is less expensive and more effective than prescription medications. As their addictions progressed, 37 patients (49%) reported that heroin was their preferred drug of abuse, and 43 patients (57%) had self-administered drugs intravenously. The patients had a tendency to cite opioids’ physical and emotional pain-relieving effects as the reason for their continued abuse, stating that the drugs made them feel "like a better person" and "normal," or that they "helped take away emotional pain and stress."
The patients’ characteristics revealed other significant similarities. The average age among patients was 32 years, 65% were male, 77% considered themselves as “white,” 74% had a high school diploma or equivalent, and 52% were unemployed. More specifically, those who considered prescription drugs initially used to relieve pain to be the root of their addictions were more likely to be older, female, have a college degree, and orally administered their drugs. About half of the patients (51%) stated that they first began using prescriptions medications to alleviate back pain or pain following surgery or an injury, while the remaining 49% stated that they began using to experiment with the drugs’ narcotic effects based on their own curiosity or social influences. All of the patients believed themselves to be “addicted.”
Alarmingly, when asked whether a doctor had questioned them regarding the presence of a substance abuse problem prior to writing them a prescription, 74% of the participants who responded to the question answered ‘no.’ The researchers advise that prescribing physicians not only should monitor their patients’ medication use, but that they are in the perfect position to identify or prevent prescription drug abuse among patients. Many pain-relieving medications are potent, highly addictive narcotics and have a high tendency to fuel dependency and abuse. All patients should be warned about these drugs’ serious adverse effects before being administered the medications. Furthermore, patients should be counseled on how to properly dispose of unused medications to help avoid misuse or diversion by friends or family members that can attribute to addiction.
The researchers hope their findings will help educate medical professionals and residents alike on how to effectively screen patients for possible cases of addiction, and to perform interventions or recommend treatment to these patients. Opioid misuse can progress rapidly and create serious hazards to health and safety, especially by paving the way to illicit drug use and addiction. Based on their findings, the researchers suggest that compared to individuals who use prescription drugs legally, those who abuse illegally-obtained prescription drugs are at an increased risk of illicit drug use.
The researchers’ study was recently published in the Journal of Addiction Medicine.
Source: HealthDay News, Robert Preidt, Prescription Painkillers Could Be New 'Gateway' Drugs, August 27, 2010