poledriver
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AUS - Plague of dodgy prescriptions puts illicit drugs in the shade
Despite a lively public debate about illicit drugs, the dominant drugs of addiction overtaking Western societies are those prescribed legally by trusted doctors. Prescription drugs, initially given to modulate chronic pain, reduce disabling anxiety or lift fledgling moods, are most likely to become chemicals of abuse and addiction.
The numbers are staggering.
The National Drug Strategy household survey results in 2009 reported more than 1.2 million Australians had used a pharmaceutical drug ''for a non-medical purpose''.
Several experts, such as Professor Nick Lintzeris of Sydney University, believe as many as 100,000 Australians may have a problem with prescription painkillers. Prescribed opioids are fast replacing heroin, cocaine and ice as the drug of choice in the illicit markets.
The estimates run even higher when it comes to abuse of anti-anxiety medications known as benzodiazepines, which include drugs such as Valium and Xanax. The prescription of Xanax, in particular, has quadrupled in the past decade, despite a study finding that it had no improved clinical efficacy, suggesting abuse is likely to be a key reason for its increased usage.
The problem is hardly unique to Australia; prescription drug addiction is a problem throughout the Western world. US authorities talk about a modern-day epidemic where prescription drug addiction is killing more people than crack cocaine in the 1980s and heroin in the 1970s combined. In the past five years, prescription drug overdoses have killed more people than car accidents in the US and there have been a spate of armed robberies upon pharmacies across the country.
In Britain, a February survey by the National Treatment Agency for Substance Misuse found that almost 80 per cent of GPs routinely prescribe drugs to which they believe the patient may be addicted.
Canadian leaders in the health industry were shocked to realise that in 2011 they had the highest per capita use of the opiate oxycodone, even higher than the US. They are frantically assessing how they can measure the depth of their problem more effectively, calling a national summit in the early part of this year.
Like most problems without easy solutions, the causes are wide ranging. The drugs are mostly useful and sometimes lifesaving when prescribed and used appropriately.
Sydney addiction expert Dr Richard Hallinan says that he has seen two shifts that have contributed to the worsening of the problem. One is that younger people carry little or no stigma about using medications casually to solve their problems. This is further borne out by a 2011 Canadian study that found for people under 25, prescription drugs are the third most popular form of drug use, after alcohol and marijuana.
Another development he notes is that there is far greater sharing of prescribed medications among family members, particularly for pain or insomnia. The medicine cabinet has become a collective resource to be shared liberally.
In my own practice, a key problem I see is the lack of stigma associated with prescription medications. Many patients who are as disabled as chronic addicts of heroin or cocaine cannot see the seriousness of their problem because their hit is mediated by a doctor.
In a New York Magazine article in March about sedative abuse, author Lisa Miller ponders whether the demands of modern life necessitate routine benzo use, quoting one expert as saying they ''stop a gap that evolution has yet to fill. As humans try to control an exponentially growing number of inputs with which they are confronted, 'our attention becomes less flexible, our minds become more chattering and the next thing we know, we're frantic'. Humans are ill-equipped to process or accommodate all these new signals.'' The result? Perhaps ''people need a bridge - a pill - between what life doles out and what people can realistically handle''.
Our way of life sounds like it is sick and drug overuse and abuse might be a symptom of this illness - what happens when existential entrapment and chemical escapism intersect.
Dr Peter Breggin, an American psychiatrist widely known for his criticism of the pharmaceutical industry, says pill popping is symptomatic of an age where introspection is either too difficult or too time-consuming for many people.
Many of us don't get to ''the causes of the causes'' of our illnesses and malfunctions and the assembly line nature of some medical practices merely enables this further. We learn to adjust and accommodate. Others learn to attach different meanings to the medical labels imposed on us so that we can live in relative peace with what may be a stigmatising diagnosis.
Still others are content simply to medicate what may well be the symptom of an underlying condition. Out of sight, out of mind.
Dr Tanveer Ahmed is a psychiatrist.
http://www.smh.com.au/opinion/socie...llicit-drugs-in-the-shade-20120612-207z0.html
Despite a lively public debate about illicit drugs, the dominant drugs of addiction overtaking Western societies are those prescribed legally by trusted doctors. Prescription drugs, initially given to modulate chronic pain, reduce disabling anxiety or lift fledgling moods, are most likely to become chemicals of abuse and addiction.
The numbers are staggering.
The National Drug Strategy household survey results in 2009 reported more than 1.2 million Australians had used a pharmaceutical drug ''for a non-medical purpose''.
Several experts, such as Professor Nick Lintzeris of Sydney University, believe as many as 100,000 Australians may have a problem with prescription painkillers. Prescribed opioids are fast replacing heroin, cocaine and ice as the drug of choice in the illicit markets.
The estimates run even higher when it comes to abuse of anti-anxiety medications known as benzodiazepines, which include drugs such as Valium and Xanax. The prescription of Xanax, in particular, has quadrupled in the past decade, despite a study finding that it had no improved clinical efficacy, suggesting abuse is likely to be a key reason for its increased usage.
The problem is hardly unique to Australia; prescription drug addiction is a problem throughout the Western world. US authorities talk about a modern-day epidemic where prescription drug addiction is killing more people than crack cocaine in the 1980s and heroin in the 1970s combined. In the past five years, prescription drug overdoses have killed more people than car accidents in the US and there have been a spate of armed robberies upon pharmacies across the country.
In Britain, a February survey by the National Treatment Agency for Substance Misuse found that almost 80 per cent of GPs routinely prescribe drugs to which they believe the patient may be addicted.
Canadian leaders in the health industry were shocked to realise that in 2011 they had the highest per capita use of the opiate oxycodone, even higher than the US. They are frantically assessing how they can measure the depth of their problem more effectively, calling a national summit in the early part of this year.
Like most problems without easy solutions, the causes are wide ranging. The drugs are mostly useful and sometimes lifesaving when prescribed and used appropriately.
Sydney addiction expert Dr Richard Hallinan says that he has seen two shifts that have contributed to the worsening of the problem. One is that younger people carry little or no stigma about using medications casually to solve their problems. This is further borne out by a 2011 Canadian study that found for people under 25, prescription drugs are the third most popular form of drug use, after alcohol and marijuana.
Another development he notes is that there is far greater sharing of prescribed medications among family members, particularly for pain or insomnia. The medicine cabinet has become a collective resource to be shared liberally.
In my own practice, a key problem I see is the lack of stigma associated with prescription medications. Many patients who are as disabled as chronic addicts of heroin or cocaine cannot see the seriousness of their problem because their hit is mediated by a doctor.
In a New York Magazine article in March about sedative abuse, author Lisa Miller ponders whether the demands of modern life necessitate routine benzo use, quoting one expert as saying they ''stop a gap that evolution has yet to fill. As humans try to control an exponentially growing number of inputs with which they are confronted, 'our attention becomes less flexible, our minds become more chattering and the next thing we know, we're frantic'. Humans are ill-equipped to process or accommodate all these new signals.'' The result? Perhaps ''people need a bridge - a pill - between what life doles out and what people can realistically handle''.
Our way of life sounds like it is sick and drug overuse and abuse might be a symptom of this illness - what happens when existential entrapment and chemical escapism intersect.
Dr Peter Breggin, an American psychiatrist widely known for his criticism of the pharmaceutical industry, says pill popping is symptomatic of an age where introspection is either too difficult or too time-consuming for many people.
Many of us don't get to ''the causes of the causes'' of our illnesses and malfunctions and the assembly line nature of some medical practices merely enables this further. We learn to adjust and accommodate. Others learn to attach different meanings to the medical labels imposed on us so that we can live in relative peace with what may be a stigmatising diagnosis.
Still others are content simply to medicate what may well be the symptom of an underlying condition. Out of sight, out of mind.
Dr Tanveer Ahmed is a psychiatrist.
http://www.smh.com.au/opinion/socie...llicit-drugs-in-the-shade-20120612-207z0.html
