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Trends in prescription drug abuse
Although prescription
drug abuse affects
many Americans, some
concerning trends can be
seen among older adults,
adolescents, and women.
Several indicators suggest that
prescription drug abuse is on
the rise in the United States.
According to the 2003 National
Survey on Drug Use and
Health (NSDUH), an estimated
4.7 million Americans used prescription
drugs nonmedically
for the first time in 2002 -
- 2.5 million used pain
relievers
- 1.2 million used
tranquilizers
- 761,000 used stimulants
- 225,000 used sedatives
Pain reliever incidence
increased-from 573,000
initiates in 1990 to 2.5 million
initiates in 2000-and has
remained stable through 2003.
In 2002, more than half (55
percent) of the new users
were females, and more than
half (56 percent) were ages
18 or older.
The Drug Abuse Warning
Network (DAWN), which monitors
medications and illicit
drugs reported in emergency
departments (EDs) across the
Nation, recently found that two
of the most frequently reported
prescription medications in
drug abuse-related cases
are benzodiazepines
(e.g., diazepam, alprazolam,
clonazepam, and lorazepam)
and opioid pain relievers
(e.g., oxycodone, hydrocodone,
morphine, methadone, and
combinations that include
these drugs). In 2002, benzodiazepines
accounted for
100,784 mentions that were
classified as drug abuse cases,
and opioid pain relievers
accounted for more than
119,000 ED mentions. From
1994 to 2002, ED mentions of
hydrocodone and oxycodone
increased by 170 percent and
450 percent, respectively.
While ED visits attributed to
drug addiction and drug-taking
for psychoactive effects have
been increasing, intentional overdose visits have remained stable since 1995.
Older adults
Persons 65 years of age and
above comprise only 13 percent
of the population, yet
account for approximately
one-third of all medications
prescribed in the United States.
Older patients are more likely
to be prescribed long-term and
multiple prescriptions, which
could lead to unintentional
misuse.
The elderly also are at risk
for prescription drug abuse, in
which they intentionally take
medications that are not medically
necessary. In addition
to prescription medications,
a large percentage of older
adults also use OTC medicines
and dietary supplements.
Because of their high rates
of comorbid illnesses, changes in drug metabolism with age,
and the potential for drug
interactions, prescription and
OTC drug abuse and misuse
can have more adverse health
consequences among the
elderly than are likely to be
seen in a younger population.
Elderly persons who take
benzodiazepines are at
increased risk for cognitive
impairment associated with
benzodiazepine use, leading
to possible falls (causing hip
and thigh fractures), as well
as vehicle accidents. However,
cognitive impairment may be
reversible once the drug is
discontinued.
Adolescents and young adults
Data from the 2003 NSDUH
indicate that 4.0 percent of
youth ages 12 to 17 reported
nonmedical use of prescription
medications in the past month.
Rates of abuse were highest
among the 18-25 age group
(6.0 percent). Among the
youngest group surveyed, ages
12-13, a higher percentage
reported using psychotherapeutics
(1.8 percent) than
marijuana (1.0 percent).
The NIDA Monitoring the
Future survey of 8th-, 10th-,
and 12th-graders found that
the nonmedical use of opioids,
tranquilizers, sedatives/barbiturates,
and amphetamines
was unchanged between 2003
and 2004. Specifically, the
survey found that 5.0 percent
of 12th-graders reported using
OxyContin without a prescription
in the past year, and
9.3 percent reported using
Vicodin, making Vicodin one
of the most commonly abused
licit drugs in this population.
Past year, nonmedical use of
tranquilizers (e.g., Valium,
Xanax) in 2004 was 2.5 percent
for 8th-graders, 5.1 percent for
10th-graders, and 7.3 percent
for 12th-graders. Also within
the past year, 6.5 percent of
12th-graders used sedatives/
barbiturates (e.g., Amytal,
Nembutal) nonmedically,
and 10.0 percent used
amphetamines (e.g., Ritalin,
Benzedrine).
Youth who use other drugs
are more likely to abuse
prescription medications.
According to the 2001 National
Household Survey on Drug
Abuse (now the NSDUH),
63 percent of youth who had
used prescription drugs nonmedically
in the past year
had also used marijuana in
the past year, compared with
17 percent of youth who had
not used prescription drugs
nonmedically in the past year.
Gender differences
Studies suggest that women are more likely than men to be prescribed an abusable prescription drug, particularly narcotics and antianxiety drugsin some cases, 55 percent more likely.
Overall, men and women
have roughly similar rates of
nonmedical use of prescription
drugs. An exception is found
among 12- to 17-year-olds. In
this age group, young women
are more likely than young
men to use psychotherapeutic drugs nonmedically. In addition,
research has shown that
women are at increased risk
for nonmedical use of narcotic
analgesics and tranquilizers
(e.g., benzodiazepines).
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