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The risks for addiction to
prescription drugs increase
when the drugs are used in
ways other than for those
prescribed. Healthcare
providers, primary care physicians,
and pharmacists, as
well as patients themselves, all
can play a role in identifying
and preventing prescription
drug abuse.
Physicians. Because about
70 percent of Americans
(approximately 191 million
people) visit their primary care
physician at least once every
2 years, these doctors are in a
unique position-not only to
prescribe medications, but also
to identify prescription drug
abuse when it exists, help the
patient recognize the problem,
set recovery goals, and seek
appropriate treatment.
Screening for prescription drug
abuse can be incorporated
into routine medical visits by
asking about substance abuse
history, current prescription
and OTC use, and reasons
for use. Doctors should take
note of rapid increases in the
amount of medication needed,
or frequent, unscheduled refill
requests. Doctors also should
be alert to the fact that those
addicted to prescription drugs
may engage in "doctor shopping"-
moving from provider
to providerÑin an effort to
obtain multiple prescriptions
for the drug(s) they abuse.
Preventing or stopping
prescription drug abuse is an
important part of patient care.
However, healthcare providers
should not avoid prescribing
or administering stimulants,
CNS depressants, or opioid
pain relievers if needed. (See
text box on "Pain Treatment
and Addiction.")
Pharmacists. By providing
clear information on how to
take a medication appropriately
and describing possible side effects or drug interactions,
pharmacists also can play
a key role in preventing
prescription drug abuse.
Moreover, by monitoring
prescriptions for falsification
or alterations and being aware
of potential "doctor shopping,"
pharmacists can be the first
line of defense in recognizing
prescription drug abuse. Some
pharmacies have developed
hotlines to alert other pharmacies
in the region when a
fraudulent prescription is
detected.
Patients. There are also
steps a patient can take to ensure
that they use prescription
medications appropriately.
Patients should always follow
the prescribed directions, be
aware of potential interactions
with other drugs, never stop
or change a dosing regimen
without first discussing it with
their healthcare provider, and
never use another person's
prescription. Patients should
inform their healthcare professionals
about all the prescription
and OTC medicines and
dietary and herbal supplements
they are taking, in addition to
a full description of their presenting
complaint, before they
obtain any other medications.
Role of health care providers
About 70 percent of Americans - approximately 191 million people - visit a health care provider, such as a primary care physician, at least once every 2 years. Thus, health care providers are in a unique position not only to prescribe needed medications appropriately, but also to identify prescription drug abuse when it exists and help the patient recognize the problem, set goals for recovery, and seek appropriate treatment when necessary. Screening for any type of substance abuse can be incorporated into routine history taking with questions about what prescriptions and over-the-counter medicines the patient is taking and why. Screening also can be performed if a patient presents with specific symptoms associated with problem use of a substance.
Over time, providers should note any rapid increases in the amount of a medication needed - which may indicate the development of tolerance - or frequent requests for refills before the quantity prescribed should have been used. They should also be alert to the fact that those addicted to prescription medications may engage in "doctor shopping," moving from provider to provider in an effort to get multiple prescriptions for the drug they abuse.
Preventing or stopping prescription drug abuse is an important part of patient care. However, health care providers should not avoid prescribing or administering strong CNS depressants and painkillers, if they are needed. (See box on pain and opiophobia.)
Role of pharmacists
Pharmacists can play a key role in preventing prescription drug misuse and abuse by providing clear information and advice about how to take a medication appropriately, about the effects the medication may have, and about any possible drug interactions. Pharmacists can help prevent prescription fraud or diversion by looking for false or altered prescription forms. Many pharmacies have developed "hotlines" to alert other pharmacies in the region when a fraud is detected.
Role of patients
There are several ways that patients can prevent prescription drug abuse. When visiting the doctor, provide a complete medical history and a description of the reason for the visit to ensure that the doctor understands the complaint and can prescribe appropriate medication. If a doctor prescribes a pain medication, stimulant, or CNS depressant, follow the directions for use carefully and learn about the effects that the drug could have, especially during the first few days during which the body is adapting to the medication. Also be aware of potential interactions with other drugs by reading all information provided by the pharmacist. Do not increase or decrease doses or abruptly stop taking a prescription without consulting a health care provider first. For example, if you are taking a pain reliever for chronic pain and the medication no longer seems to be effectively controlling the pain, speak with your physician; do not increase the dose on your own. Finally, never use another person's prescription.
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