Guest Commentary: Crisis in our Communities - Drug Abuse

Mike Toscani, PharmD
Project Director
Jefferson School of Population Health


I recently attended the American Pain Society Meeting in Baltimore, where I sat in on a symposium on drug abuse facilitated by a principal and students from a recovery high school in Massachusetts. A few key messages rang true, in addition to success stories for individuals with these problems.

The abuse of prescription drugs and illicit substances has risen considerably in the past decade. Strikingly, the use of these substances is increasing in our young population. A recent survey found that almost 10% of 12th graders have experimented with prescription opioids like Vicodin (hydrocodone).

Many cultural and environmental factors have been cited as playing a role in increasing the risk associated with drug abuse, including teens who infrequently eat dinner with their parents, teens who have seen their parents drunk, and parents who do not monitor their teen’s activities and do not safeguard their own prescription medications.

Most teens say that prescription medications are very easy to obtain, and most acquire them from their parents’ or relatives’ medicine cabinets. Some of the recovery high school students spoke in vivid detail of their first experience with alcohol, marijuana or prescription products. Some described that the desire to experience euphoria and the need to continue to use was like a “runaway train” despite the ill feelings, family disputes, threat of law enforcement interventions, and negative social interactions that accompany substance abuse.

Key messages for health professionals include encouraging patients to lock their medicines, dispose of medications when periods of treatment are over (flushing unused medication down the toilet is recommended), and assess and monitor risk in patients who receive controlled substances. Health professionals should take a “universal precautions” approach to those individuals who are prescribed “chronic therapy” with these agents to reduce the potential for abuse. Helpful tools include: risk surveys, opioid treatment agreements, urine drug testing, and reminders to remove medications from areas that can be easily accessed.

New technologies to reduce the risk of tampering and abuse of prescription products are under evaluation by the FDA. Additional data will need to be collected to assess the value of these products in practice.

For more information on drug abuse and attitudes of teens toward drug use, please visit the web sites below:

National Center on Addiction and Substance Abuse at Columbia University

The Partnership for a Drug-Free America. The Partnership Attitude Tracking Study (PATS). Teens 2008 Report. Feb 26, 2009.