Prescription for Disaster
Last week, President Bush announced a strategy to crack down on the abuse and diversion of prescription medications. It is a worthwhile goal, and one place to look is on America's college campuses where diversion of prescription medications is a growing and alarming trend.
Recent studies show that college students are increasingly diverting prescription drugs from their legal and legitimate use and using them to get "high." The problem is one that is tough to measure given the ready availability of these medications through legal channels and the shortcomings of self-reporting surveys. But it is safe to say that if the problem has drawn the attention of federal authorities, the trend is pretty well established.
The joy and the danger of being young is the deep-rooted belief in one's own immortality. Old age, infirmity and death seem light years away so the dangers of abusing what are legal and therefore assumed to be safe prescription medications do not outweigh any short term thrill of a new high.
Combine this with an absence of knowledge about the health risks associated with prolonged abuse of prescription medications and you've got a recipe for disaster. There have been amazing developments in the pharmaceutical arena just in the past decade that have helped a myriad of health problems. But prescription diversion, aside from the health risks, trivializes the medical conditions that the drugs are designed to treat.
The most commonly diverted prescription drugs are stimulants e.g. methylphenidate (Ritalin), pseudoephedrine, opioid Analgesics like hydrocodone (Vicodin, Lortab) and Dextromethorphan. When used legitimately for their intended medical purposes, they are safe and effective.
The example of stimulants illustrates the problem: stimulants are used to treat attention deficit/hyperactivity disorder (ADHD). ADHD is a mental health disorder, which the Centers for Disease Control estimates affects up to 7 percent of school-age children in the US. Research shows more than 50 percent of individuals will still have symptoms as adults. Doctors use medication and behavior therapy to treat it, tremendously improving their patients' lives.
Unfortunately, research and news reports show college students who do not have ADHD are obtaining prescription stimulants to feel "speedy" or pull all-nighters to study and attempt to keep up or improve their grades. It used to be that the drug of choice for desperate students determined to pull all-nighters was a dubious combination of coffee and diet pills. These days, students seem to be looking for something more potent.
Of the 2,250 college-age students who completed an Internet survey, 3 percent reported illicit methylphenidate [Ritalin] use within the past year. Illicit methylphenidate users were significantly more likely to use alcohol and drugs and report adverse alcohol- and drug-related consequences. In other words, a hit of Ritalin is likely to be on the weekly party menu of binge drinking and other drugs of choice. The irony here is this runs counter to all the research that shows people who use these medications for their prescribed and legitimate use are less likely to abuse other drugs.
The problem is gender neutral and on the rise. In 2003, one-fifth of teens reported abuse of prescription painkillers and one in ten reported abuse of Ritalin or Adderall without a doctor's prescription. According to one recent study, almost 70 percent of subjects who ever received a stimulant medication, reported using it to "get high" "ever" while 35 percent of the subjects who ever received a stimulant medication reported either selling or giving the medication "ever" to someone else to "get high."
The bottom line is that serious consequences will result if this trend is not reversed. Here are just a few:
-- Misuse of stimulants can cause weight loss, extreme nausea, dizziness, overdose and even death.
-- Any prescription drug taken without a doctor's supervision and without the diagnosed condition that the medication is designed to treat, risk serious, lasting side effects.
-- Just as performance-enhancing drugs in sports lead to cheating, stimulant-abuse among students gives them an unfair advantage over their peers.
-- ADHD students are put in the uncomfortable position of being asked if they want to sell their medication.
-- When a prescription medication is misused, genuine patients suffer because the criminal activity trivializes their treatment and illness.
So what can we do about it? Universities have a legal and moral obligation to educate the young people on their campuses about the medical risks of prescription misuse. Fraternities and sororities should be made to participate in educating their members as a condition for keeping their charters. Pharmaceutical companies should lend a hand to the effort by providing materials that clearly outline the dangers of misuse.
Not every problem requires an exclusively government-based solution. A broad coalition of private and public entities can and should be assembled to address this problem. And the President should use the bully pulpit of his office, as Nancy Reagan did so effectively as First Lady in the 1980s with the "Just Say No" campaign, to bring attention to this issue before it becomes an out-of-control crisis.