11 th Annual Methamphetamine & Substance Abuse Conference April 24, 2014
Prescription medications that are taken for reasons or in ways not intended by a medical professional, or taken by someone other than the person for whom they were prescribed. 1 Medications are taken in large doses to achieve a euphoric effect or to reduce withdrawal symptoms. 2 1 Drug Facts: Prescription and Over-the-Counter Medications. (May 2013). National Institution for Drug Abuse. Retrieved March 20, 2014 from http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications. 2 Injury Prevention & Control. Policy Impact: Prescription Painkiller Overdoses. (July 2, 2013). Centers for Disease Control and Prevention. Retrieved March 20, 2014 from http://www.cdc.gov/homeandrecreationalsafety/rxbrief/.
Not following medical instructions, but the person taking the drug is not looking to “get high” or abuse the drug but is trying to treat a condition or symptom. o A person takes a sleeping pill but they can’t fall asleep so they take another pill an hour later. o A person offers their prescription medication used to treat back pain to a friend who has similar pain. o A person has an old prescription for a muscle relaxant when they hurt their back and now wants to use it for a small spasm in their neck.
A person who is abusing prescription painkillers might take larger doses to achieve a euphoric effect and reduce withdrawal symptoms. These larger doses can cause breathing to slow down so much that breathing stops, resulting in a fatal overdose. 3 About one-half of prescription painkiller deaths involve at least one other drug, including benzodiazepines, cocaine, and heroin. Alcohol is also involved in many overdose deaths. 4 3 Injury Prevention & Control. Policy Impact: Prescription Painkiller Overdoses. (July 2, 2013). Centers for Disease Control and Prevention. Retrieved March 20, 2014 from http://www.cdc.gov/homeandrecreationalsafety/rxbrief/. 4 CDC. Warner M, Chen LH, Makuc DM. Increase in fatal poisonings involving opioid analgesics in the United States, 1999-2006. NCHS Data Brief;22 Sept 2009. Retrieved March 20, 2014 and available from URL : http://www.cdc.gov/nchs/data/databriefs/db22.pdf
Drug overdose death rates in the United States have more than tripled since 1990 and have never been higher. In 2008, more than 36,000 people died from drug overdoses, and most of these deaths were caused by prescription drugs. 5 In 2010, 2 million people reported using prescription painkillers non-medically for the first time within the last year. 6 5. CDC. Vital Signs: Overdoses of Prescription Opioid Pain Relievers — United States, 1999-2008. MMWR 2011; 60: 1-6. Retrieved March 20, 2014 and available from URL: http://www.cdc.gov/homeandrecreationalsafety/rxbrief/. 6. CDC Substance Abuse and Mental Health Services Administration. Results from the 2010 National Survey on Drug Use and Health: volume 1: summary of national findings. Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies; 2011. Retrieved March 20, 2014 and available from URL: http://oas.samhsa.gov/NSDUH/2k10NSDUH/2k10Results.htm#2.16 or URL: http://www.cdc.gov/homeandrecreationalsafety/rxbrief/.
Past year nonmedical users of psychotherapeutic drugs were asked how they obtained the drugs they most recently used non-medically. Rates averaged across 2011 and 2012 show that more than one half (54%) of the nonmedical users of pain relievers, tranquilizers, stimulants, and sedatives aged 12 or older got the prescription drugs they most recently used "from a friend or relative for free .“ 7 7 Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings. U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. (September 2013). Illicit Drug Use. Source of Prescription Drugs. Retrieved March 20, 2014 from: http://samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm#ch2.16.
About 4 in 5 of these nonmedical users who obtained prescription drugs from a friend or relative for free indicated that their friend or relative had obtained the drugs from one doctor. 8 Nearly 1 in 5 (19.7%) of nonmedical users obtained prescription drugs through a prescription from one doctor. Another 10.9% bought them from a friend or relative. 9 8 & 9 Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings. U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. (September 2013). Illicit Drug Use. Source of Prescription Drugs. Retrieved March 20, 2014 from: http://samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm#ch2.16.
4% of these nonmedical users in 2011-2012 took pain relievers from a friend or relative without asking. 10 An annual average of 4.3% got pain relievers from a drug dealer or other stranger; 1.8% got pain relievers from more than one doctor; 0.8% stole pain relievers from a doctor's office, clinic, hospital, or pharmacy; 0.2% bought the pain relievers on the Internet and 5.1% got pain relievers by writing fake prescriptions, or in “some other way." 11 10 & 11 Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings. U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. (September 2013). Illicit Drug Use. Source of Prescription Drugs. Retrieved March 20, 2014 from: http://samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm#ch2.16.
About 1 in 20 of these past year nonmedical users of pain relievers (5.4%) reported that the friend or relative got the pain relievers from another friend or relative for free. 12 4.1% reported that the friend or relative bought the pain relievers from a friend or relative. 13 1.4% reported that the friend or relative bought the pain relievers from a drug dealer or other stranger. 14 12, 13 & 14 Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings. U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. (September 2013). Illicit Drug Use. Source of Prescription Drugs. Retrieved March 20, 2014 from: http://samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm#ch2.16.
1.3% reported that the friend or relative took the pain relievers from another friend or relative without asking. 15 0.2% reported that the friend or relative bought the pain relievers on the Internet. 16 Other sources include getting the pain reliever from one doctor (82.2%), getting the pain reliever from more than one doctor (3.6%) or from another source (1.8%). 17 15, 16 & 17 Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings. U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. (September 2013). Illicit Drug Use. Source of Prescription Drugs. Retrieved March 20, 2014 from: http://samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm#ch2.16.
How Rx Drugs gs Were Obtained ained From 1 Doctor (19.7%) Bought from Friend or Relative (10.9%) Took w/o Asking (4%) From a Drug Dealer (4.3%) From More than 1 Doctor (1.8%) Stole (0.8%) Internet (0.2%) Other (5.1%) Free From a Friend or Relative (54%)
Friends ds & Relativ ives es From 1 Doctor (82.2%) From More than 1 Doctor (3.6%) From Another Friend or Relative for Free (5.4%) Bought From Another Friend or Relative (4.1%) From a Drug Dealer or Stranger (1.4%) Took From Another Friend or Relative w/o Asking (1.3%) Internet (0.2%) Other (1.8%)
Up until about 2008 DCI hardly ever, if ever, investigated a prescription case. 18 For calendar year 2013, prescription cases were 21% of the Division of Criminal Investigation's (DCI) drug enforcement case load. This is a slight increase from the past couple of years. 19 18 & 19 K. Haller, personal communication, March 13, 2014.
DCI investigations are not user cases. In other words, DCI is not targeting people that are just using, they are targeting those people that are diverting, distributing, selling, etc. 20 Hydrocodone continues to be the most abused prescription controlled substance in the state. 21 20 K. Haller, personal communication, March 13, 2014. 21 D. Wills, personal communication, March 24, 2014.
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