The quiet epidemic

There isn't much attention paid to prescription drug abuse, except perhaps when a Hollywood star dies from an overdose. However, it is estimated that nearly one in five Americans has used prescription drugs for nonmedicinal reasons, and 15 percent may be abusing prescription drugs. This silent epidemic has become the leading cause of addiction.

This week, the Maryland Chapter of the National Council on Alcoholism and Drug Dependence and the University of Maryland Medical Center sponsored the annual Tuerk Conference, a gathering of 1,200 health professionals working in the field of addictions to focus on treatment and prevention of prescription drug abuse. Confronting and debunking the common myth that prescription drugs are less deadly and less addictive was one of the items on the agenda.


The dangers of prescription drug abuse are growing at an exponential rate. Between 1992 and 2002, the number of prescriptions written increased by 61 percent, but the number of prescriptions written for opiates increased by almost 400 percent. Opiates reflect three-quarters of all prescription drugs abused. Actor Heath Ledger had Vicodin (hydrocodone), OxyContin (oxycodone), Valium (diazepam), and Xanax (alprazolam) in his bloodstream when he died. All are legal opiates.

According to a report this month by the Centers for Disease Control and Prevention, hospitalizations for poisoning by prescription opioids, sedatives and tranquilizers jumped 65 percent from 1999 to 2006. One-third of new addicts report that their first drug experience was with prescription drugs.


Christopher Shea, clinical director of Father Martin's Ashley and chairman of the board of the National Council on Alcoholism and Drug Dependence, confirms that he is seeing growing admissions to his inpatient treatment center for prescription drug abuse. More often than not, the abuse began when a person was taking pain pills as prescribed.

More and more teenagers are turning away from street drugs and using prescription drugs to get high. This has contributed to a high street value for pain pills, and some otherwise law-abiding citizens are selling their pills for a tremendous profit. According to the White House Office of National Drug Control Policy, prescription drugs are second to marijuana as the drug of choice for today's teens. In fact, seven of the top 10 drugs used by 12th-graders were prescription drugs. More than 40 percent of high school seniors reported that painkillers are "fairly" or "very" easy to get. They also reported that they believed that if they were to get caught, there was less shame attached to the use of prescription drugs than to street drugs. This mirrors the perceptions of their parents, who when queried said that they felt prescription drugs were a safer alternative to drugs typically sold by a drug dealer.

There is nothing safer about prescription drugs. They are just as addictive as street drugs. Prescription opiates like hydrocodone are synthetic heroin, and the brain does no differentiate between legal or illegal drugs. The high is the same, and the eventual drug dependence, both physical and emotional, is the same. The only difference is that prescriptions drugs are obtained through the doctor's office, the pharmacy or the pilfering of a friend's or parent's medicine cabinet.

Meaningful change will require that we raise awareness on the dangers of prescription medicine and add substantial resources for treatment and prevention. The Obama administration, recognizing the importance of these issues, has proposed a 6.5 percent increase for prevention and treatment in the fiscal 2011 budget.

R. Gil Kerlikowske, director of the White House Office of National Drug Control Policy, said in announcing the budget increase: "With drug use accounting for tens of billions of dollars per year in health care costs, and drug overdoses ranking second only to motor vehicle crashes as the leading cause of accidental death, the nation needs to discard the idea that enforcement alone can eliminate our drug problem."

Mental health clinicians all over Maryland applaud the Obama administration's decision to prioritize a public health policy response to drug dependence and abuse.

Nancy Rosen-Cohen, Ph.D., is the executive director of the National Council on Alcoholism and Drug Dependence-Maryland. Her e-mail is