Even with medications that are legally prescribed and dispensed, the potential for addiction is high.
When we consider the subject of drug abuse and addiction, stereotypes abound. Many of us, upon hearing the term “drug addict,” envision a young to middle-aged unemployed male who has a tendency toward criminal behavior and possibly a history of incarceration. Our mental image would include strained or estranged family relationships, more than likely a deadbeat dad who's irresponsible, untrustworthy and always in need of a loan. His church attendance might be only on Mother's Day and Easter-and even then only after a fair degree of coercion or a guilt-laden plea. He is certainly not a believer.
What we are not likely to envision is the doting grandmother who attends church regularly and organizes the Bible study for seniors. She's the one who always has a pleasant smile and encouraging words, whose “thorn in the flesh” is a bad case of arthritis with a little insomnia. Addicted to drugs? Abusing drugs? God forbid!
Reality Check Drug addiction and substance abuse are “equal opportunity” afflictions. Many addicts do fit the description of our stereotypical man whose drug of choice is illegal. But what about legal drugs obtained by means of a signed prescription from a licensed physician, dispensed through a reputable pharmacy, and paid for by a health insurance plan? Can addiction and abuse occur in this scenario? Yes!
In fact, disturbing data indicate the abuse of prescription drugs is on the rise in the U.S. In the last two decades, there has been an estimated 300 percent increase in the number of new prescription drug abusers. And although this problem affects many Americans irrespective of race, age, gender or socioeconomic status, an alarming trend is found in the increasing incidence of prescription drug abuse among older adults (affecting 17 percent of men and women over 60), adolescents and women.
Before the specific problem of prescription drug abuse is discussed, we should examine the broader issue of substance abuse, particularly how it affects women. The term “substance abuse” does not refer to illicit drugs only. To the contrary, the vast majority of substances abused by women are perfectly legal.
Substance Abuse in Women - Substance abuse is one of the most serious, though often neglected, women's health issues in the U.S. today. The death and disability related to tobacco, alcohol and drug abuse-specifically their role in the development of cardiovascular disease and cancer-make substance abuse the No. 1 preventable cause of death for U.S. women.
Consider the following statistics:
What may come as a surprise is this: if we examine the statistics pertaining to drug use, the number of women abusing prescription drugs is double the number of those using illegal drugs.
Prescription Drugs - It is estimated that 9 million Americans currently use prescription drugs in a nonprescribed manner, and 48 million have done so at some point in their lifetimes. A “nonprescribed manner” would include taking excessive amounts of your own medication, or using medication prescribed to someone else. Although a wide variety of legal drugs can be abused, there are three categories.
Pain Medications - There are many types of drugs effective in alleviating pain. The category of drugs known as the “opioids” (or prescription narcotics) carries with it the potential for addiction and abuse. Medications in this class, including morphine, codeine and oxycodone, are available as single agents, or in combination with other pain relievers such as acetaminophen, ibuprofen and aspirin.
When used for the short-term management of pain, opioids are safe, effective and rarely cause addiction. The pain resulting from surgery, dental work or an injury responds well to opioids. And since this type of pain is not expected to last for any significant length of time, prescription narcotics are an appropriate choice. Long-term use and the use of opioids for reasons other than pain control, however, can lead to dependence and addiction.
Sedatives and Tranquilizers - These medications work to slow down normal brain function and are prescribed for the treatment of anxiety and sleep disorders.
Stimulants - These drugs increase alertness, attention and energy. Some of the weight-loss medications once on the market belonged to this category. Now, however, stimulants are used primarily for the treatment of narcolepsy and attention-deficit hyperactivity disorder (ADHD).
Of these three categories, men and women are equally likely to abuse pain medications and stimulants. Women, though, are more likely to abuse tranquilizers and sedatives. Why this is the case is not entirely clear.
One possible explanation is that physicians are more inclined to prescribe drugs with the potential for abuse to their female patients than to their male patients. Older women are often given sedatives for insomnia, though men with the same complaint may be offered only a few helpful tips on how to improve sleep. And since, from a physiological standpoint, women are more susceptible to developing an addiction than men, we find ourselves in the jeopardizing position of having easier access to prescriptions that may very well lead to addiction.
Addressing the Problem - Everyone plays a role in curtailing this problem. Physicians and health care providers are responsible for keeping a close watch on patients who are prescribed drugs that have the potential for abuse and addiction. Pharmacists should be providing clear information on the proper way to take medications, and must also monitor prescriptions for falsification and look for prescriptions written for the same medication but issued by different physicians.
The ultimate solution though, lies with the patient. If you take prescription medications, ask your physician to indicate those that have the potential for abuse. Make sure you understand ways to avoid addiction and ask if there are other medications that would be just as effective without this risk. Take your medication as prescribed, and never change the dosing regimen on your own. If you feel the dose is inadequate, discuss this with your physician or health care provider. Never take medications belonging to someone else, and keep your own medication in a safe place, especially if you live with others.
One important way humans are distinguished from animals is that God has given us the power to make choices. Free will is a blessing but carries with it a great deal of responsibility. As a physician, I believe God has given us the wisdom and knowledge to develop medications that help those who are afflicted. Some of these medications are quite effective, but carry with them the potential for abuse and addiction. Keep in mind, the medications themselves are neutral. Our choice in how we use them makes them either a blessing or a curse.
After reading this article, if you suspect or know that you have a problem with prescription drug abuse, you are not alone and help is available. Ask your health care provider or your pastor for resource information, or contact the National Clearinghouse for Alcohol and Drug Information at 1-800-729-6686. Don't delay. Put denial and shame behind you-they will only hinder your deliverance-and make the choice today to get the help you need.
Kara Davis, M.D., is a doctor of internal medicine and a former assistant professor of medicine at the University of Illinois. She is also the author of Spiritual Secrets to Weight Loss (Charisma House).
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