Rx drugs must be utilized wisely

Last week, Meg Haskell introduced and accurately characterized the problem of teen and young adult drug abuse and dependence as “an epidemic.” This week, I’d like to discuss the fastest growing element of this epidemic, the abuse of prescription drugs.

From 1992 to 2003 in the Unites States, abuse of controlled prescription drugs grew at a rate twice that of marijuana abuse, five times that of cocaine abuse and 60 times that of heroin abuse, according to a 2005 survey of physicians and pharmacists conducted by the National Center on Addiction and Substance Abuse at Columbia University. Nationally, admissions to hospital emergency rooms for prescription drug misuse are now greater than admissions for illicit drugs.

In Maine, we have had more than our fair share of prescription drug abuse. While abuse of methadone and OxyContin have dominated the headlines, other prescription drugs such as Xanax, Klonopin, Ritalin and Adderall are being abused by young people with increasing frequency. According to the Maine Youth Drug and Alcohol Use Survey, one in four 10th and 11th graders have used prescription drugs not prescribed for them. Only alcohol, marijuana and nicotine were used more frequently. Heroin has been used by 3 percent of these young students.

I’m a child of the ’60s. Those of us who experimented with illicit drugs in those days had to obtain and use those substances furtively, well aware of the legal penalties of being caught. Harvard professor and pop culture icon Dr. Timothy Leary advocated for the use of LSD and marijuana for a cultural microsecond, but everyone knew those drugs were medically and psychologically harmful.

Today, the pharmaceutical industry is on overdrive, marketing powerful medicines that are no longer used just to treat illness, but to help lift our “normal” selves to an “improved” status. Consider this list of problems that prescription drugs address: obesity, anxiety, depression, memory loss, sleeplessness, inattention, moodiness, uncontrolled anger, reduced sexual desire, and erectile dysfunction, just to name a few.

It is in this context – “better living through chemistry”- that our children confront the question, “Should I take this drug?” They don’t need to wander into seedy neighborhoods and negotiate with drug dealers. They don’t have to hide the smell, or clear their eyes, or camouflage their breath. They can find these drugs in their parents’ medicine cabinets. Physicians, among the most respected people in our community, prescribe them. These drugs are medicine, they are supposed to make you better. They have to be safe, don’t they?

I am not a Luddite, advocating a return to “natural” living. I have seen the dramatic benefits prescription drugs can yield. But I have also seen the casualties of prescription drug dependency. A recent study in England found that fully half of those patients who had taken Klonopin (a drug commonly prescribed for anxiety) for more than one year were unable to discontinue that medication when they tried. A couple of years ago I treated a man whose 17-year-old daughter had become addicted to OxyContin. In the course of four years, she went through three treatment programs, probation, county jail and then prison. She had spent, borrowed and pilfered her way through $200,000 of his no longer secure retirement. “I would give all that and more just to get my daughter back,” he told me tearfully. Another recent client, the mother of a prescription drug-addicted son, was guilt-ridden about praying that he remain in jail because he was finally clean, a state he had not attained in all the various forms of treatment he had tried.

How can we slow this epidemic down? “Just Say No” doesn’t begin to counter how often our society says “Yes” to these medications. We need to make distinctions between which of our problems require medication and which are best addressed through other solutions such as exercise, friendships, self-discipline, prayer, etc. Let’s show our children our willingness to try a variety of strategies to improve our lives, setting an example that doesn’t always involve reaching for a bottle of pills.

Prevention, as always, is the key to avoiding the suffering and torment that too many Maine parents will face tonight.

Dr. John Keefe, married with three sons, is a clinical psychologist with a practice in Bangor. Send comments about “Finding a Fix” by calling 990-8111 or e-mailing findingafix@bangordailynews.net.