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Jewish World Review April 11, 2001 / 18 Nissan, 5761

Lee Bowman

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Consumer Reports

Growing danger of prescription-drug abuse -- Government and pharmaceutical industry leaders are teaming up to warn of a growing danger from misuse and abuse of prescription drugs.

Each year, more than 4 million Americans over age 12 are using sedatives, tranquilizers, stimulants and painkillers for non-medical reasons, with about half starting the abuse in the past year.

"We're trying to fend off what could become a major public health problem," said Dr. Alan Leshner, director of the National Institute on Drug Abuse, during a news conference in Washington on Tuesday.

"We find reports of increasing misuse of prescription drugs in some segments of the population - older adults, adolescents and women --- are particularly worrisome because their numbers appear to be increasing rapidly," he added.

A coalition of groups representing pharmacists, physicians and patient advocates are working with the institute to help alert both health providers and patients to the problem.

"Two hundred million Americans are seen by a doctor at least once a year, and we need to be sure we're aware of what each patient is taking and how much," said Dr. Karla Birkholz, a Phoenix doctor and board member of the American Academy of Family Physicians.

"We have to work with the physicians to ensure responsible use of drugs," said Huntington, W.Va., pharmacist Thomas Menighan. "But we also have to work within some strict guidelines to protect patient confidentiality," said Menighan, who is president of the American Pharmaceutical Association.

He and other pharmacy representatives said that while new computerized drug records help prevent over-prescribing to some extent, it's still difficult to deal with a patient who's "doctor shopping" - running up drug prescriptions through different doctors and filling them at different pharmacies.

"We are struggling with this, and there is no formal procedure for handling these problems. Perhaps some mechanisms will come out of this coalition," Menighan said.

Although some drug abusers do steal drugs or prescriptions outright, a gradual slip into dependence and addiction is more common, experts say.

"No one sets out to become addicted to prescription drugs," Leshner said. "But these are powerful medications and they have to be used as directed and in collaboration with your physician."

Birkholz and others said abuse often begins for people prescribed sedatives to help them sleep, or pain medications intended for short-term use after surgery but then stretches on for months.

"But there really is no typical abuser," said Dr. Joseph Autry, acting administrator of the Substance Abuse and Mental Health Services Administration.

Men and women misuse prescription drugs in about equal numbers, but some studies do indicate that women may be more likely to abuse psychoactive drugs because they're about three times more likely to be diagnosed and treated for depression.

Leshner also said that additional research is needed to understand why more people seem to be abusing prescriptions.

"We really don't know why abuse has risen so dramatically among 12-25-year-olds, whether this is a just a cyclical thing among the young, or what's driving it. We're soliciting new research proposals now to try and find out."

Other studies suggest that as many as 17 percent of senior citizens are abusing prescriptions, even though Leshner said that addiction to pain medications remains relatively rare.

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