Worldwide Prescription Drug Abuse

Recently, the International NarcoticsControl Board (INCB) reportdeemed prescription drug abusea global problem, not just one in theUnited States. The board members pointedout that, in many cases, prescriptiondrugs were the abuser's first choice, andabuse of pharmaceuticals had surpassedthe abuse of traditional illicit drugs inmany countries. The report said thatabuse in the United States had nearly doubledfrom 1992 to 2003, with over 15 millionpeople abusing licit pharmaceuticals.

Most experts agree that prescriptiondrug abuse has surpassed the abuse ofall illicit drugs with the exception of marijuanain the United States. In addition, insome states, deaths due to overdose ofpharmaceuticals have clearly exceededdeaths related to illicit drugs such ascocaine and heroin.

This INCB report also identified parts ofSouth Africa, South Asia, and Europe asrising hotbeds of prescription drug abuse.They indicate that the demand is so highthat residents are resorting to Internetpharmacies to help quench their thirst fortheir illicitly obtained medications. As inAmerica, this makes those individualsmore susceptible to counterfeit drugs,and they have no way of measuring theingredients and dosing strength.

One response to the INCB report Ifound quoted the health minister fromCyprus, who said that prescription drugabuse did not exist inhis nation. He went onto say that individualsin his country couldget these drugs onlyby going to a doctorand taking the prescriptionto a pharmacy,and an individualcould not simply walkinto a Cyprus pharmacyand buy thesedrugs without a prescriptionfrom a physician.The health ministeralso indicated thatofficials had conducteda check of somekind and found thatInternet purchases byresidents of Cypruswere not a problem.

I found this an interesting assessmentof the nonproblem in Cyprus and thoughtit sounded somewhat similar to the apparentlack of knowledge or initiative bysegments of our federal government justa few years ago when assessing thewidespread abuse of pharmaceuticals.

The INCB's report should not be surprisingto anyone, since human beingsare human beings, and addiction doesnot discriminate by sex, race, or any ethnicboundary. In many countries, however,even the legitimate prescribing anddispensing of controlled substances islow and scrutiny is very high, making itmore difficult for residents to obtain thedrugs through "doctor shopping" andother scams. This likely means more individualsare getting their prescription highthrough the smuggled market or theInternet, where government control ismuch more difficult.

Regardless, this INCB report is ultimatelypositive, as hopefully more andmore countries and their governmentsbegin to recognize this issue as a serioushealth and crime problem and do somethingabout it now.

The only way to successfully tacklethis problem is through global collaboration.International smuggling and theInternet are not individual country problems;they are a global problem and contributeto a very significant portion of theprescription drug abuse in America andlikely worldwide.

John Burke, commander ofthe Warren County, Ohio,drug task force and retiredcommander of the CincinnatiPolice PharmaceuticalDiversion Squad, is a 38-yearveteran of law enforcement.Cmdr Burke also is the currentpresident of the National Association of Drug DiversionInvestigators. For information, he can bereached by e-mail at burke@choice.net, viathe Web site www.rxdiversion.com, or byphone at 513-336-0070.