Health Systems Pharmacy Editor's Note: Minimizing Prescription Drug Abuse

Several recent events have coincided to raise my level of awareness regarding the diversion of controlled prescription drugs. I know that the emergency departments of hospitals and health systems have put strategies in place to discourage patients from using them as a means to "shop" for selected controlled substances, especially oxycodone and related products that are particularly popular drugs of abuse.

In fact, practitioners who spend a significant time in these environments have become acutely aware of controlled drug-seeking behaviors, and I have seen signs posted in individual emergency department rooms that warn patients of the institution's heightened awareness about such efforts and their commitment to ensure that selected controlled substances do not get into the hands of individuals who intend to abuse or divert them. I have also seen many public service announcements encouraging parents to safeguard their prescriptions to discourage young people from gaining access to prescription drugs in their own homes.

The results of the Health and Human Services 2007 National Survey on Drug Use and Health for teenagers revealed some eye-opening findings. Almost a third of teenagers believe that prescription pain medications are not addictive and about 40% believe prescription drugs are safer than illicit drugs. The report also reflects that 20% of the respondents had abused prescription drugs to get high. For prescription drugs, pain relievers are by far the most popular drugs abused, followed by tranquilizers. I was pleasantly surprised to learn that more than 75% of the respondents had seen or heard drug prevention messages in school, and about an equal percentage had heard such messages outside of school.

As the profession with the societal covenant for controlling prescription drugs, we have the opportunity, if not the responsibility, to prevent or minimize prescription drug abuse. As a pharmacy student, I remember participating in a program funded by the Z. Smith Reynolds Foundation through the University of North Carolina School of Pharmacy, which sent trained pharmacy students into several hundred North Carolina high schools to teach "the truth" about substance abuse without sensationalizing the information.

Our efforts were extremely well received, and I felt that it really did make a difference. Given that prescription drug abuse among teens is second only to marijuana use, and that many urban myths apparently exist regarding these legal drugs, perhaps it is time to reconsider an organized effort to engage teens again. We also can support efforts under way to educate parents regarding these trends and stress the importance of safeguarding prescription medications in the home.

The state of Oregon recently passed legislation to help combat prescription drug abuse. Senate Bill 365 goes into effect in July 2010 and creates a prescription drug database for monitoring the prescription and dispensing of drugs in Schedules II-IV and requires physicians and pharmacists to enter relevant information into a state-wide database that can be accessed prior to prescribing or dispensing any Schedule II-IV drug. I realize that the law is not perfect and that extra time and expense will be borne by practitioners, but it seems that it is the least we can do to minimize the inappropriate use of selected prescription drugs.

I would encourage pharmacists, state boards of pharmacy, and national and state associations to collaborate to provide the leadership and guidance to minimize this problem and continue to earn our societal covenant. What do you think?