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Prescription Drugs Facts & Figures

Overview

Contents
Overview
Extent of Use
Health Effects
Treatment
Arrests & Sentencing
Production & Trafficking
Street Terms
Other Links
Sources

The non-medical use or abuse of prescription drugs remains a serious public health concern. According to the National Institute on Drug Abuse's (NIDA) research report Prescription Drugs: Abuse and Addiction, there are three classes of prescription drugs that are most commonly abused:1

  • opioids, which are most often prescribed to treat pain—examples include: codeine, oxycodone (OxyContin and Percocet), and morphine (Kadian and Avinza);
  • central nervous system (CNS) depressants, which are used to treat anxiety and sleep disorders—examples include: barbiturates (Mebaral and Nembutal) and benzodiazepines (Valium and Xanax);
  • stimulants, which are prescribed to treat the sleep disorder narcolepsy, attention-deficit hyperactivity disorder (ADHD), and obesity—examples include: dextroamphetamine (Dexedrine and Adderall) and methylphenidate (Ritalin and Concerta).

Many Americans benefit from the appropriate use of prescription pain killers, but, when abused, they can be as addictive and dangerous as illegal drugs. Prescription drugs should only be taken exactly as directed by a medical professional.

The Synthetic Drug Control Strategy addresses the extent of and problems associated with prescription drug abuse. Prescription drugs account for the second most commonly abused category of drugs, behind marijuana and ahead of cocaine, heroin, methamphetamine, and other drugs. Prescription drug abuse poses a unique challenge because of the need to balance prevention, education, and enforcement, with the need for legitimate access to controlled substance prescription drugs.2

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Extent of Use

Data from the National Drug Intelligence Center's 2006 National Drug Threat Survey (NDTS) reveal that 78.8% of state and local law enforcement agencies reported either high or moderate availability of illegally diverted pharmaceuticals.3

According to the 2007 National Survey on Drug Use and Health (NSDUH), approximately 50 million Americans aged 12 or older reported non-medical use of any psychotherapeutic at some point in their lifetimes, representing 20.3% of the population aged 12 or older. Nearly 7 million Americans aged 12 or older reported current (past month) use of psychotherapeutic drugs for non-medical purposes, representing 2.8% of the population. In this report, psychotherapeutics include any prescription-type pain reliever, tranquilizer, stimulant, or sedative but do not include over-the-counter drugs.4

Percent of U.S. Household Population 12 and Older Reporting Past Month Non-Medical Use of Psychotherapeutics, 2007, by Age

 

12-17

18-25

26 or older

12 or older

Non-medical use of psychother.

   3.3%

   6.0%

   2.2%

   2.8%

    Pain relievers

2.7

4.6

1.6

2.1

          OxyContin

0.2

0.5

0.1

0.1

    Tranquilizers

0.7

1.7

0.6

0.7

    Stimulants

0.5

1.1

0.3

0.4

    Sedatives

0.1

0.2

0.1

0.1

Additional data from the 2007 NSDUH show that 2.5 million people, aged 12 or older, initiated nonmedical use of prescription pain relievers within the past year, which averages out to around 7,000 initiates per day. The estimated number of past year initiates of nonmedical pain reliever use declined from 2.5 million in 2003 to 2.1 million in 2007.5

Each year, the Monitoring the Future (MTF) study asks drug use and related questions of 8th, 10th, and 12th graders nationwide. MTF provides usage estimates for alcohol, tobacco, illegal drugs, and substances that are only legally available by prescription. The study includes data for the non-medical use of amphetamines, stimulants including Ritalin, and sedatives (barbiturates) including: methaqualone, tranquilizers, the narcotic pain relievers Vicodin and OxyContin, as well as GHB, Ketamine, and Rohypnol, which is not legal for prescription in the United States. Survey respondents were asked to exclude from their responses any use of prescription drugs that occurred under medical supervision.6

MTF data for 2007 show that lifetime prevalence rates for amphetamine use without a doctor's orders were 6.5% for 8th graders, 11.1% for 10th graders, and 11.4% for 12th graders.7

Percent of Students Reporting Lifetime Non-Medical Use of Psychotherapeutics, 2007, by Grade

Drug

8th Grade

10th Grade

12th Grade

Amphetamines

  6.5%

 11.1%

   11.4%

Sedatives

n/a

n/a

9.3

    Methaqualone

n/a

n/a

1.0

Tranquilizers

3.9

7.4

9.5

Approximately 9.6% of 12th graders surveyed in 2007 reported annual (past year) use of Vicodin without a doctor's orders.8

Percent of Students Reporting Annual Non-Medical Use of Prescriptions, 2007, by Grade

Drug

8th Grade

10th Grade

12th Grade

OxyContin

   1.8%

   3.9%

   5.2%

Vicodin

2.7

7.2

9.6

Amphetamines

4.2

8.0

7.5

    Ritalin

2.1

2.8

3.8

Sedatives

n/a

n/a

6.2

Methaqualone

n/a

n/a

0.5

Tranquilizers

2.4

5.3

6.2

According to data from the Bureau of Justice Statistics, approximately 21.3% of State prisoners and 16.9% of Federal prisoners surveyed in 2004 indicated that they abused depressants at some point in their lives. For this report, depressants were defined to include barbiturates, tranquilizers and Quaalude.9

Percent of State and Federal Prisoners Reporting Abuse of Depressants, 1997 and 2004

 
State Prisoners
Federal Prisoners
1997
2004
1997
2004

At time of offense

     1.8%

      2.0%

     1.0%

      1.4%

In month before offense

  5.1

   5.4

  3.2

   4.4

Regularly*

11.3

   9.9

  8.0

  8.6

Ever in lifetime

23.7

21.3

16.5

16.9

* Used drugs at least once a week for at least a month.

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Health Effects

The health risks associated with prescription drug abuse vary depending on the drug. For example, abuse of opioids, narcotics and pain relievers can slow or stop breathing. The abuse of depressants, including benzodiazepines and other tranquilizers, barbiturates and other sedatives, can result in seizure, respiratory depression and decreased heart rate. Stimulant abuse can lead to high body temperature, irregular heart rate, cardiovascular system failure and seizure.10 Inappropriate use of prescription drugs, including use without a prescription or medical supervision, or using in a manner other than exactly as prescribed, can lead to addiction in some cases.11

The Drug Abuse Warning Network (DAWN) receives reports of emergency department (ED) episodes involving the non-medical use of legal drugs. These can involve the deliberate abuse of prescribed or legally obtained over-the-counter (OTC) medications or of pharmaceuticals diverted for abuse. Accidental overdoses or adverse reactions to OTC or prescription drugs taken as directed are not reportable to DAWN unless they are present in combination with an illicit drug.12

During 2005, there were an estimated 598,542 ED visits that involved non-medical use of prescription or OTC pharmaceuticals or dietary supplements. CNS agents were involved in an estimated 305,973 ED visits and psychotherapeutic agents were involved in an estimated 275,430 visits.13

Number of ED Drug Mentions, Non-Medical Use of Selected Psychotherapeutics, 2005

Drug

Mentions

Psychotherapeutic agents

275,430

    Antidepressants

  61,023

    Antipsychotics

  37,327

    Antiolytics, sedatives, and hypnotics

204,711

    CNS stimulants

  10,616

CNS agents

305,973

    Analgesics

264,857

Respiratory agents

  26,694

Cardiovascular agents

  30,246

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Treatment

There is no single type of treatment which is appropriate for individuals addicted to prescription drugs. Treatment options must take into account the specific type of drug used along with the needs of the individual.

Several options are available for effectively treating addiction to prescription opioids and are drawn from research regarding the treatment of heroin addiction. Options include medications, such as naltrexone, methadone, and buprenorphine, as well as behavioral counseling.14

Patients addicted to barbiturates or benzodiazepines should not attempt to stop taking the drugs on their own, as withdrawal from these drugs can be problematic, and in the case of certain CNS depressants, potentially life-threatening. Patients addicted to these medications should undergo medically supervised detoxification because the treatment dose must be gradually tapered. Inpatient or outpatient counseling can help the individual during this process. Cognitive-behavioral therapy has also successfully been used to help individuals adapt to the removal from benzodiazepines.15

Treatment of addiction to prescription stimulants is often based on behavioral therapies that have proven effective in treating cocaine or methamphetamine addiction. Depending on the patient's situation, the first steps in treating prescription stimulant addiction may be tapering off the drug's dose and attempting to treat withdrawal symptoms. The detoxification process could then be followed by one of many behavioral therapies.16

According to the Treatment Episode Data Set (TEDS), opiates other than heroin (“other opiates/synthetics”) accounted for 4.2% of the total TEDS admissions in 2006 (74,750 admissions). These drugs include codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, propoxyphene, tramadol, and any other drug with morphine-like effects.17

Number of Admissions for Prescription-Type Substances, 2004-2006

Drug

2004

2005

2006

Other opiates/synthetics

64,682

68,942

74,750

    Non-Rx methadone

   3,371

3,885

4,346

    Other opiates/
    synthetics

61,311

65,057

70,404

Tranquilizers

  8,804

8,170

8,011

    Benzodiazepine

  8,101

7,637

7,536

    Other tranquilizers

703

533

475

Sedatives/hypnotics

  4,479

4,401

3,866

    Barbiturates

  1,348

1,362

989

    Other sedatives/
    hypnotics

  3,131

3,039

2,877

Total all drugs

1,892,154

1,861,209

1,800,717

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Arrests and Sentencing

There are a variety of responses to prescription fraud that can be used by police, pharmacists, and others to try to prevent and address this crime:18

  • improve pharmacists' screening of prescriptions and patients
  • employ security measures (for example, use tamper-resistant prescription pads)
  • prescribe drugs electronically
  • create a database of customers
  • use police crackdowns to target specific doctors/pharmacies

Some states have developed prescription monitoring programs, which can help prevent and detect the diversion and abuse of pharmaceutical controlled substances.19 Through the Bureau of Justice Assistance's Harold Rogers Prescription Drug Monitoring Program, funds are available to develop and enhance such programs.

A variety of Federal agencies are involved in the enforcement of crimes associated with prescription drug diversion. For example, the Food and Drug Administration (FDA) Office of Criminal Investigation and the Drug Enforcement Administration (DEA) work together on criminal investigations involving the illegal sale, use, and diversion of controlled substances, including illegal sales over the Internet. Additionally, the FDA and U.S. Customs and Border Protection conduct spot examinations of mail and courier shipments to check for foreign drugs being sent to U.S. consumers.20 Additionally, the Department of Justice has prosecuted doctors and pharmacies who illegally distribute via the Internet.21

The illegal sale of pharmaceutical drugs using the Internet or e-mails advertising the sale of drugs can be reported to the following agencies:

The DEA has also launched a toll-free international hotline (1-877-RxAbuse) to report the illegal sale and abuse of pharmaceutical drugs. Using the hotline, anonymous tips can be provided about the diversion of prescription drugs into the illegal market by individuals and suspicious Internet pharmacies.

During FY 2004, there were 5,556 Federal drug arrests for "other" drugs. This category of drugs includes barbiturates, hallucinogens, opiates other than heroin, and synthetic drugs.22

According to the Drug Enforcement Administration (DEA), there were 237 Federal arrests involving Oxycodone during 2006. During 2005, there were 236 such arrests.23

Number of Federal Drug-Related Arrests, Pharmaceuticals, 2004-2006

Drug

2004

2005

2006

Oxycodone

137

236

237

Hydrocodone

111

186

242

Hydromorphone

  28

  11

  12

Benzodiazepines

  23

  26

  30

Methylphenidate

    1

    2

  4

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Production & Trafficking

Individuals illegally obtain prescription drugs through a variety of means, such as:24

  • Doctor shopping or other prescription fraud
  • Illegal online pharmacies
  • Theft and burglary (from residences, pharmacies, etc.)
  • Receiving/purchasing from friends or family
  • Overprescribing (negligent or occasionally even intentional overprescribing by physicians or other prescribers)

A research study was conducted in 2007 on behalf of the National Center on Addiction and Substance Abuse (CASA) at Columbia University. A total of 210 hours was devoted to documenting the number of Internet sites dispensing selected prescription drugs. Using Internet search engines and e-mail advertisements, researchers discovered that of the 187 Internet sites found to be selling controlled prescription drugs during this period, 157 (84%) did not require any prescription. Of these sites, 52 (33%) clearly stated that no prescription was needed, 83 (53%) offered an “online consultation” and 22 (14%) made no mention of a prescription.25

Only 30 of the 187 Internet sites found during the 2007 study required a prescription. Of these, 17 (57%) only required patients to fax a prescription, 4 (13%) required that a patient mail the prescription and 9 (30%) indicated that a doctor would be contacted prior to dispensing the drug.26

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Street Terms27

Term

Definition

80

OxyContin pill

Doctor shopping

Going from doctor to doctor to fraudulently obtain prescriptions

Murder 8

Fentanyl

Pharming
Consuming a mixture of prescription substances
Ritz and Ts
Combination of Ritalin and Talwin injected

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Other Links

Commonly Prescribed Medications: Use and Consequences
This table provides information about prescribed opioids, depressants, and stimulants and includes possible harmful effects if the substances are misused.

Drug Enforcement Administration: Controlled Substances in Alphabetical Order
This section of the Drug Enforcement Administration (DEA) Web site is a general reference guide to controlled substance Schedules.

Drug Enforcement Administration Diversion Control Program
The Diversion Control Program is responsible for two distinct problems: the diversion of controlled pharmaceuticals and the diversion of controlled chemicals.

Food and Drug Administration Center for Drug Evaluation and Research
The Center for Drug Evaluation and Research (CDER) promotes and protects the health of Americans by assuring that all prescription and over-the-counter drugs are safe and effective.

Misuse of Prescription Drugs: Data from the 2002, 2003, and 2004 National Surveys on Drug Use and Health
This report covers the non-medical use of four broad classes of prescription psychotherapeutics including pain relievers, tranquilizers, stimulants, and sedatives, as well as the specific drugs OxyContin and methamphetamine.

Prescription Medications
This section of the National Institute on Drug Abuse (NIDA) Web site provides basic information on prescription drugs and links to numerous reports and Web based resources on prescription drug abuse.

Selected Prescription Drugs with Potential for Abuse (PDF)
This resource provides a chart of information detailing individual prescription drugs along with their street names, DEA scheduling and health effects.

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Sources

1 National Institute on Drug Abuse, Prescription Drugs: Abuse and Addiction, August 2005

2 Office of National Drug Control Policy, Synthetic Drug Control Strategy: A Focus on Methamphetamine and Prescription Drug Abuse, May 2006

3 National Drug Intelligence Center, National Drug Threat Assessment 2007, October 2006

4 Substance Abuse and Mental Health Services Administration, Results from the 2007 National Survey on Drug Use and Health: National Findings, September 2008

5 Ibid.

6 National Institute on Drug Abuse and University of Michigan, 2007 Monitoring the Future Drug Data Tables, December 2007

7 Ibid.

8 Ibid.

9 Bureau of Justice Statistics, Drug Use and Dependence, State and Federal Prisoners, 2004, 2004, October 2006

10 National Drug Intelligence Center, Prescription Drugs Fast Facts (PDF), June 2003

11 National Institute on Drug Abuse, InfoFacts: Prescription and Over-the-Counter Medications, August 2008

12 Substance Abuse and Mental Health Services Administration, Drug Abuse Warning Network, 2005: National Estimates of Drug-Related Emergency Department Visits, March 2007

13 Ibid.

14 National Institute on Drug Abuse, Prescription Drugs: Abuse and Addiction (PDF), August 2005

15 National Institute on Drug Abuse, Prescription Drugs: Abuse and Addiction (PDF), August 2005

16 National Institute on Drug Abuse, Prescription Drugs: Abuse and Addiction (PDF), August 2005

17 Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) Highlights—2006, February 2008

18 Office of Community Oriented Policing Services, Prescription Fraud (PDF), May 2004

19 Drug Enforcement Administration Diversion Control Program, A Closer Look At State Prescription Monitoring Programs: Frequently Asked Questions

20 Office of National Drug Control Policy, “Reducing Prescription Drug Abuse,” (PDF) March 2004

21 Office of National Drug Control Policy, Synthetic Drug Control Strategy: A Focus on Methamphetamine and Prescription Drug Abuse, May 2006

22 Bureau of Justice Statistics, Compendium of Federal Justice Statistics, 2004, December 2006

23 National Drug Intelligence Center, National Drug Threat Assessment 2008, October 2007

24 Office of National Drug Control Policy, Synthetic Drug Control Strategy: A Focus on Methamphetamine and Prescription Drug Abuse, May 2006

25 National Center on Addiction and Substance Abuse, “You’ve Got Drugs!” IV: Prescription Drug Pushers on the Internet (PDF), May 2007

26 Ibid.

27 Office of National Drug Control Policy, Drug Policy Information Clearinghouse, Street Terms: Drugs and the Drug Trade

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  • View a clip (Quicktime, 55 sec.) demonstrating one way to properly dispose of prescription drugs.
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