Prescription Drug Abuse and Governmental Policy
Prescription drug abuse is a very serious problem in the United States. What social factors contribute to this kind of drug abuse? What is our state and government doing to control the abuse and rehabilitate its users? Are their actions adequate and ethical? Is this problem mainly in the United States or does it occur in other countries and what do they do to combat the issue? Many issues surround these questions yet are there any ethically solid solutions?
The most credited social factor associated with prescription drug abuse is that of low income people. , their drug of choice being opioid pain killers. The Center for Disease Control (CDC) reports that Medicare recipients where prescribed these medications at “twice the rate” of non-Medicare recipients. (CDC 2012) Medicare is a state funded medical coverage provided to low-income people and families. Strangely enough the majority of painkillers abused are given to the users freely by family and friends (CDC, 2012). As with most drug and alcohol abuse there are mitigating psychological factors that are present that often are a result of the person’s environment. If a person is scraping by on very low income and has to worry about meeting their basic human needs on a daily basis it is understandable how and why this could cause someone to become depressed. Depression is defined by the CDC as “changes in mood, self-attitude, cognitive functioning, sleep, appetite, and energy level”. (CDC, 2008) In this state of mind because opiates provide such a euphoric feeling it is understandable how these medications can become addictive very easily. Yet how do we control distribution of these medications after they prescribed to patients?
In the state of Maine and many other states there is a program called the Prescription Monitoring Program ore PMP. This program was created by legislation in 2003 to track all scheduled drug prescriptions that are considered to be controlled substances. These programs are designed to provide doctors and pharmacists with an accurate record of a patients prescription history, allows ministering of the patient and provided Threshold Reports to help clinicians determine which patients may be abusing and/or redistributing prescription medication. (OSA, 2005) On a national level a report was created by the Office of National Drug Control Policy (ONDCP) outlining various ways to reduce prescription drug abuse by expanding the PMP programs to all states, increasing education about abuse and creating more efficient ways of disposing unused prescriptions. (ONDCP, 2011)
These are the major policies enacted to help prevent this abuse. Yet how effective are these programs? According to the data collected by the National Institute of Drug Abuse there has been a “ 450%” increase in prescription drug use from 1998 to 2008. That is a massive increase that actually parallels the 400% increase in sales from pharmaceutical companies in the same time frame. (Volkow, D. N, 2010) This is only one class of prescription yet is the most prevalent with regards to frequency of abuse. Although in need of further support, it seems to me that these programs are not working very effectively.
As these programs do not seem to have much of an effect are they ethically sound according to the National Association of Social Workers (NASW) Code of Ethics? The first ideal stated in the NASW is commitment to the client. It clearly states that a “Social workers’ primary responsibility is to promote the wellbeing of clients”. (NASW 2008) That being said it seems that the fact that these programs are not very effective yet continue without readjustment violates this first tenet. Secondly it is also the ethical responsibility of a social worker to respect confidentiality and privacy, yet these programs remove these factors as they provide multiple people across multiple fields’ easy access to your personal and medical information. (NASW, 2008)
This problem is not contained to only the U.S. In a report by United Nations Office on Drugs and Crime Northern Ireland holds the highest rate of prescriptions of opioids at 8.4%. (UNODC, 2011) The policies created to prevent this abuse are much the same as the United States in that they promote the tracking of individuals and their prescriptions. Because of the massive rise in prescriptions abuse worldwide the National Prescription Drug Abuse Policy was created. To this day the United Nations continue to promote education, treatment and prevention strategies while working with other governments to implement such policies.
Who is most at risk, Policy Impact: Prescription Painkiller Overdoses, Injury Prevention & Control, Center for Disease Control and Prevention, 2012. Retrieved on Mar. 28th 2012 from http://www.cdc.gov/homeandrecreationalsafety/rxbrief/
Commitment to Clients 1.01 & Privacy and Confidentiality 1.07, Code of Ethics of the National Association of Social Workers, National Association of Social Workers, 2008. Retrieved on Mar. 28th 2012 from http://www.socialworkers.org/pubs/code/code.asp
Epidemic Responding To America’s Prescription Drug Abuse Crisis, Office of National Drug Control Policy, 2011. Retrieved on Mar 28th 2012 from http://www.whitehouse.gov/sites/default/files/ondcp/policy-and-research/rx_abuse_plan.pdf
Office of Substance Abuse (OSA)
Maine's Prescription Monitoring Program, Office of Substance Abuse, Department of Health and Human Services, 2005. Retrieved on Mar. 27th 2012 from http://www.maine.gov/dhhs/osa/data/pmp/
Europe, The non-medical use of prescription drugs—policy direction issues, United Nations Office on Drugs and Crime, 2011. Pg.8 par.5. Retrieved on Mar 28th 2012 from http://www.unodc.org/docs/youthnet/Final_Prescription_Drugs_Paper.pdf
Volkow, D. N
Troubling Signs of a Growing Problem, Prescription Drug Abuse, National Institute of Drug Abuse, 2005. Retrieved on Mar. 27th 2012 from http://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2010/09/prescription-drug-abuse