Khaas Baat : A Publication for Indian Americans in Florida
Health & Wellness

Prescription drug abuse – A major societal problem? Part I


One night, shortly after I moved to Brooksville some 30 years ago and established my cardiology/internal medicine practice, my answering service called me and said a gentle man called “Ray” wants to talk to you urgently. Eager to get new patients, I called him immediately. He said he has just moved from Atlanta and is having incessant cough and needed Tussionex. This cough syrup is a powerful one that contains the addictive drug, codeine. I told him to come in the morning to the office or go to Emergency Room. He was unhappy that I didn’t prescribe the medicine right away.

The following morning, he was pacing up and down in my waiting room, by the time I reached the office. He didn’t want any work up (that was all done in Atlanta, but didn’t want me to get those records either!), so I gave him 8 ounces of Tussionex and told him this should last him two weeks or more. He was quite happy and thanked me profusely. But three days later, I got a call from the local pharmacist for a refill. I asked him to come to the office to be evaluated before I prescribed more. It was a different Ray who I saw on that day. An angry and confrontational man!

“I am suffering … it’s your duty to prescribe me Tussionex.” There was the hint of a threat in his voice. I gave him one more prescription and told him that he will need to see a pulmonary specialist. By that time, I knew he needed a “detox” center but didn’t have the guts to tell him. He stomped out of the office.

Three days later, the same pharmacist called me. “Are you new here, doc?”
“Yes, why do you ask?”
“Ray is here, for a refill.”
“No, can’t give him any more,” I said.

Then he gave me a piece of advice. He knew that Ray was abusing drugs and would look for the newest doctor in town to get what he wants. It is better to refer them to an “abuse center.” Fortunately, I didn’t see Ray anymore.

The recent flurry of reports about escalating prescription drug abuse, over-prescription of narcotic pain pills, closing of a few pain clinics, and suspension of physician licenses have caused great concern among the general public. The main problem appears to be the chronic use and abuse of codeine-containing narcotic drugs such as oxycodone, percocet, etc., and their impact on society.

Most people take medicines only for the reasons their doctors prescribe them and stop them when they are told to. But an estimated 20 percent of people in the United States use prescription drugs for non-medical reasons, disregarding the potentially dangerous side effects they can cause. This is prescription drug abuse. Abusing some of these drugs can easily lead to addiction. You can develop an addiction to narcotic painkillers like oxycodone, sedatives such as sleeping pills and tranquilizers like valium, Xanax, etc.

It is a serious and growing problem in America. It does not respect any profession, ethnicity or nationality; all of us are susceptible. It is not uncommon among Indians too. According to National Institutes of Health, prescription drugs are the second most commonly abused category of drugs, behind marijuana, but ahead of cocaine, heroin, methamphetamine and other drugs.

Experts don't know exactly why this type of drug abuse is increasing. The availability of drugs is probably one reason. Doctors are prescribing more of these drugs for health problems than ever before, sometimes indiscriminately. In August 2011, 14 physicians were indicted as members of "the nation's largest criminal organization" involved in illegally distributing opioid analgesics! Many Florida physicians have also been cited for similar offense and some have lost their licenses to practice medicine too. Unfortunately, these pain medication scams are being reported more often these days. Online pharmacies make it easy to get prescription drugs without a prescription, even for youngsters.

I am not questioning the rightful need to alleviate pain by whatever means available for patients who have legitimate illnesses such as advanced cancer or severe spinal disease not amenable to any other therapy. Some acute painful medical conditions, including trauma, may need short-term drug therapy. These people should not be branded as addicts and should not suffer from lack of appropriate painkillers.

However, there is a segment of population who are truly addicted to pain medications.

To be continued …

Dr. M. P. Ravindra Nathan is a Brooksville cardiologist.

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