Educate Patients on the Risks of Prescription and Non-Prescription Drugs

Introductory Paragraph

There is a common misperception in the United States that prescription drug use is without risks since these drugs are legal and used for medical purposes. Pain relievers, along with other prescription drugs such as sedatives, stimulants, and tranquilizers, are highly prescribed in the United States and have the potential for misuse, dependence, overdose, and even death when used inappropriately . In the late 1990s, healthcare providers began to prescribe opioid pain relievers at high rates due to pharmaceutical companies’ reassurance that patients would not likely become addicted to this medication . However, the increase in prescription use soon led to misuse of prescription and nonprescription opioid use . In 2015, the National Survey on Drug Use and Health reported that 91.8 million adults used prescription pain relievers. The individuals who reported misuse of prescription pain relievers stated that they did so in order to relieve pain, relax, help with sleep, and relieve tension. The two most commonly reported sources of obtaining pain relievers that were misused came from friends or relatives and healthcare providers. For this reason, physicians should consider speaking with their patients about potential risks of misusing medication, not sharing prescription medication with friends or family members, keeping medication out of reach from others, and appropriately disposing of remaining dosages .

Key Information

Overview

The most common types of prescription medication that are misused are: opioids used to treat pain, central nervous system depressants used to treat anxiety and sleep issues, and stimulants used to treat attention deficit disorders . Over the past 15 years, the United States has experienced a rise in emergency room visits, overdoses leading to death, and increased drug treatment admissions. Fatality rates from overdose rose from 3,442 in 1999 to 17,029 in 2017 . In 2020, the most commonly misused prescription drug was psychotherapeutic medication. That year, almost 17 million people, or about 6% of people 12 and older, attested to misusing this type of medication within the past 12 months . Also in 2020, SAMHSA reported 9.5 million people ages 12 and older had misused opioids (both prescription and non-prescription) . Clearly, prescription and non-prescription substance use is beginning to spiral out of control, causing personal, financial, physical, and mental health issues for victims of addiction and those close to them.

Many times, individuals can become addicted to non-prescription narcotics after being prescribed medication to treat a condition. Prescription opioids, for example, are used to treat pain and are highly addictive the longer an individual uses them. One can take prescription opioids and develop a tolerance over time. Physicians are aware of this, it may be difficult for some patients to continue to receive a prescription or be prescribed an increased dosage. In some cases, this can lead to patients trying to seek out medication not prescribed to them or non-prescription narcotics like heroin or other opioids .

Risk Factors for Prescription and Non-prescription Drug Misuse

The misuse of prescription medication far surpasses the rate of misuse of illicit substances, except for marijuana usage, with the largest users being adolescents and young adults . For this reason, it is important that care providers provide adequate education on the risk factors of prescription drug use and screen patients for common risk factors before prescribing addictive medication. Individuals are at a heightened risk for misusing drugs if they have experienced or are currently experiencing the following:

• Stressful circumstances
• Poverty
• Unemployment
• Family History of Substance Use
• Personal History of Substance Use
• Mental Disorders
• History of Criminal Activity or DUIs
• Contact with highrisk environments or individuals who use substances

Identifying ways to educate patients about the risks and consequences of misusing substances is vital in order to reduce the impact addiction has on society. The Center for Disease Control reports that over 80 million people have had contact with a primary care provider over the past year . This information lends itself to the need for physicians to incorporate approaches that educate individuals on the risks of misusing substances, incorporate effective screening practices, and develop other ways to reduce the harmful effects of prescription and non-prescription misuse. Since physicians frequently come into contact with people at risk for misusing substances, they are in a unique position to also provide valuable information that could not only prevent misuse but prevent detrimental impacts on the patients such as death, loss of wages, criminal justice involvement, and disruption of household functioning. Many individuals consider it the responsibility of physicians and pharmacists to increase their monitoring of when and how often addictive drugs are prescribed to patients. SAMHSA reports that more doctors readily prescribe highly addictive painkillers far more frequently than a decade ago. Pharmacists can aid in this effort to reduce the addiction by regularly checking prescription drug registries to identify patients who may be overprescribed by their physicians .

The Role of Physicians and Primary Care Providers

Finding ways to educate patients about the risks and consequences of misusing substances is vital in order to reduce the impact addiction has on society. The Center for Disease Control reports that over 80 million people have had contact with a primary care provider over the past year . This information lends itself to the need for physicians to incorporate approaches that educate individuals on the risks of misusing substances, incorporate effective screening practices, and develop other ways to reduce the harmful effects of prescription and non-prescription misuse. Since physicians frequently come into contact with people at risk for misusing substances, they are in a unique position to also provide valuable information that could not only prevent misuse but prevent detrimental impacts on the patients such as death, loss of wages, criminal justice involvement, and disruption of household functioning.

Referring at Risk or In-Need Patients to Community Resources

Emergency Rooms that provide counseling, medication, and referrals to treatment centers have a significant and positive impact on the patients who come in for drug-related issues or complaints . A doctor can identify and screen for all types of drug use and assist their patients in recognizing any risky behavior or existing drug addiction. In conjunction with Prescription Drug Monitoring Programs (PDMP), doctors can begin to identify patients who have drug-seeking behaviors and refer them to community resources. This approach may reduce the number of individuals who escalate prescription drug misuse to illicit non-prescription drug abuse or other dangerous street narcotics.

Relevant Research

In this section, please capture any recent findings, reports, or data on the topic. Please also highlight any gaps or existing disparities. Please include references and links to the information so that we may add a footnote for the reader to find further information. Do we have any available research about discriminatory practices? Is there information about the value of access to educational opportunities?

Impactful Federal, State, and Local Policies

In April of 2022, the Biden Administration released the National Drug Control Strategy in an effort to address addiction and overdoses in the United States. A major focus of this strategy is emphasizing the need for developing stronger data collection systems in order to implement better public health interventions. The administration’s effort to build trust and engagement with those struggling with addiction could lead to more individuals seeking help, gaining education, and reducing overdose and drug dependency .

Available Tools and Resources

Oftentimes, there are already great resources in the field that have been developed, but they are not housed in a single place. Please use this section to share information about those resources and drive the reader to that resource. It may be a worksheet, toolkit, fact sheet, framework/model, infographic, new technology, etc. I suggest no more than 5 really good links and a corresponding description for the reader. We also can use this section to highlight some of the great resources and programs at SAFE Project.

Promising Practices

Please link to any best practice models or case studies that highlight creative/innovative or successful efforts in support of this strategy. Is there a community that does a really good job in this area that other communities should replicate? Please write a brief description and provide a link.