A rose by any other name smells the same

by Kurt St. Angelo

A new report from the National Center on Addiction and Substance Abuse (CASA) at Columbia University suggests that makers and sellers of legal prescription drugs are more dangerous to society than their illegal counterparts.

More than 15 million Americans - 1 in every 20 - abuse prescription drugs. These drugs include pain relievers such as OxyContin and Vicodin, central nervous system depressants such as Xanax and Valium, and stimulants including Adderall and Ritalin. There is almost twice the number of admitted prescription drug abusers today as in 1992. More Americans abuse prescription drugs than illegal cocaine, hallucinogens, heroin and inhalants combined.

The CASA study found that between 1992 and 2002 prescriptions for controlled drugs increased more than 150 percent and that the number of prescription abusers went up seven times the rate of the U.S. population. Adult abuse rose 81 percent. Abuse by kids ages 12 to 17 increased 212 percent.

The study found a 542 percent increase in the number of teens abusing painkillers for the first time, compared with a 124 percent increase for adults. In 2003, 2.3 million of these teenagers - roughly one in every ten - admitted to using at least one prescription drug for a non-medical purpose.

During the past fifeen years, the sale of prescription drugs has more than tripled in the United States. In 1990, national spending was $37.7 billion. Today Americans spend $132 billion. Prescription drug costs have risen at more than 15 percent per year for the past several years and are the fastest-growing portion of health-care costs in America.

So it seems odd that, according to the CASA study, 43.3 percent of physicians do not ask about prescription drug use when discussing a patient's health history. Nearly one-third of physicians fail to obtain records from previous doctors before prescribing controlled drugs. Maybe this is because only 39.6 percent received any training in medical school in identifying prescription drug abuse and addiction.

If illegal drug dealers are to be blamed and severely punished for the death, addiction and destruction caused by illegal drugs, then it's only fair that makers and dealers of legal drugs should be held equally accountable for the death, addiction and destruction caused by their
products.

It is estimated that over 2 million hospital patients in America each year - over 6 percent of all patients - have serious adverse drug reactions (ADRs) from prescription drugs. In a study for the Journal of Clinical Pharmaceutical Therapy, ADRs were cited as the reason for 7.5 percent of all hospital admissions. In the year 2002 alone, prescription drugs were implicated in almost 30 percent of drug-related emergency room deaths.

According to best estimates, between 106,000 and 144,000 people die in America each year from prescription ADRs. Although figures vary, likely fewer than 10,000 people die each year from adverse reactions and overdoses to all illegal drugs. The Journal of the American Medical Association estimates that prescription-drug-related morbidity and mortality cost this nation more than $136 billion a year.

In 1994 the data of two researchers from the University of Arizona indicated that 60 percent of all people who are prescribed pharmaceutical drugs end up with a drug-related problem. These result in almost 9 million hospital admissions a year, at an estimated cost of $47.4 billion.

Drug companies could not have devised a more lopsided regulatory scheme that insulates them from the harmful effects of their drugs and their drug distribution policies. Today some of the hardest drugs known to mankind, and some of the most addictive, are now more readily available for abuse than the traditionally less-harmful illegal ones. Wouldn't it be smarter and safer for people to, for instance, smoke marijuana instead of popping toxic pills and drinking alcohol for their fun? Freedom of choice includes the freedom to make better choices. Prohibition doesn't.

Behind every bad government policy are special-interest groups. Drug makers, doctors and pharmacists make billions in profits from over-producing, over-prescribing and over-dispensing very dangerous drugs. Their drugs are now competing - and winning - in the vast American ecreational marketplace. Ostensibly these legal drug dealers look a lot like the illegal ones. The big difference is that they use bigger guns - including government and the media - to secure their unwarranted monopoly positions.