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03-26-12 Why are prescription drugs so available?

Question of the Week
March 26, 2012
Why are prescription drugs so available?
12,000 US residents die annually from unintended prescription drug overdose.  The US contains 4.6% of world population yet consumes 80% of the global hydrocodone supply.  The US rate of prescription drug use is 11.3 prescriptions per person.  In Tennessee, there are 17.3 prescriptions per person.  As this is an average, many persons have more than the average to balance those who have fewer than this amount. 
In the late 90s, the consensus of professionals was that chronic pain was being undertreated in individuals with impairment.  These beliefs lead to liberalization of laws governing opioid prescriptions.  And in 2000, JCAHO introduced new, more liberal pain management standards. 
Diversion (channeling from legal sources to illicit marketplace) occurs from illegal sale and recycling of prescriptions by physicians and pharmacists; doctor shopping; theft, forgery or alteration of a prescription by patients; shorting (undercounting); pilferage by pharmacists/employees; medicine cabinet thefts and internet sales.                                
There is the erroneous belief that OTC medications or those prescribed by a physician are safe.  This belief and easy availability has changed the face of teenage drug abuse.  “You can always find a doctor who you can convince that you have a sleeping problem to get Ambien or that you have ADD and get Adderall.  I have friends who have ailments who get lots of pills and sell them for cheap.  As long as prescription drugs are taken right, they’re much safer than street drugs”.   Pharming parties (prescription drugs are exchanged and randomly ingested) are very popular in many Tennessee communities.
This question prepared by: Donna Seger, MD  Medical Toxicologist