Prescription Drug Abuse Essay

Introduction

Prescription drug abuse is a practice that is on the rise in most parts of the world today with culprits finding it easy and more convenient to abuse these drugs than their controlled illegal counterparts.  Ready access and the low cost of these drugs avails them to all sections of the population from children to the elderly. The fact that the possession and the use of these drugs is not an offense actionable in a court of law makes their abuse to pass unnoticed to the ordinary person on the street. Luckily, medical personnel, parents and social workers have identified it as a common occurrence that needs urgent attention. The health departments have put up rigorous campaigns and measures to address the problem with a lot of attention paid to the treatment of the physical effects of the abuse of these substances. The physical effects of the abuse of prescription drugs are noticeable and serious, requiring all the attention it gets. However, although we treat the physical aspects of drug abuse, we must discontinue the practice of ignoring the mental and behavioral conditions that contribute or accompany it.

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McHugh, Nielsen and Weiss (2015) defines the abuse of prescription drugs as the inappropriate use of prescription drugs to manage conditions other than those they are intended for and without the supervision of health professionals. In a study on the subject, McHugh found that abusers of prescription drugs use them to manage stress, anxiety, pain or lack of sleep and other mild conditions attributed to physical or psychological disorders. While their unsupervised use resolves the immediate problem, their prolonged use leads to dependence that leaves the users with long-term effects even after stopping their use. 

Prescription Drugs Abused

Yu (2012) identified the most commonly abused prescription drugs as opioids, benzodiazepines and amphetamines. Opioids are a class of drugs that interact with opioid receptors in the body and in the brain to curb pain when used. They include prescription painkillers and illegal narcotics such as heroin used to numb the feeling of pain. These drugs also cause a natural high akin to that of alcohol use and other entertainment drugs, hence their abuse among users (Caraballo et al. 2016). Common prescription opioids include morphine, codeine, hydrocodone, oxycodone and many others. When used correctly and for short periods, opioids are effective painkillers and relieve the discomfort suffered by the users. Prolonged use of these drugs leads to dependence and cases of overdose have led to many deaths. 

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Benzodiazepines are among the most widely used prescription drugs in the US and the world in general. In the US alone, there are more than fifteen benzodiazepines approved by the Food and Drug Agency (FDA). Benzodiazepines act on the central nervous system to induce sleep, reduce panic disorders, to reduce anxiety, to prevent seizures, to induce mental and muscle relaxation among other uses (Caraballo et al. 2016). Besides the dependence arising from abuse of these drugs, some benzodiazepines are long acting or they remain in the body system for long periods, leading to physiological problems, especially in elderly people. Liver impairment has been reported among long-term users of benzodiazepines in addition to dizziness and unsteadiness. 

Amphetamines are stimulants of the central nervous system by suppressing the reuptake of neurotransmitters. They elicit feelings of wellbeing, confidence, concentration, energy and stamina in users. This class of drugs is highly addictive and their effects fatal in many cases. Overuse of amphetamines leads to malnutrition, itching of the skin and sores, psychosis, reduced immunity, temporary or permanent brain damage and mood swings among other effects. Abusers of amphetamines also suffer many social, economic and financial problems due to their addictive nature and their adverse effects on the normal functioning of the user. 

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Signs and Symptoms of Prescription Drug Abuse

Treatment of abuse of prescription drugs begins with the identification of signs and symptoms of abuse. Retan (2014) notes that abusers of opioids become less sensitive to pain due to dependence and tolerance. They feel a compulsive need to use the drugs and lose control on their intake of the drug despite knowledge of the addiction. Other signs include reduced social interaction, anxiety, drowsiness, mood swings, poor memory and apathy. Behavioral symptoms include neglect of work or school assignments, preoccupation with acquisition of drugs, financial impropriety, poor grooming and developing a new set of friends among others. 

Retan (2014) notes that abusers of benzodiazepines experience drowsiness, blurred vision, amnesia, irritability, impaired judgment, poor coordination, confusion and dementia. Behaviorally, abusers of benzodiazepines show the same character with those of opioids. The symptoms include absence from work or school, neglect of friends and family, acquisition of new friends, excessive working and abuse of other substances among other signs. 

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Retan (2014 also asserts that amphetamine abusers show signs of dry mouth, lack of appetite, irritability, restlessness and behavioral signs exhibited by abusers of opioids and benzodiazepines. Physical signs of abuse include high blood pressure, irregular heartbeat, headaches, blurred vision, chest pain, seizures, fever, hallucinations and tremors. Additional signs include excessive aggression, anxiety and unpredictable behavior. In brief, the signs and symptoms of the abusers of the three classes of drugs are similar and difficult to isolate. The key concern remains to identify any symptoms of drug abuse before investigating further to establish the drug under abuse for treatment. 

Treatment of Prescription Drug Abuse

According to Midgley (2017), the treatment of prescription drug abuse should take a three-pronged approach combining physical, mental and emotional aspects. Physical treatment of prescription drug abuse, like the treatment of any other substance abuse, mainly constitutes tapering off or withholding the intake of the harmful substance. Inevitably, abusers of prescription drugs suffer withdrawal stress of stopping their use. Health experts are reluctant to use other drugs to treat the abuse of other substances and medical interventions are rare and seriously supervised. There may be need to use other medications depending on the severity of the case and the presenting symptoms and their seriousness. For instance, where a patient is suffering high blood pressure, it becomes necessary to attend to the blood pressure as it may lead to instant death if not resolved. In addition, heavy abusers may need help dealing with the withdrawal symptoms early in the recovery process. Common drugs used to mitigate withdrawal symptoms buprenorphine, clonidine and Vivitrol. 

Typically, therefore, the treatment of prescription drug abuse is tapering off the patient from the drugs. Other drugs are used to purely minimize the withdrawal symptoms and their debilitating effects on the body. Withdrawal symptoms for stimulant abuse do not have any approved drug for their treatment and tapering off remains the only option. However, the physician may recommend other measures to reverse or to arrest long-term effects of the abuse of the drugs. In view of the difficulty in treating prescription drug abuse, the prevention of the same is more beneficial than intervention. 

Mental treatment is the most common and a very effective method of drug abuse applicable to prescription drug abuse (Midgley 2017). This treatment approach seeks to strengthen the mental capacities of the patient to resist the urge to continue the abuse and to give him reasons to stop the habit. The common method of mental treatment is counselling therapy. Counselling is a holistic method that takes into account, the causes, the environment and the triggers of the drug abuse. Typically, counselling seeks to establish the causes that led to the abuse of the drug. The goal is to enable the patient to identify potential triggers of relapses to prepare them to resist them by staying alert. In cases where there was an underlying cause of the abuse, therapist helps the patient find a solution to that problem as its continued existence may easily lead to a relapse. An important aspect of therapy is teaching the patient strategies and skills for resisting the unhealthy cravings and practices that fuelled the drug abuse. The concern is to empower the patient to identify the triggers of the abuse and to identify the alternative actions that help him to ignore the cravings.

Santucci (2012) suggests that drug abusers on therapy need to become involved in healthy activities that serve as alternatives to abuse or serve as distraction from the cravings of abusers. The healthy activities need to be developed in line with the interests of the patient. For instance, a patient with a passion for athletics may need to revisit their sports acumen to provide alternative leisure. When a relapse occurs, the patients should be taught the actions to take to prevent a spiral down to addiction again. 

Midgley (2017) adds that emotional treatment of prescription drug addiction or abuse is an important support approach for the other two treatments. Studies show that most drug abusers (including prescription drug abusers) have underlying family problems that lead them to seek solace from the drugs or substances of abuse. In many cases, drug abusers are escaping from a sense of rejection or failure to be recognized by people close to them. In some cases, they seek approval from friends who may end up leading them to drug abuse. Unfortunately, the abuse of drugs exacerbates rather than reduces the emotional situation that leads to the vice. Drug abusers develop low esteem, as they are aware that they are engaging in antisocial behavior. The result is withdrawal from society and daily life and acquisition of new friends who are most likely engaging in the same act. The further they withdraw from their families and initial friends, the ore the abusers become lonely and sink deeper into the practice. Besides, they no longer find pleasure in activities that previously entertained the. The result is a feeling of absolute loneliness amid other people. Emotional treatment involves other family members and people around the patient such as coworkers, schoolmates, friends, teachers and other figures of concern. The approach is to counsel the in-group and immediate mates to provide support to the patient to assist him or her to cope with the symptoms of withdrawal. Strengthening the feeling of appreciation and unconditional love for the patient helps them to work harder to recover and to avoid relapses. Blaming the patient and isolating him or her make them feel rejected again and a relapse becomes inevitable. 

Human Services for Prescription Drug Abuse

Schulden, Lopez and Compton (2012) observes that a number of programs are available to assist patients of prescription drug abuse depending on the severity of the case. He identifies inpatient programs, outpatient programs, counselling, community outreach and prevention as the exiting approaches employed by human services. Inpatient programs are residential drug addiction programs designed to assist the patient recover from addiction in a controlled environment with no environmental incentives to relapse. This is the most effective program for high addiction patients who cannot recover on their own. In many cases, these patients exhibit all the symptoms of drug addiction from life-threatening poor health, behavioral changes and socio-economic incapacity. 

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According to Ellis and Bussert (2016) inpatient programs have their advantages and disadvantages. The main advantage is the controlled environment that helps prevent relapse. The patient also receives support from other patients suffering from the same problem and it helps in their recovery process. Unfortunately, the program is expensive and requires long durations ranging from thirty days to ninety days. Most insurance policies do not cover drug addiction and the patients are rarely in position to pay for themselves. It remains on the family, friends or social services to cater for their stay during rehabilitation. Besides, working patients have to make special arrangements with employers and students forego studies for some time. 

Outpatient programs are similar to inpatient programs except that the patient is not on full board at the rehabilitation center (Ellis and Bussert 2016). They are cheaper in comparison and offer the patient access to professional support including medical treatment. The support from the other patients is also available to the outpatient to speed recovery. On the other hand, interaction with former friends and peers while away from the center exposes the outpatient to relapse. 

Counselling is a psychological therapy offered in many institutions. Social workers identify members of society suffering from or susceptible to drug abuse and recommend counselling. Commonly, local governments provide counsellors for vulnerable members for free to mitigate the debilitating effects of social ills through their social services departments. Rowe (2012) notes that family therapy is particularly important as an intervention to prevent deteriorating relations within the family and with the rest of the society. In this approach, the goal is to win the support of the family in assisting the patient to recover and to change his or her lifestyle to a healthier one. It has the advantage of creating stronger families or preventing further fallouts. This approach works for case that are no advanced and for patients who themselves recognize the need to for help. Group counseling is another approach of this method where one counsellor offers therapy to a small group of drug abusers with similar characteristics. 

Community outreach is a program where social workers visit drug abusers in their homes or places or work for informal talks and advice. The social workers are not necessarily counsellors but people of good social standing in the eyes of the patients. They point out the dangers of the practice of drug abuse and advise the patients on the strategies to counter the habit. This approach is useful with experimenters with drug abuse and not real addicts. It serves to jolt them to reality to prevent them from sinking into the dangerous habit for addiction where recovery becomes difficult and costly. 

Prevention is the anticipatory method of dealing with drug abuse where people in authority try to prevent the occurrence of the vice before it happens. This requires a multi-sector approach that touches on the most vulnerable members of society. Typically, the approach is to create awareness on the dangers of drug abuse among vulnerable groups with the aim of deterring them from engaging in the act. 

The first step in preventing drug abuse is identifying the risk factors and the vulnerable groups associated with each factor or a combination of several (Abuse 2014).  Among the youth, the common risk factors are aggressive behavior, lack of or insufficient parental supervision, substance abuse, availability of drugs and poverty. Social workers identify dysfunctional families investigate the circumstances to establish the need for intervention. The education sector has several programs that help instructors to identify students exhibiting risky behavior besides embedding drug abuse awareness in school programs. 

Once the risk factors have been identified, protective factors to mediate their potential impact needs to be established (Abuse 2014). Protective factors for the vulnerable groups include impulse control, parental monitoring and drug use policies. Planning for the prevention of drug use includes awareness campaigns to inform the vulnerable groups of the impact of drug abuse on their lives and society. This exercise requires the cooperation of many sectors including physicians commanding the respect and trust of society. Finally the human services authorities implement the prevention plans and evaluate them for effectiveness.

Conclusion

Prescription drug abuse is a common problem that requires the attention of the whole society as it is on the rise. This abuse is no different from the abuse of other substances and prescription drugs misused have fatal effects. The treatment of prescription drug abuse is more mental and emotional methods than physical methods as the use of other drugs to treat it can cause more health problems. Counselling, community outreach and prevention are effective methods to combat the problem.