Beruflich Dokumente
Kultur Dokumente
Megha Sevalia
2/8/17
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Twenty-two year old patient A survived a car accident and was prescribed strong
painkillers, to which she developed a dependency. She returned to the hospital within a year with
liver failure. Thirty year old patient B suffers from headaches frequently so he takes medicine
daily to prevent them. He now suffers from a medicine overuse headache when he takes
medicine as well. Both of these people led fairly normal lives but now have developed an
addiction that will need to be treated the same way that drug abuse addictions are treated, as well
as internal injuries that they could have avoided. They both feel that they did not consciously
choose to do drugs, and do not understand how this situation occurred for them, as well as for
many others around the world. Medicine misuse has roots in a variety of situations, from injury
to ignorance. Adding onto the long list of causes are a number of factors which can make a
person more susceptible to misuse, and more likely to end up in an alarming situation. Medicine
misuse, impacted by a variety of factors, occurs at a dangerous rate and creates many harmful
consequences, but can be prevented through a combination of people receiving more information
on the topic, and taking precautions with medicine intake. In order to begin this process, this
paper will categorize factors contributing to medicine misuse, inform readers about the severity
of related internal injuries, and explain a prevention mechanism that can be used to evade this
problem.
Medicine misuse is a subsection of overall drug abuse. While drug abuse covers the
effects on the body, medicine misuse focuses around the specific situations where the drug
misuse leads from purposes originally intended to benefit ones health. A simpler differentiation
can be made by stating that medicine misuse is an unfortunate consequence of carelessly using
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medicines, even if the original purpose was meant to heal a person. Due to the nature of this
problem, a variety of factors arise which could influence how susceptible a person is to misusing
medicine. After all, not everybody in society who uses medicine ends up misusing it. However, a
significant portion of people who use medicine do at some point misuse it. Nearly 1.3 million
Americans aged 12 years and older experience problem use of prescription drugs, signifying
physiological dependence or heavy daily use, report Simoni-Wastila & Strickler (n.d.).
Medicine misuse generally arises from one of the following situations. One would be if a person
is involved in a major accident after which they are put on multiple medicines to help them heal.
This type of high level of dependency can create a tolerance and addiction to the medicines.
Often times, a person can find themselves craving the effects after they leave intensive care and
run out of prescriptions. Another common situation that can arise is when a person repeatedly
uses small doses of a medicine to rid themselves of a minor ailment, such as a common headache
or back pain. When a person frequently uses this medicine, the physiological effects will not
only relieve them of the ailment, but will also cause addicting side effects on other parts of the
body as well (Harsanyi, 2016). This can cause a person to start wanting the drug all of the time
and start imagining the pain to a higher degree, ultimately also leading to misuse. High
dependency on medicines also can lead to other situations such as doctor shopping, which
occurs frequently when a doctor stops prescribing medication to a patient, but in needing the
effects of the medicine, the patient visits a large number of doctors to try and procure multiple
prescriptions for the drug (Doctor shopping for narcotics common after trauma surgery, 2014).
While there are systems in place to track medication distribution, many misusers are still
successful in obtaining the medicines. If the medication is an over-the-counter drug, then they
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generally face virtually no limits. Even if it is prescription based, a large number of misusers turn
to black markets, where there are even less barriers. There are various other situations similar to
these, but regardless of the situation or the other contributing factors, some misuse trends remain
There are a number of common medicines that are the mostly commonly misused, as
listed here: Acetaminophen, Opioids, Stimulants, and Depressants (Prescription drug abuse: Risk
factors, n.d.). Acetaminophen is the primary ingredient in most pain relievers. This type of
medicine can be used by people searching for any type of pain relief, as its effects spread among
the whole body, not just the intended location of pain. Due to this, a person can often grow to
become dependent on the medicine for pain relief, and over time the amount of the drug that they
need will exponentially increase. Opioids are also common pain relievers that people misuse.
The overall process of how they become misused is pretty similar to that of Acetaminophen,
except Opioids have been in circulation for much longer than many other drugs (Prescription
drug abuse: Risk factors, n.d.). They have been used recreationally as well, and the general
amount people need has always been higher, and dependency rises to that high level. Stimulants
are medicines that help people pay attention. These often are introduced to a person when they
are coming out of an illness and are not feeling aware enough to operate through many daily
tasks. Stimulants used during this time can be very beneficial for a person, but at a heightened
awareness a person may feel more competent and continue using the medicines when it is not
needed. Depressants are another type of common medicines. These ingredients are often found in
anti-anxiety medication or night time medicines as they help the body relax, grow less anxious,
or ultimately get drowsy (Prescription drug abuse: Risk factors, n.d.). These medicines are often
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misused by people who realize that they are more comfortable at reduced anxiety levels or
insomniacs who like the sleep aid. Altogether, all of these medicines end up harming the body
because of the high number of physiological effects they can produce (Myers, n.d.). When
produced at high frequencies, they can cause damage to the body, often irreversible. However,
this generally only happens if a person does excessively misuse a medicine, which is largely
A number of factors have been examined and linked to medicinal misuse, many of which
seem completely unrelated. One major influence category was a persons nature, referring to
innate qualities, such as gender (Khan Academy, 2015). In fact, females have been found to be
more prone to medicine misuse, with up to 43% increased odds (Simoli-Wastila, L., Ritter, G.,
& Strickler, G., 2004). Race is also a factor that was examined, but the only difference found was
that people of the white race misuse more often than people of any other nonwhite race
(Simoli-Wastila, L., Ritter, G., & Strickler, G., 2004). However, injury does not discriminate
among races, and subsequently misuse patients were found internationally and at in similar
amounts. Age was studied as well, although this factor had questionable elements. For example,
young children are automatically discounted because they are given medicine by their parents. In
addition, elderly people generally take more medicines due to exhibiting more ailments, adding
additional confounding variables. However, studies did correlate being a young adult to having a
higher probability of misusing, just in that the number of overall drug addicts traditionally are
younger, and purposeful misuse also ranged higher in this age group (Prescription drug abuse:
Risk factors, n.d.). Another factor discussed is genetics. Different genes can make a person more
susceptible to addiction, and carriers of the gene are more likely to misuse (Prescription drug
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abuse: Risk factors, n.d.). The A1 allele of the dopamine receptor gene DRD2 is one of these
genes that misusers often carry (Prescription drug abuse: Risk factors, n.d.). Family history is
also a major part of whether a person might misuse, but this category overlaps into the other big
influence, which is a persons nurturing. If a person witnessed parents or other family members
misuse medicines, or show addictive behaviors, then they often will be more likely to misuse in
the future (Khan Academy, 2015). Similarly, social influences among friends can create a similar
influence as the reality of medicine effects are often blurred when it seems as if everybody is
taking them regularly (Khan Academy, 2015). In terms of income, people in lower social classes
misused medicine more, but this can be attributed clearly to lifestyle. People with lower incomes
often do not receive the same optimal treatment as upper income people, leading to them relying
on medicines well past the injury for pain relief (Simoni-Wastila, 2004). In addition, people with
lower incomes often work more frequently and do more physically demanding labor, which can
lead to various ailments. Conversely, people with higher incomes are reported to recreationally
use prescription drugs more. Marital status is another significant influence, and single people are
more likely to misuse than those who are married or in a committed relationship. Finally,
education also plays a large role in a persons likeliness to misuse, as people with less education
often misuse more often, which can be supported by the likeliness that they do not understand
the true nature of the medicines they are using and cannot foresee any future negative
The significance of medicine misuse stems from the fact that some of the problems that
could be caused from it are often major and generally irreversible. Many of the short term effects
resemble the outcomes of general drug abuse. The misuser develops a dependence, from which
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an addiction stems. Without the medicine in their system, the person feels a physical weakness,
possible headaches, and stomachaches (Diener & Limmroth, 2004). With many strong
prescription drugs it does not take long for an addiction to develop, meaning that these symptoms
can occur at a faster rate than if they were frequently using many recreational drugs (Leise,
2014). Long term effects include teeth, nail, hair, and bone problems, which can include frailty
or discoloration. Strong medications often accumulate in the liver, where toxins are meant to be
filtered out, which can lead to liver hepatotoxicity (poisoning) (Mckay, 2001). From this injury
onwards, the outcomes become dangerous and irreversible. Dr. William M. Lee of the University
of Texas Southwestern Medical Center in Dallas states that, drugs cause about 55 percent of the
liver failure cases evaluated at liver transplant centers (Tarkan, L.,2001). Liver toxicity can
sometimes be cured with hospital care, but often leads to the need for a liver transplant (Mckay,
2001). The consequences become potentially fatal if liver failure is reached, as liver failure can
spark other organ failure if the liver is not replaced (Frei, 2010). In addition, there are a number
of indirectly related effects that can eventually create a harmful effect, which is that many
illnesses and diseases have become resistant to common medications. These illnesses range from
simple infections to Tuberculosis and even Human Immunodeficiency Virus (HIV) (The global
epidemic of drug resistance: misuse of medicines is making diseases harder to fight, 2002). As
these medications become stronger, the chances of them creating more severe symptoms and
being harder to fight increase strongly. Many misuse patients in turn have developed such a high
tolerance for various medications that if they acquire any of these illnesses they require
significantly stronger medications to fight off the sickness. The severity of all of these effects
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Medicine misuse prevention can generally be combatted with a general drug abuse
prevention program, coupled with information about medicine misuse. A large portion of todays
children will receive general drug prevention instruction through an education, or special interest
group. However, the variety of different types that exist make it difficult to measure if everyone
is receiving the most effective lessons. One difference include whether everyone participating
are receiving the same education, or if a target group is receiving supplemental instruction. In
one study, researchers found that, only 11 out of 136 treatment-control contrasts... involved
target populations that were at elevated risk for substance use or other problem behaviors
(Gottfredson, D. C., & Wilson, D. B., 2003). Other researchers have supported that having
specific target group instruction for higher risk students in addition to a general discussion is
more successful in prevention (Hawkins, J. D., Catalano, R. F., & Miller, J. Y., n.d.). Another
major factor is the age of the children when they are hearing this information. While medicine
misuse peaks during the late teenage and young adult years, the most effective prevention
programs targeted middle school aged children as opposed to elementary school or high school
aged ones. Furthermore the length of the program can make a difference in effectiveness.
Programs generally range from a one time assembly-style presentation, to a couple month long
duration, to even longer extended ones. While it might seem reasonable that the longest ones
would be best as they have the ability to check back on the same students and measure their
progress in terms of how they view drugs, research has shown that mid-range, brief programs of
less than 4.5 months are generally as effective as those of longer duration (Gottfredson, D. C.,
& Wilson, D. B., 2003). This is an important factor to consider because many schools or interest
groups that do not have special programs are often influenced by the high cost of many.
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However, it is supported that an effective program does not have to be the longest, most
expensive one. Lastly, another important factor in prevention program success is the role of the
person delivering the preventive intervention (Gottfredson, D. C., & Wilson, D. B., 2003).
There is not a major difference in who is giving the information, but studies have shown that
peer involvement in giving the information is the most effective. Regardless of many of these
differences, it is considerably more important to have one in general. Even though they address
general drug abuse, the curriculum generally briefly also covers medicine misuse, and generating
awareness about the problem is the greatest prevention mechanism that can be used.
Altogether, medicine misuse is an expansive problem with many different angles which
will be a difficult problem to solve. The research supports that the majority of medicine misuse
factors are not more or less important in contributing to the misuse; rather, the prevalence of
contributing factors intensifies the susceptibility to misuse, along with the type of root situation
from which it arises. Since this makes the possibility of misuse greater, it is important to
understand the effects of medicine misuse, which can be observed through the internal injuries
that result from them. The short term effects resemble many of the effects of recreational drug
abuse, but the long term effects are generally much more serious due to patients not even
considering that they are harming themselves. Many patients think they are treating themselves,
but will end up causing great harm to their organs, which can even lead to death. Although
prevention program vary greatly, there has been a notable amount of success with a few. It is
important to further develop many of these programs and include more information specifically
about medicine misuse, a topic many students do not consider at all. With more education on it,
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there is a definite chance that the future will see less devastating injuries cause by something that
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