Lancaster 1

Michael Lancaster

Ben Jorgensen

English 1010

April 2, 2017

Final Project

It kills more people than car accidents every year. The Centers for Disease Control and

Prevention (CDC) classified it as an epidemic and the World Health Organization (WHO)

reported it threatened the achievements of modern medicine. Prescription drug abuse is a global

problem, and the U.S. is the worlds biggest addict. In a society where cash is king, not even

staggering death tolls will slow this down.

The number of people in America who died from taking prescription pain killers

quadrupled between 1999 and 2010, a new report from the Trust for America's Health says.

These fatalities now outnumber deaths from heroin and cocaine combined, that same report

found. More than 12 million people said they abused prescription drugs in 2010. The only other

drug people abuse more is marijuana, the White House noted in a 2011 report. While painkillers

are the leading cause of accidental death, abuse of antibiotics led to the development of super

bugs and antidepressant prescriptions rose more than 400 percent from 2005-08. Meanwhile, the

pharmaceutical industry brought in more than $1 trillion last year, a number thats grown every

year since 2005. Prescription drugs are the third most commonly abused category of drugs,

behind alcohol and marijuana and ahead of cocaine, heroin, and methamphetamine. Some

prescription drugs can become addictive, especially when used in a manner inconsistent with
 Lancaster 2

their labeling by someone other than the patient for whom they were prescribed, or when taken

in a manner or dosage other than prescribed.

Prescription drugs can be broken down into categories. These categories include opioids

(for pain), central nervous system (CNS) depressants (for anxiety and sleep disorders), and

stimulants (for ADHD and narcolepsy). However, opioids take the cake when it comes to fatality

rates. Compared to street drugs, gaining access to prescription medicines is not as difficult as you

may think. For example, many family homes have a drawer or cupboard filled with unused drugs

from old prescription bottles. Couple this with the fact that sales of prescription opioids in the

U.S. nearly quadrupled from 1999 to 2014, but there has not been an overall change in the

amount of pain Americans report. This greater availability of opioid and other prescribed drugs

has been accompanied by alarming increases in the negative consequences related to their abuse.

For example, the estimated number of emergency department visits involving nonmedical use of

opioid analgesics increased from 144,600 in 2004 to 305,900 in 2008; treatment admissions for

primary abuse of opiates other than heroin increased from one percent of all admissions in 1997

to five percent in 2007 and overdose deaths due to prescription opioid pain relievers have more

than tripled in the past 20 years, escalating to 16,651 deaths in the United States in 2010.

So why is this happening? Why is this okay? Why are health care providers prescribing

these medications? Its okay because the pharmaceutical industry is a trillion dollar industry. An

industry that compensates its distributors well. Many doctors earn money from pharmaceutical

companies for speaking formally about a specific drug, either to a group of patients or to other

doctors. A common speaking fee is $1,000 per talk, though many make more than that. If the talk

is not near the doctor's home location, then airfare, food and lodging are often provided in
 Lancaster 3

addition to the base fee. Most doctors speak on more than one occasion for the same drug or

device. This kind of work can earn a doctor who keeps at it a lot of money. ProPublica, a

nonprofit social justice newsroom, has been tracking payments made to doctors from

pharmaceutical companies since 2010. According to their publicly searchable database, some

doctors made more than $100,000 in a single year for speaking engagements. Another reason for

this epidemic is the over prescribing of such medications. This is not to say that health care

providers are at fault for this. Rather, patients and their honesty may be the problem. In the

medical field there is a common phrase: Pain is what the patient says it is (Michelle Lancaster.

RN). If a patient tells you they are experiencing large amounts of pain there is no way to know

for sure whether or not a patient is being completely honest about the amount of pain they are in.

Naturally this can lead to the over prescribing of pain medications to patients that are less then

honorable in their intentions.

On the other hand, prescription medications arent all bad. There are many benefits. One

is the awareness of ailments that the advertising of prescription meds can bring. 64% of

physicians surveyed in April 2013 agreed that Direct to Consumer or DTC ads encourage

patients to contact a health professional. A 2010 Prevention Magazine survey reported that 29

million patients talked to their doctors about a medical condition after seeing DTC prescription

drug ads and most discussed behavioral and lifestyle changes; over half of those patients

received non-prescription or generic drugs rather than the brand-name prescription drug seen in

the ad, meaning that talking to the doctor was the real benefit. When a health care provider and

patient relationship is based on honestly and integrity it allows for correct treatment and

prescription of ailments. Such as a patient needing medication for diabetes or a patient with a
 Lancaster 4

heart condition. These types of patients that establish an honest relationship with their health care

provider show that not all prescription medication is bad.

But if prescription medication is here to heal or cure the medical issues Americans suffer

from then why are the number of Americans using or addicted to prescription medications on the

rise. Nearly 3 in 5 American adults take a prescription drug, up markedly since 2000 because of

much higher use of almost every type of medication, including antidepressants and treatments for

high cholesterol and diabetes. In a study published in the Journal of the American Medical

Association, researchers found that the prevalence of prescription drug use among people 20 and

older had risen to 59 percent in 2012 from 51 percent just a dozen years earlier. During the same

period, the percentage of people taking five or more prescription drugs nearly doubled, to 15

percent from 8 percent. More than 1 in 3 American adults -- 35 percent -- were given painkiller

prescriptions by medical providers last year. The total rate of painkiller use is even higher (38

percent) when you factor in the number of adults who obtained painkillers for misuse via other

means, from friends or relatives, or via drug dealers. These numbers come from a recent

Substance Abuse and Mental Health Services Administration report that highlights the use of

prescription painkillers in modern American life. The report indicates that in 2015, more

American adults used prescription painkillers than used cigarettes, smokeless tobacco or cigars

combined.

Again, why is all this happening? Its happening because money is important. So

important that not even death or breaking the law can stop this highly profitable pharmaceutical

beast. The Los Angeles Times recently published a scathing expos on Purdue Pharma,

describing how the company had extensive knowledge of and evidence showing their drug
 Lancaster 5

OxyContin was being sold through pill mills and organized drug rings, yet did nothing to stop it.

According to the article for more than a decade, Purdue collected extensive evidence suggesting

illegal trafficking of OxyContin and, in many cases, did not share it with law enforcement or cut

off the flow of pills. A former Purdue executive, who monitored pharmacies for criminal activity,

acknowledged that even when the company had evidence pharmacies were colluding with drug

dealers, it did not stop supplying distributors selling to those stores. Purdue knew about many

suspicious doctors and pharmacies from prescribing records, pharmacy orders, and field reports

from sales representatives and, in some instances, its own surveillance operations, according to

court and law enforcement records. Purdue insists it has at all times complied with the law. Yet

according to federal law, drug makers are required to report suspicious drug orders and activity

to the U.S. Drug Enforcement Administration (DEA), and must also reject orders if they suspect

the drugs may be sold on the black market. Purdue did neither.

With such astounding negative data. One would think that government action would be

necessary. Frustratingly, government action is simply "feeding the beast" that is Big Pharma.

While concerns about rising addiction rates led to the passing of the Comprehensive Addiction

and Recovery Act, which was approved by the U.S. Senate in May, the bill does little to address

the root of the problem. Rather than punish drug makers who promote addiction through

misleading or false marketing, the bill focuses on the treatment of addicts and availability of anti-

addiction drugs. For example, the bill will allow doctors and nurse practitioners to prescribe

buprenorphine, which has previously been notoriously difficult to obtain. While safe and

effective treatment is certainly necessary, one could argue that replacing one addictive drug with

another is not a real solution. Rather than reining in the misuse and excessive use of narcotic

painkillers, the bill simply rewards Big Pharma with more orders for more albeit different pills!
 Lancaster 6

So the same industry that created the addiction problem in the first place is now rewarded for its

callousness, as the government's plan to address the addiction epidemic simply feeds back into

the drug industry's pockets.

Drug companies intentionally got people addicted and now they're providing the

treatment drugs, which will be paid for by your tax dollars. The 2017 budget will include over $1

billion in "new mandatory funding over two years to expand access to treatment for prescription

drug abuse and heroin use." Why isn't the drug industry being held accountable for at least part

of this enormous financial burden? Instead, drug companies are raking in more money than ever

before. For example, with increasing demand, the price for the overdose-reversing drug naloxone

(Narcan) has nearly doubled, from $20 to $40 per dose and why isn't more done to prevent the

misuse and overuse of narcotic painkillers in the first place, especially since they've been clearly

identified as the new gateway drug to heroin? More and more politicians are now starting to view

and discuss opioid addiction as a disease, but none address the heart of the problem or the

elephant in the room, which is that this "disease" has been created intentionally by the drug

industry and the federal government. This pays, because then they can make even more money

on the drugs issued to treat the addicts.

If Americans are so happy, then why do we consume 80 percent of the entire global

supply of prescription painkillers? Less than 5 percent of the worlds population lives in this

country, and yet we buy four-fifths of these highly addictive drugs. We are a deeply unhappy

nation that has been trained to turn to pills as a quick fix for our hurt and our pain.

Yes, there are medical situations that call for prescription medications. But what we are

seeing in America today goes far, far beyond that. We are a nation of addicts that is always in
 Lancaster 7

search of a way to fill the gaping holes that we feel deep in our hearts. This prescription

medication crisis is just another symptom of a much deeper problem.

Works Cited

Abuse, National Institute on Drug. Prescription and Over-the-Counter Medications. NIDA,

www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications.

Accessed 1 Apr. 2017.

Allfather, Peter. On chronic pain, being lied to, and prescribing pain meds. M.D. to be, Times

Union, 14 Feb. 2014, blog.timesunion.com/mdtobe/on-chronic-pain-being-lied-to-and-

prescribing-pain-meds/4545/. Accessed 1 Apr. 2017.

America's painkiller epidemic, explained. The Week - All you need to know about everything

that matters, 13 Feb. 2016, theweek.com/articles/605224/americas-painkiller-epidemic-

explained. Accessed 17 Mar. 2017.

Angell, Marcia. The Truth About the Drug Companies. Want To Know,

www.wanttoknow.info/truthaboutdrugcompanies. Accessed 1 Apr. 2017.

Drug Industry Is Responsible for Mass Addiction. Mercola.com,

articles.mercola.com/sites/articles/archive/2016/07/28/opioid-painkiller-addiction-

conspiracy.aspx. Accessed 1 Apr. 2017.

 Lancaster 8

Elkins, Chris. Hooked on Pharmaceuticals: Prescription Drug Abuse in America. DrugWatch,

29 July 2015, www.drugwatch.com/2015/07/29/drug-abuse-in-america/. Accessed 1 Apr.

2017.

Fuchs, Erin. The Dark Side Of America's Rush Into Prescription Drugs Has Never Been More

Obvious. Business Insider, Business Insider, 17 Oct. 2013,

www.businessinsider.com/why-america-has-a-prescription-drug-problem-2013-10.

Accessed 1 Apr. 2017.

Lancaster, Michelle. Professional Interview Concerning Prescription Medications. 2 Apr. 2017.

Prescribing Data. Centers for Disease Control and Prevention, Centers for Disease Control

and Prevention, 20 Dec. 2016, www.cdc.gov/drugoverdose/data/prescribing.html.

Accessed 1 Apr. 2017.

Prescription Drug Abuse Statistics. CLAAD, claad.org/rx-drug-abuse-stats/. Accessed 1 Apr.

2017.

Skyrocketing Antidepressant Use Fueling Epidemic of Increased Suicides? CCHR

International, 2 May 2016, www.cchrint.org/2016/05/02/skyrocketing-antidepressant-

use-fueling-epidemic-of-increased-suicides/. Accessed 21 Mar. 2017.

Speights, Keith. 12 Big Pharma Stats That Will Blow You Away. The Motley Fool, The Motley

Fool, 1 Jan. 1970, www.fool.com/investing/2016/07/31/12-big-pharma-stats-that-will-

blow-you-away.aspx. Accessed 22 Mar. 2017.