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THE HIP HOP DOC: Medical Moments with Dr. Rani Whitfield (Volume 1, Edition 9) - Prescription Drug Abuse: Whose at Fault?
When I write a prescription for a patient, it is for a specific purpose: the blood pressure is too high, the blood sugar is out of control, or they have a sinus infection.
Many physicians write blood pressure medications, diabetic medications, or antibiotics without reservation because of the confidence in the drug and the understanding that the patient will take the medicine as prescribed. But when it comes to the patient in pain, the situation gets a little sticky.
I have personally become more cautious when it comes to prescribing medicine to treat pain. Each year approximately 9 million people use prescription medication for non-medical purposes. An estimated 20 percent of people in the United States are using prescription drugs for non-medical purposes and abuse of prescription painkillers now ranks second behind marijuana as the Nation’s most prevalent illegal drug problem.
The situation has gotten so bad that in February of 2007 the federal government issued new guidelines for proper disposal of unused, unneeded, or expired prescription drugs. So who’s at fault: the doctor prescribing the medications or the patients taking them? BOTH! So let us explore prescription drug abuse and its effects on the body and society.
One of the most irritating things that a patient tells a physician is that they did not take or complete a prescription for whatever reason without notifying the doctor’s office. Whether it is a side effect, cost, or an uncomfortable feeling with taking the pills or potions, there was a reason the physician wrote the prescription. An example of this and a major problem that has developed in the United States is antibiotic resistance. Because antibiotics have been over prescribed by physicians and patients are not always compliant with taking them, bacteria have become resistant to the common and inexpensive antibiotics and we now face a potentially life threatening group of bacteria called MRSA (methicillin resistant staph aureus). Further more, national studies and reports indicate that the intentional abuse of opiods (codeine, oxycodone, morphine) used to treat pain, central nervous system depressants (barbiturates and benzodiazepines like valium) used to treat short term anxiety, and stimulants (dextroamphetamine and methylphenidate) use for weight loss and the treatment of Attention Deficit Disorder (ADD) is of growing concern particularly among teenagers. Prescription drug abuse is not a new problem, but one that deserves renewed attention as physicians are prescribing more medications for various health problems and in some cases, patients purchase prescriptions without seeing the doctor by accessing online pharmacies or “trying” their neighbors, family member, or friends medication. The end result is abuse of the medication, an increased risk of unwanted side effects and depending on the drug, addiction or death.
Physicians are the gatekeepers, in most instances, to prescribing medications. If he/she does not communicate effectively to the patient the purpose for the drug, the length of time the drug should be taken, and specifics about the drug (potential side effects, addictive potential, cost, etc…) then problems can arise; the worst being addiction and or death. Patients will often self medicate, take more than the prescription requires, mix medicines or seek advice from friends, family or coworkers instead of the doctor if the medicine is not working as they expect them too. They often deny having problems if confronted about abuse because ”a doctor” prescribed the medication to them. The individuals most at risk for prescription drug abuse include women, teenagers, the elderly, and individuals in poor health. No longer is the issue of drug abuse labeled by inner cities and crack houses. You can now find drugs of abuse in the gated communities as well and I see the end results of this everyday: destruction of families and incarceration. Drug abuse and addiction knows no face, name, or ethnicity.
Millions of Americans go to the doctor in search of “medicine” to rid them of physical and emotional pain and doctors respond by using the pen and the prescription pad. The customer is always right and if he/she is unhappy, the doctor shopping will begin. As physicians, we have the responsibility to educate our patients on proper prescription drug use, potential side effects, and any potential for addiction the drug may have. Manage care plans want doctors to see more patients in a shorter period of time, while the patient demands a prescription because the co-pay has been paid. This trend has to stop! Patients must have confidence in their physician and trust that all things are not treated by medicine alone. More time should be spent educating patients and not prescribing pills for every symptom. As long as prescription drugs are the main treatment of choice for the multitude of medical problems that exist, abuse and addiction statistics will continue to rise.
Dr. Rani Whitfield is a board certified Family Practice and Sports Medicine Physician who lives in Baton Rouge, LA. He is affectionately known as “Tha Hip Hop Doc” as he uses music and medicine to educate young people on health issues. Watch him on the BET Special Feel free to shoot your medical related questions to him at DrRani@ h2doc.com.
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