Friday, February 02, 2007

The Roots of Prescription Drug Addiction

In the wake of the arrest of Williamson County's sheriff on allegations that he illegally purchased prescription drugs, The Tennessean published a story this morning reporting that this is a growing problem nationally, and particularly in the southeastern United States, including Tennessee. However, they do not delve into the issue of why that would be the case.

The root of the problem of prescription drug addiction is this: too many doctors too frequently prescribe controlled substances to patients suffering from chronic pain.

A key word in that previous sentence is "chronic." The Oracle should quickly state that he is not a medical professional and is not qualified to give medical advice, but it is his understanding that opiates can be appropriate for acute pain or for short term pain relief. However, they should not generally be prescribed for periods of more than two weeks (please bear in mind that this is a general rule related to things such as back pain -- I am not addressing issues such as appropriate treatment of, for example, terminally ill cancer patients).

Research indicates that somewhere around 10% of the population is genetically predisposed to addiction. No one knows in advance who is among the 10%. Prescribing opiates for lengthy periods of time is the equivalent of a roll of the dice. Of course, this is not entirely the fault of doctors. Some patients only know that they want out of pain and will change doctors until they find one to give them the drugs. Some physicians become resigned to this and acquiesce to patient wishes. This is both a social and a medical problem.

Nonetheless, the effects are devastating. One official from a western state says that he has documented over 300 instances of suicide: long term treatment using controlled substances prescribed by a doctor results in addiction, which in turn results in the loss of jobs, financial ruin and bankruptcy, and divorce and isolation. Fortunately, not everyone goes down that path, but it is all too common.

Of course, every drug addict is responsible for his actions. However, The Oracle, who has never suffered from such problems, has some sympathy for those who need help. And our society needs to confront the ways that we aid and abet the behavior.

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