Saturday, January 20, 2007
doctor patient relationships, seeking a high on prescription drugs, Your Doctor and You - Seventh in a Series
Young, Healthy, Single, and Seeking a High
What Can Doctors Do?
What can doctors do about prescription drug “borrowing” and “prescribing” by one young person to another, or for that matter, obtaining these drugs over the Net?
Not much. But doctors can be alert to misuse symptoms – deterioration of school performance, lassitude, agitation, inappropriate behavior.
Multiple Drug Misuse in Heroine Users
They can also recognize that “doctor shopping” leads to “polypharmacy,” the use of multiple drugs. This is common among heroin users. In fatal deaths from heroin, multiple drug use is reported in 90 percent of toxicology reports. Prescription drugs were present in 80 percent of subjects. Subjects aged 14 to 24 years dying of overdoses use medical services six times more frequently than the general population. More than half of prescribed drugs were those prone to misuse, such as benzodiazepines and opioid analgesics.
A pattern of increasing drug -seeking behavior in the years before death was identified, with doctor-visitation rates, increased number of different doctors seen. Prescriptions peaked in the year before death (Data cited above from various Oregon studies, of heroin deaths, including Heroine Overdose Deaths --- Multnomah County, Oregon, 1993—1999).
Drug Access Techniques
Young adults trade unused prescription drugs, get medications without prescriptions from the Internet, and, in some cases, deceive doctors to obtain medications they think they need. It’s illegal to give prescription medication to another person, but the offense is rarely prosecuted.
Moving to the Beat of a Different Drug Drummer
Present practices of young adults giving mood-altering drugs to peers have a different goal than use of marijuana, cocaine, or powerful painkillers. These young adults don’t want to get high. They want to feel better - less depressed, less stressed out, more focused, better rested. The quickest route to this blissful happiness that end often seems to be medications for which they do not have a prescription.
A Pill for Regulating Every Mood
Some seek to regulate every minor mood; some want to enhance their performance at school or work; some simply want to find the best drug to treat a genuine mental illness.
Young people say many general practitioners, pressed for time and unfamiliar with the ever-growing inventory of psychiatric drugs, are happy to take their suggestions. Young prescription abusers have learned it pays to be informed. You can use your expertise to influence or manipulate primary care doctors.
Health Officials Worry
Health officials say they worry that as prescription pills get passed around in small batches, information about risks and dosage aren’t included. Even careful self-mediators, they say, may not realize the harmful interaction that drugs can have when used together or may react unpredictably to a drug.
Reflecting the Culture
Young people mirror America’s culture – a culture largely devoid of formal rites of passage and often unobservant of the few that exist.
Consequently, young people may make up their own rites of passage. These include feeling good at all times through drinking, drugging, and prescription drug use.
Contributing to Medicalization
These behaviors may well be a carry-over from the “medicalization” of untoward behaviors when young adults were going through school. Doctors may unwittingly contribute to this later behavior by prescribing mood-altering drugs to students referred to them by school authorities or parents. Drug prescriptions among the young meant to counter depression, anxiety, and mood or attention disorders went up 250 percent from 1994 to 2001 (Brandeis University Study).
Prescriptions for hyperactivity, attention deficit syndrome, and bad behavior most often target boys. One of every ten boys who visited a doctor during this time period left the doctor’s office with a prescription.
Of this phenomenon, conservative commentator Thomas Sowell commented,
“The motto used to be ‘Boys will be boys.’ Now it is ‘Boys will be medicated.’ The 3Rs have become Repression, Re-education, and Ritalin.”
The doctor culture may have created a counter-culture.
Doctors can't control swapping of information on prescription drugs or giving of these drugs to friends. The Internet has changed our culture. The young can now go directly to the Internet to learn about the psychopharmacology of these drugs. Many feel they know just as much as doctors, who are hard pressed to keep up with new drugs pouring out of pharmaceutical company pipelines. Also these young people can learn from Internet support groups, like CrazyBoards.org, and they are perfectly capable and competent of using the Internet to order drugs from Canadian pharmacies and other sites. Also, through email and one-to-one relationships, the young are accustomed to exchanging highly personal information, an unthinkable behavior in previous generations.