- Emergency physicians see first-hand the devastating consequences of drug misuse and abuse: every day thousands of people visit emergency departments because of drug overdoses, and every day about 120 of them die.[i]
- Drug abuse affects every single town and city in this country.
- Emergency physicians have taken a leadership role in educating the public about drug abuse and it is essential that they be involved in developing policies about this issue.
- Parents are the first line of defense in preventing teen drug use and abuse.
What impact does drug abuse have on emergency departments?
More than two million people abuse drugs in the United States and more than half of them – 1.2 million – end up in the emergency department every year.[ii] Poisonings are the leading cause of injury-related death in the United States, and drugs account for 90 percent of those poisonings.[i] Two-thirds of emergency department visits for drug overdoses involve prescription painkillers. [ii]
Emergency department visits for drug poisonings increased for all age groups from 2004-2007 to 2008-2011.[iii] However, the highest rate of visits is for young adults age 20 to 34.[iv] While prescription drug abuse has been responsible for a large percentage of drug overdoses and deaths in the United States, the street drug heroin has resurged as a killer: the rate for deaths involving heroin quadrupled between 2000 and 2013.[v]
What are the harmful effects of drug misuse and abuse?
Drug misuse and abuse exact staggering costs on American society. The Centers for Disease Control and Prevention (CDC) has classified prescription drug abuse specifically as an epidemic.[vi] Drug abuse destroys lives, families and entire communities. The federal government estimates that drug abuse costs the U.S. economy hundreds of billions of dollars in increased health care costs, crime and lost productivity.[vii]
What can people do to prevent drug abuse?
In 2012 and 2013, almost 55 percent of people who misused prescription painkillers got them from a friend or relative. More than two-thirds (68 percent) of new prescription drug abusers say they got their pills from a friend or relative.[viii]
- Safeguard and monitor your own medications – both prescription drugs and over-the-counter medications — at home and if you carry them with you in a purse or briefcase. Seventy percent of 12th graders who use prescription drugs non-medically report that they got their drugs from family or friends.[ix]
- Store medicines out of sight – consider locking them up or storing them in an unlikely place.
- Safely dispose of old or unused medications – even the expired ones.
- Be alert to the symptoms of prescription drug addiction.
- Talk to the kids in your life about prescription drug abuse.
Parents are the first line of defense against drug abuse. Be alert to behavioral symptoms such as:
- Attitude changes: more irritable, secretive, withdrawn, overly sensitive, inappropriately angry, defiant, euphoric
- Extreme mood swings (including depression and anger)
- Irresponsibility: late coming home, late for school or class and dishonesty
- Altered lifestyle: new interests, changes in friendships, changes in eating habits, unexplained cash
- Physical deterioration: difficulty concentrating, loss of coordination, weight loss, slurred speech, red or glassy eyes, sniffing or runny nose, appearing “spaced out”
- Unexplained deterioration in school performance
- Behavior problems such as stealing or sexual promiscuity
- Changes in personal hygiene
- Presence of drugs or paraphernalia (e.g., cigarette papers, pipes, clips, spoons)
There is some concern that even short courses of narcotic pain relievers increase abuse rates. Therefore, emergency physicians also recommend that patients who visit emergency departments remain open to trying non-narcotic painkillers if that is what the emergency physician recommends. Many patients refuse to try non-steroidal anti-inflammatory medications for minor injuries, even though they may be effective at relieving the pain of minor injuries.
What role do emergency physicians play in the prescription drug abuse problem in the U.S.?
Emergency physicians have worked to educate the public about drug abuse, both nationally and at the grass-roots level.
Drug abusers obtain prescription drugs from various sources — clinics, doctors’ offices, even a neighbor or friend’s medicine cabinet. While some drug-seekers attempt to obtain prescription drugs in the emergency department, emergency physicians typically dispense only a few narcotic pills at a time – enough to last until a patient can see their regular medical provider. Only 17 percent of emergency department patients leave with a prescription for opioid pain relievers.[x]
Prescription drug monitoring programs can be very effective in the states that have them. Emergency physicians can look up a patient to see if they have a record of drug-seeking. However, emergency physicians are not in law enforcement. Dedicated drug-seekers can be creative about feeding their addictions, and it is important that emergency physicians be able to provide adequate pain medication to patients who legitimately need it.
There is no objective test for pain, which accounts for 42 percent of all emergency department visits.[xi] Emergency physicians’ first responsibility is to the patient and to relieving suffering.
Some emergency physicians warn that mandatory drug monitoring programs could have the unintended consequence of inhibiting their ability to provide pain relief to patients who legitimately need it.[xii] However, some research shows that access to prescription drug monitoring program data actually increases the amount of pain medication emergency physicians prescribe to about half their patients.[xiii]
Because the issue is so complex, it is essential that emergency physicians be involved in developing policies about these programs.
[x] Annals of Emergency Medicine, Hoppe et al., “Opioid Prescribing in a Cross Section of U.S. Emergency Departments,” 2015
[xiii] Annals of Emergency Medicine, Baehren, et al., “A Statewide Prescription Monitoring Program Affects Emergency Department Prescribing Behaviors,” 2009.
(Last updated 2015)