Preventing and recognizing prescription drug abuse

Preventing and
recognizing
prescription
drug abuse

The risks for addiction to
prescription drugs increase when
they are used in ways other than as
prescribed (e.g., at higher doses, by
different routes of administration,
or combined with alcohol or other
drugs). Physicians, their patients,
and pharmacists all can play a
role in identifying and preventing
prescription drug abuse.
To ensure proper
medical care,
patients should
discuss any and all
drug use—including
prescription and
over-the-counter
medications—with
their doctors.
Prescription Drug Monitoring Programs
allow physicians and pharmacists to
track prescriptions and help identify
patients who are “doctor shopping.”
Physicians. More than 80
percent of Americans had contact
with a healthcare professional
in the past year, placing doctors
in a unique position, not only to
prescribe medications, but also
to identify abuse (or nonmedical
use) of prescription drugs
and prevent the escalation to
addiction. By asking about all
drugs, physicians can help their
patients recognize that a problem
exists, set recovery goals, and seek
appropriate treatment. Screening
for prescription drug abuse can be
incorporated into routine medical
visits. Doctors should also take
note of rapid increases in the
amount of medication needed
or frequent, unscheduled refill
requests. Doctors should be alert
to the fact that those addicted to
prescription drugs may engage in
“doctor shopping”—moving from
provider to provider—in an effort
to obtain multiple prescriptions for
the drug(s) they abuse.
Preventing or stopping
prescription drug abuse is an
important part of patient care.
However, healthcare providers
should not avoid prescribing
stimulants, CNS depressants, or
opioid pain relievers if needed.
Patients. For their part,
patients can take steps to ensure
that they use prescription
medications appropriately: always
follow the prescribed directions,
be aware of potential interactions
with other drugs, never stop
or change a dosing regimen
without first discussing it with a
healthcare provider, and never
use another person’s prescription.
In addition to describing their
medical problem, patients should
always inform their healthcare
professionals about all the
prescriptions, OTC medicines, and
dietary and herbal supplements
they are taking, before they
obtain any other medications.
Additionally, unused or expired
medications should be properly

discarded per U.S. Food and Drug
Administration (FDA) guidelines
or at U.S. Drug Enforcement
Administration collection sites.
Pharmacists. Pharmacists
dispense medications and can help
patients understand instructions
for taking them. By being watchful
for prescription falsifications
or alterations, pharmacists can
serve as the first line of defense
in recognizing prescription drug
abuse. Some pharmacies have
developed hotlines to alert other
pharmacies in the region when a
fraudulent prescription is detected.
Moreover, prescription drug
monitoring programs (PDMPs),
which require physicians and
pharmacists to log each filled
prescription into a State database,
can assist medical professionals
in identifying patients who are
getting prescriptions from multiple
sources. As of May 2011, 48
States and 1 territory have enacted
legislation authorizing PDMPs, 34
of which are operational.