Deadly Drugs Scourge?
There has been a lot of media coverage of the debate surrounding the fourth most popular street drug, Mephedrone, in the UK recently (May 2010). Following several deaths reputedly attributable to the drug, it has been banned by the government causing no less than 7 advisors on the Advisory Council on the Misuse of Drugs (A.C.M.D.) to have quit citing decisions based upon political rather than scientific grounds as the sticking point.
According to Fiona Measham, a criminologist and member of the A.C.M.D., the media reporting of deaths following recreational drug use follows 'the usual cycle of exaggeration, distortion, inaccuracy and sensationalism'.
Whilst society is inclined to frown upon someone buying potentially risky street drugs from a dealer, what if your local doctor turned out to be the biggest drug dealer of them all and responsible for more deaths than these shady characters?
What if our focus on this issue is completely misplaced and deeply hypocritical?
Addictive prescription medications
Concern centres on two groups of pharmaceuticals when it comes to addiction: antidepressants and painkillers and these issues are addressed below.
1. Antidepressant addiction and abuse
In recent years, there has been a 10% annual increase in the use of antidepressants with, according to a 2005 U.S. Center for Disease Control and Prevention study, 118 million of the 2.4 billion drugs prescribed annually in the U.S. being for antidepressants. In the UK, there were 31 million N.H.S. prescriptions for Prozac alone in 2006 and approximately 16 million for the benzodiazepine family of drugs including Valium, Ativan and Temazepam. The antidepressant drug market has now topped annual worldwide sales of over £8 billion ($11 billion).
The benzodiazepine antidepressant group of drugs are recognised as being highly addictive as demonstrated by the fact that the Priory clinic estimates that it can take 10 days to wean an addict off heroin, but they estimate that it takes six months to rehabilitate someone who is dependent on Valium. The Council for Involuntary Tranquilliser Addiction (C.I.T.A.) run by Liverpool University, estimates that there are up to 1.5 million people in the U.K. who have unwittingly become addicted to benzodiazepines.
Xanax is a short-acting benzodiazepine designed to combat anxiety, but when taken with alcohol can lead to wild and uninhibited behaviour and this drug has been cited by the police as an issue in many order offences.
Prozac is an antidepressant belonging to a group of drugs known as selective serotonin uptake inhibitors or S.S.R.Is. This means that they act by making more of the feel-good chemical serotonin available. Whilst these pharmaceutical drugs are not regarded as addictive, users can still experience serious withdrawal symptoms if they come off them too quickly and so may avoid the necessity to do so.
Prozac is now over 20 years old and the patent has expired, which has led to the development of a new generation of enhanced S.S.R.Is known as selective serotonin and noradrenaline (norephinephrine) re-uptake inhibitors or S.S.N.R.Is such as the branded antidepressant drugs Cymbalta manufactured by Eli Lilly and Effexor made by Wyeth. These drugs increase serotonin levels whilst simultaneously boosting adrenaline (epinephrine) levels, making the individual feel energetic (and possibly manic).
SSNRI drugs have proved to be some of the most ‘successful’ drugs ever with Effexor currently having over a third of the antidepressant market share with annual sales of £3 billion ($4 billion) and sales of Cymbalta rapidly growing and currently at £2.3 billion ($3 billion) per annum.
Effexor was one of the drugs that the pop star Robbie Williams was admitted into prescription drug rehabilitation for, and whilst the manufacturer, Wyeth, acknowledges unpleasant side-effects in 10% of users there is a petition signed by over 15,000 people who claim dependency or serious adverse side-effects caused by these antidepressants.
Many leading experts are concerned about our tendency to medicalise unwelcome feelings when what we may really need is to make changes - no matter how challenging - in our lives.
2. Painkiller addiction and abuse
Other drugs open to dependency and abuse are the potent painkillers such as the opioid analgesics including codeine, dihydrocodeine (in the branded drug Viocodin and in DF118 in the UK), oxycodone (brand name OxyContin), hydrocodone (Viocodin) and Fentanyl which may be available over-the-counter (OTC) as well as on prescription depending upon national laws.
At the General Medical Association conference in 2004 it was suggested that there might be as many as 50,000 people addicted to over-the-counter drugs in the U.K. Following concern that some of these medications are believed to increase suicidal tendencies, the European Medicines Agency has calling for OTC drugs to have a 'suicide rating'.
Some recent examples of headlines involving addiction to painkillers are listed below.
The British comedian, Mel Smith, recently came clean about his seven-year struggle with dependency on Nurofen Plus (ibuprofen enhanced with an opioid). His habit initially started when he took the painkiller for gout and was abruptly terminated when he ended up in Accident and Emergency with two ruptured stomach ulcers.
The rock singer Ozzy Osbourne was addicted to the painkiller, Vicodin for many years and his daughter, Kelly, and his son, Jack, have both had problems with dependence upon prescription medication.
The actor, Owen Wilson, attempted suicide in 2007 after a three-day binge on OxyContin.
The one-time record producer Phil Spector was found guilty of the murder of Lana Clarkson in 2003 after reputedly taking seven prescription medications including opioid analgesics which may or may not have been mixed with alcohol on the night in question.
Safety advice about prescription medication
To safeguard your health and to make sure you don't become a victim of prescription medication addiction or interaction, follow these guidelines:
As a general rule, don't take any medication you absolutely don't have to.
Various health professionals generally do not share information so specialists treating one condition may be unaware of drugs prescribed for another. So keep a list of your prescription medications for reference and share it with any health professional or pharmacist.
Any time you are prescribed a new medication speak to the pharmacist.
When prescribed a new drug, check whether there are any interactions with alcohol and be aware that some liquid medications also contain alcohol to which you could potentially become addicted.
Check online for drug interactions at sites such as www.drugstore.com or www.medscape.com
Use the same pharmacy which will have an automated computer system which will flag potential interactions between prescription medications.
The advent of 'Internet pharmacies'
Whilst some of the problems with prescription medication addiction may unwittingly have been initiated or maintained by physicians, addicts can now buy the medications directly over the internet without prescription. A recent United Nations report estimates that 600,000 people in the U.K. have bought prescription medicines online.
Hamid Ghodse of St George's hospital, London and an International Narcotics Control Board delegate, estimates that the unregulated market in prescription drugs is likely to double to £40 billion ($79 billion) over the next four years. At least 10% of the pharmaceutical drugs available in this way are estimated to be counterfeit drugs, and this figure rises to 50% in the developing world. Other issues are crude copies, the inclusion of contaminated or dangerous chemicals and no instructions or list of side-effects.
The recreational use of pharmaceutical drugs
According to a United Nations’ International Narcotics Control Board report published in 2006 the misuse of pharmaceutical drugs is now a bigger problem worldwide than the trade in illicit substances and mood-altering prescription medications have now become the recreational drug of choice for many. The ‘high’ obtained from these prescription medications when taken in inappropriate amounts is comparable to that of practically every illicit drug without the attendant risk of legal stricture.
Professor Heather Ashton of Newcastle University agrees that benzodiazepines in particular are used by 90% of drug abusers worldwide and have become part of the drug scene. Abusers may crush the pharmaceutical pills and either snort or inject them, in the same way they might use cocaine or heroin. The U.S. Drug Enforcement Administration now states that Vicodin is the fourth most widely abused drug in the country (after cocaine, heroin and marijuana). And OxyContin - a ‘smart drug’ designed to act as a painkiller over an extended period - also provides a sustained ‘high’.
Sales of the painkiller OxyContin grew from £30 million ($40 million) the first year to £750 million ($1 billion) within 4 years of release and the pharmaceutical drug is referred to as ‘hillbilly heroin’ because of its popularity among the rural poor.
The young have been quick to seize on the legal ‘highs’ offered by prescription medications with a doubling of teenagers expressing interest in the five years prior to the National Household Survey in 2001. Street slang has moved with the times with ‘pharming’ referring to taking a cocktail of prescription medications, ‘doctor shopping’ referring to visiting several doctors to obtain various pharmaceutical drugs and ‘pill ladies’ to the elderly who can be used to source legitimately prescribed heavy-duty painkillers.
Pharmaceutical side-effect: Death!
A 2007 report by the U.S. Centers for Disease Control and Prevention estimated that there were at least 20,000 unintentional deaths due to prescription medicine poisioning in 2004. Men were twice as likely as women to lose their life in this way and particularly middle-aged white men. The number of deaths where potent painkillers were involved has more than doubled in the last decade. The following is a list of just some of the high-profile deaths attributable, or partly attributable, to prescription medication:
The pop star Michael Jackson was reported to have been taking a cocktail of up to seven prescription medications in the months leading up to his untimely death, including the painkiller Demerol and the anti-anxiety drugs Xanax and Zoloft.
Although officially listed as suicide, the actress Marilyn Monroe’s death in 1962 from an overdose of the sleeping pills Nembutal and chloral hydrate is now considered by many forensic experts and investigators to have been an accidental overdose.
Brittany Murphy, the Hollywood actress who died suddenly in the shower in 2009, is reported to have been taking pharmaceuticals for flu-like symptoms and it was also claimed that there were a lot of prescription medications prescribed for her, her husband and her mother found at the house.
A chronic insomniac, the singer Elvis Presley died in 1977 and was taking the potent sleeping tablet, Placidyl, combined with Dexedrine to counter the effects of the sleeping pills.
The singer and actress Judy Garland died in 1969 of an accidental overdose of Seconal.
The Hollywood actor Heath Ledger died in 2008 at the age of 28 of an accidental overdose of prescription medications that included painkillers, anti-anxiety drugs and sleeping tablets.
The eccentric and reclusive billionaire Howard Hughes died in 1976 officially of liver failure, but the autopsy showed lethal amounts of codeine and valium in his system.
Anna Nicole Smith the starlet, model and widow of the octogenarian billionaire, Howard Marshall, also died unexpectedly and suddenly in 2007 of a cocktail of painkillers, muscle relaxants, sleeping pills and antidepressants.
Simon Cowell beware! The pop impresario currently riding high on both sides of 'the pond' openly admits to relying upon sleeping tablets every night to sleep. He chooses to work in the early hours of the morning and with regular commuting between the U.K. and U.S. jet lag may also be an issue. Perhaps he should seriously consider the fate of many before him and make some life-changes.
Final thoughts about mood-altering pharmaceuticals
All governments, truth be told, have lost the 'war on drugs' and on an 'if you can't beat them, join them' basis, it has been reported that the U.K. Government has called upon pharmaceutical companies to invent ‘safe’ recreational pharmaceutical drugs with no side-effects or dependency.
This brings to mind Aldous Huxley’s vision of the ‘Brave New World’ of 2540 where everyone is encouraged to consume the state-supplied hangover-free drug 'soma' which was designed to replace spirituality and keep everyone in an artificially-induced placid, malleable and blissed-out state.
You have been warned...