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Doctors must be more vigilant

http://www.boston.com/bostonglobe/editorial_opinion/editorials/articles/2010/08/10/doctors_must_be_more_vigilant?mode=PF

PRESCRIPTION MEDICINES, when taken as directed, improve the quality of life of millions of people. But the recent rise in the abuse of many of these medications is cause for concern. While individuals must ultimately look out for themselves, doctors should also take greater responsibility for ensuring that the drugs they prescribe don’t feed an addiction. Like any other devastating side effect of medication, the risk of addiction needs to be monitored continually.

A new study from the Centers for Disease Control and Prevention found that emergency room visits for prescription drug abuse rose sharply in the last few years. Trips to the ER involving opioids like oxycodone, hydrocodone and methadone rose 111 percent from 2004 to 2008 (from an estimated 145,000 to 306,000), while visits related to abuse of sedatives went up 89 percent during the same period (from 144,000 to about 272,000).

Abuse rates went up quickly after age 17 and peaked during ages 21 to 24. However, this is a problem that affects all age groups: The rate of abuse-related ER visits among 20-year-olds was similar to that of people in their early 50s. Perhaps the scariest statistic is this: by 2008, ER visits for abuse of all drugs stood at an estimated 2 million nationwide. Of those, visits for abuse of prescription medications were equal in numbers, at 1 million estimated visits, to those linked to illegal drugs.

For some abusers, the problem begins as a slippery slope of higher and higher doses until dependence on a sedative or painkiller is inescapable. For others, the ill-fated journey starts with experimentation after a seemingly innocent trip to the medicine cabinet at home. Either way, the fact that these are not illegal drugs makes the problem much more difficult to recognize and tackle.

Doctors should be especially mindful: according to one study, the prescription rates for these types of medications has risen in recent years. Since addicts will often lie and connive to get the prescriptions they crave, medical professionals must take to heart the edict that their responsibility is to the health of the patient, not the patient’s wishes.