"Our nation is in the throes of an epidemic of controlled prescription drug abuse and addiction," said Joseph A. Califano, Jr., CASA's chairman and president and former U.S. Secretary of Health, Education and Welfare. "Pharmacists must stop pointing the finger at patients and step up their vigilance and take more responsibility to curb abuse and diversion of potentially addictive controlled prescription drugs like opioids, depressants and stimulants."
CASA surveyed 1,030 pharmacists between July 21 and October 31, 2004. The survey has a margin of error of +/- 3 percent. Among its major findings:
• 51.8 percent of pharmacists believe that patients account for the bulk
of the diversion problem.
• When a patient presents a prescription for a controlled drug, 26.5
percent of pharmacists somewhat or very often think it is for purposes
of diversion or abuse.
• 78.4 percent of pharmacists become somewhat or very concerned about
diversion or abuse when a patient asks for a controlled drug by its
brand name.
• 28.9 percent of pharmacists have experienced a theft or robbery of
controlled drugs at their pharmacy within the last five years.
• 20.9 percent of pharmacists do not stock certain controlled drugs in
order to prevent diversion.
• Only about half of pharmacists received any training in preventing
prescription drug diversion (48.1 percent) or identifying abuse or
addiction (49.6 percent) since pharmacy school.
CASA also surveyed 979 physicians to better understand the mechanisms of diversion of prescription drugs and how medical professionals deal with this problem. Among that survey's major findings:
• 43.3 percent of physicians do not ask about prescription drug abuse when
taking a patient's health history.
• 33 percent do not regularly call or obtain records from the patient's
previous (or other treating) physician before prescribing controlled
drugs on a long-term basis.
• 47.1 percent say that patients commonly try to pressure them into
prescribing a controlled drug.
• 59.1 percent of physicians believe that patients account for the bulk of
the diversion problem.
• Physicians perceive the three main mechanisms of diversion to be patient
doctor shopping (96.4 percent), patient deception or manipulation of
doctors (87.8 percent), and forged or altered prescriptions (69.4
percent).
• 74.1 percent of physicians have refrained from prescribing controlled
drugs during the past 12 months because of concern that a patient might
become addicted to them.
• Only 19.1 percent of physicians received any medical school training in
identifying prescription drug diversion.
• Only 39.6 percent of physicians received any training in medical school
in identifying prescription drug abuse and addiction.
Results of the pharmacist and physician surveys were published in Under the Counter: The Diversion and Abuse of Controlled Prescription Drugs in the U.S., a 214-page CASA report detailing the findings of an intensive three-year study of prescription opioids (e.g., OxyContin, Vicodin), central nervous system (CNS) depressants (e.g., Valium, Xanax), CNS stimulants (e.g., Ritalin, Adderall) and steroids. Among the report's overall key findings:
• From 1992 to 2003, while the U.S. population increased 14 percent, the
number of 12 to 17 year olds who abused controlled prescription drugs
jumped 212 percent and the number of adults 18 and older abusing such
drugs climbed 81 percent.
• From 1992 to 2003, abuse of controlled prescription drugs grew at a rate
twice that of marijuana abuse; five times that of cocaine abuse; 60
times that of heroin abuse.
• From 1992 to 2003, the number of people abusing controlled prescription
drugs increased seven times faster than the increase in the U.S.
population.
• The 15.1 million Americans abusing controlled prescription drugs exceed
the combined number abusing cocaine (5.9 million), hallucinogens (4.0
million), inhalants (2.1 million) and heroin (.3 million).
CASA is the only national organization that brings together under one roof all the professional disciplines needed to study and combat all types of substance abuse as they affect all aspects of society. CASA has issued more than 50 reports, has conducted demonstration projects focused on children, families and schools at 89 sites in 41 cities in 22 states, and has been testing the effectiveness of drug and alcohol treatment, monitoring 15,000 individuals in more than 200 programs and five drug courts in 26 states. CASA is the creator of the nationwide Family Day initiative -- the fourth Monday in September -- that promotes parental engagement as a simple and effective way to reduce children's risk of smoking, drinking and using illegal drugs. To become a CASA member, please visit http://www.casacolumbia.org/ and click "Become a Member" on the main menu or send an e-mail to [email protected] for more information.