June 2001 • Volume 7 • Number 6
Rx for drug abuse?
Director Karla Birkholz, M.D., answers reporters' questions at the National Press Club.The National Institute on Drug Abuse, the Academy and six other organizations launched a campaign this spring, the National Initiative on Prescription Drug Misuse and Abuse.
AAFP Director Karla Birkholz, M.D., of Phoenix was the only practicing physician helping kick off the campaign at a press conference in Washington.
When asked how to distinguish between abuse and proper use of drugs, she said, "Here's what I tell my patients. 'If you're using your medicine properly, you'll be more effective and productive in your life. If you're using it to get high or escape your life, that's abuse.'"
In a later interview, Birkholz said misuse can include not taking medicine for fear of addiction, taking it in wrong dosages and taking it for reasons other than those intended. And she said some patients coordinate their own care, going to different specialists and taking multiple medications with serious repercussions.
Birkholz noted a further problem: underprescription.
"With our pain patients, we should be treating their pain and their depression and anxiety," said Birkholz. "Some physicians are afraid of using high-powered drugs, but those drugs may be what our patients need."
Sometimes, combining medications at lower doses may yield fewer harmful side effects in patients with problems such as hypertension, diabetes and depression, said Birkholz.
Birkholz told of a psychiatrist who once advised her, "If you have a patient needing more than one antidepressant, you should refer the patient to a psychiatrist." Birkholz replied, "Do you know what I do for a living? I have to manage multiple medications. That's my job."
Collaborating partners in the national prescription drug initiative are the AAFP, National Institute on Drug Abuse, AARP, American Pharmaceutical Association, National Association of Chain Drug Stores, National Community Pharmacists Association, National Council on Patient Information and Education, and Pharmaceutical Research and Manufacturers of America.
Info from NIDA
The National Institute on Drug Abuse reports:
- Some 46.6 percent of physicians find it difficult to discuss prescription drug abuse with their patients, according to a survey of primary care physicians and patients.
- An estimated nine million Americans used prescription drugs for nonmedical reasons in 1999.
- The most commonly misused or abused prescription drugs are opioids, central nervous system depressants and stimulants. Those drugs, when not taken as prescribed, can alter the brain's activity and lead to dependence and, possibly, addiction.
- Up to 17 percent of adults 60 or older may be affected by prescription drug abuse or misuse.
A new publication to help health care professionals discuss prescription drug abuse with patients is online at http://www.drugabuse.gov/ResearchReports/Prescription/Prescription.html and may be ordered by calling NIDA at (800) 729-6686 and requesting the research report on prescription drugs.
FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.
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