Prescription Drug Abuse Case Study

Problem: Prescription drug abuse is any use of prescription medications in a way that is not intended by the prescribing medical professional. Prescription drug abuse and misuse involves taking shared medication, as well as over consumption of medications in order to experience elicited feelings. Inappropriate or excessive drug use may become compulsive and ongoing despite negative consequences (https://www.drugabuse.gov/publications/research-reports/prescription-drugs/what-prescription-drug-abuse).
Canada is the second-largest per capita consumer of prescription opioids in the world, trailing only the United States. In addition, the rates of prescription medication consumption, and the harms associated, have increased more steeply than those in the U.S. from 2000-2010, which can be seen by a 203% increase of opioid prescribed Standardized Defined Daily Doses (S-DDD) (International Narcotics Control Board, 2013). Though many Canadians rely on these prescriptions for normal daily functioning and behave responsibly with medications, the harms associated with prescription drug abuse can be profound and permanent, such as addiction, overdose, and suicide. Therefore, the aim of this exploration is to illustrate which Canadians are most frequently abusing
prescription medications, how these drugs are being obtained by abusers, and what the government of Canada has done, and is going to do, in regards to recognizing and preventing additional abuse and misuse. Prescription medication abuse can have devastating effects on the individuals and the families of those abusing drugs. It is important for all Canadians to understand what can be done to prevent legitimate prescription drug users, become illegitimate drug abusers. The use of the structural functionalist perspective is valuable with regards to this topic. By using this theoretical lens, we can see that those who abuse drugs experience what Emile Durkheim classified as “anomie”. Durkheim would state that those who experience high amounts of anomie feel detached from social institutions and must be reintegrated into proper installments so that society can continue to exist as one unified interconnected network. Decreasing the rates of prescription drug abuse will benefit many Canadians which may be appreciated in crime reduction, less restrictive budgeting for medical and social services, and increased economic production by individuals who may be reintegrated in the workforce (CCSA, 2013).

Literature Review: The harm associated with prescription medication abuse has emerged as one the foremost health and safety concerns in North America. Although, these prescribed drugs have healing purposes, they also seem to have a high predisposition to be misused because of their psychological and physiological dependence properties. In 2011, 22.9% of Canadians 15 years and older stated that they had used at least one psychoactive medication in the past year and 3.2% of these users (corresponding to 0.7% of the total population) reported abusing such a drug (Health Canada, 2012a). In Ontario between 2005 and 2011, there was almost 250% increase of emergency room visits related to narcotic withdrawal, psychosis, overdose, intoxication, and other related prescription medication diagnosis (Expert Working Group on Narcotic Addiction, 2012). Furthermore, prescription pharmaceuticals are now involved in more overdose deaths than either heroin or cocaine in North America. Although it should also be noted that most overdoses and deaths associated with these medications are usually accompanied by some form of non-prescription based substance such as alcohol. With regards to oxycodone-related deaths in Ontario, 92% involved a non-opioid depressant (CMAJ 2009). Thus, it can be concluded that most prescription medication deaths are a combined use of multiple drug substances which involve opioid-based prescription pharmaceuticals. Although prescription medication use is widespread throughout Canada’s population, rates of misuse of certain pharmaceuticals is seen as higher in some peoples. Those included in this article are women, youth, seniors, and Aboriginals.
Women
According to data from the 2011 Canadian Alcohol and Drug Use Monitoring Survey (CADUMS), women (25.5%) had a significantly higher rate of prescription medication use compared to their male (20.2%) counterparts in 2010. However, it must be noted that although women have higher rates of prescription medication use, men are more likely to use illicit drugs that are not prescribed by a medical professional. Of those women aged 15 to 44, 22% reported the use of at least one prescription medication in 2011, of those medications 17% were pain relievers and 8.2% were sedatives or tranquilizers (Health Canada, 2012b).
Youth
Youth view prescription pharmaceuticals “safer” than some illicit street drugs (Twombly & Holtz, 2008). Thus, youth’s perceptions of drug safeness, along with higher rates of availability, may be partially responsible for increased rates of consumption and feelings of anomie towards Canada’s societal institutions. Youth have been shown to be more affected by general substance abuse compared to older adults. Studies show that brain development during adolescence is extensive and rapid. However, drug use during this time has been shown to hinder this important process, leaving some youth to not grow to their full psychological potential. Additional effects of drug use during the early adolescence stage include increased risk of later drug dependence, multi-drug use and possibly the use of riskier drugs (CCSA, 2007). Data from CADUMS indicates that in 2011, pain relievers (14.3%) were found to be higher than that of sedatives and tranquilizers (4.0%) and stimulants (2.4%) among youth aged 15 to 24 (Health Canada, 2012a). Additionally, findings from the 2008 Alberta Youth Experiences Survey, showed in a CCSA report, stated that almost one in five (17.2%) grades 7 to 12 students reported using prescription drugs without a prescription in the 12 months prior to being surveyed. Codeine was found to be the most frequently used prescription drug, with 15.5% of students having used it in the past year (Alberta Health Services, 2009 as cited in CCSA, 2014).

Seniors
Prescription medications are frequently prescribed to adults, aged 65 and older, because of the prevalence of chronic pain, insomnia, and mental illness in this demographic. Powerful psychoactive drugs, such as benzodiazepines, may be dangerous to this age group even though prescribed medically because of increased feelings of confusion, drowsiness or the lack of coordination, which may increase the risk of falls (CCSA, 2014). As the baby-boomers enter the golden age, it is expected that prescribed pharmaceuticals will be amplified as an outcome of this large, aging demographic. Therefore, it is safe to assume that prescription drug misuse programs will need to increase as well in order to keep societies institutions running smoothly.
Aboriginals
The harmful effects that are associated with substance abuse are disproportionately more harmful for Aboriginal Canadians.
Health Canada’s First Nations and Inuit Health Branch (FNIHB), Non-Insured Health Benefits (NIHB) program show that 898 opioid prescriptions were dispensed per 1,000 First Nations individuals aged 15 and older in Ontario in 2007, with 119 prescriptions for oxycodone tablets alone (Health Canada, 2010). Furthermore, the study goes on to say that from 2000 to 2010 there was a stable number of patients receiving opioid prescriptions, such as OxyContin. However, it is also the case that the amount of OxyContin tablets being prescribed to those patients has increased within those same ten
years. As countless studies show, drugs do their worst to people when they are already living stressful lives, dealing with low income, poor health, and inadequate housing. For Aboriginal Canadians, these are characteristics that are all too prevalent in their population compared to the rest of the Canadian population.
According to Robert K. Merton, the father of strain theory, substance abuse and misuse can be attributed to the conflict between culturally defined goals and socially approved means of reaching those goals. This gap between goals and means is what Merton called “anomie”. Merton believed that those exposed to community level conditions of poverty, unemployment, and other means of social breakdown, are more likely to retreat from their harsh realities by abandoning efforts to achieve goals and escape to an alternate state of reality by abusing substances. He classified this as retreatism, which is one of Merton’s possible five solutions that people use to adjust to anomie that he called “adaptions” (textbook).
Methadone maintenance treatment in Ontario has risen substantially over 10 years, from approximately 7,800 in 2001 to 35,228 in 2011, with these increases considered to be largely driven by individuals with problematic prescription opioid use (Fischer & Argento, 2012). As this assignment will show below, many addictions to opioids and associated pharmaceuticals are a result of legitimate prescribing for therapeutic purposes, “double doctoring” and diversion techniques such as prescription fraud and forgery, thefts and robberies, street drug markets and Internet purchases. Oxycodone is a semi-synthetic opioid based narcotic that is prescribed to patients suffering from moderate to severe pain. Legitimate prescriptions of oxycodone increased by 850% between 1991 and 2007. Additionally, of 1,095 overdose deaths between 1991 and 2004, 56.1% of patients had been given an opioid prescription within four weeks before death