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Essay title: Drug Abuse
Substance Abuse
The Challenge for Physicians and Public Policymakers

The government also plays a significant role in financially assisting non-governmental organizations and other voluntary organizations involved in the fight against drug abuse. Several acts of parliament have also been established to curb the menace posed by the misuse of drugs and appropriate punishment given to those involved.

In conclusion, although substance abuse has become a major problem in the society, concrete steps should be taken to weaken the hold on drugs. The effects of substance abuse are disastrous and cannot be ignored. Jack CA Thank you for helping me out with my college essay - I was totally stuck and your guides and manuals assisted me with my writing.

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John TX I highly recommend this student blog to anyone in need of professional essay writing help. Self-medication to augment my prescriptions? Should the pain patient, the heart failure patient, the person with COPD who uses recreational drugs all have medications that make life tolerable withdrawn.

Replies to Drs Newman and Reitan. The authors appreciate the comments of Drs. Retan asserts that the paper supports the use of random urine drug testing for patients at significant risk of prescription drug abuse and then questions the appropriateness of this position.

In actuality, the paper does not take this position. The paper only recognizes in Policy 8 that third parties e. The College, in the accompanying text to the position statement, further indicates its position that treatment and prevention are essential to eradicating drug abuse in our society, and reflects a history of advocating for the development of treatment guidelines to provide the best-quality treatment of all who need it, recognizing that addiction is a chronic condition that must be treated continuously throughout the life of the drug dependent patient and calling for adequate funding to ensure that treatment is available.

Sign In Set Up Account. You will be directed to acponline. Open Athens Shibboleth Log In. Subscribe to Annals of Internal Medicine. Position Papers 4 February This article was published online first at www. Individuals who served on the Health and Public Policy Committee at the time of the project's approval were: Bush, MD; Douglas M.

Olive, MD; Shakaib U. The inappropriate use and abuse of prescription drugs is a serious public health problem. The CDC reports that drug overdose, particularly due to the increase in nonmedical use of prescription pain-relief drugs, is the second leading cause of deaths from unintentional injuries in the United States, exceeded only by motor vehicle fatalities 2.

A recent analysis of preliminary CDC data suggests that drug overdose may now be the leading cause of such deaths 3. Prescription drug abuse is found throughout all aspects of our population.

Physicians and other health professionals with prescribing privileges are entrusted with the authority to use medications in the treatment of their patients and therefore have an important role to play in helping to ensure safe and effective use of this treatment option and the deterrence of its abuse.

The American College of Physicians ACP developed this position paper to provide guidance to prescribers and policymakers regarding measures to effectively address the problem of prescription drug abuse. A Substance Abuse and Mental Health Services Administration survey found that 16 million Americans age 12 years and older had taken a prescription pain reliever, tranquilizer, stimulant, or sedative for nonmedical purposes at least once in the previous year; 7.

Of these drug abusers, Also in , there were 2. Furthermore, the Substance Abuse and Mental Health Services Administration survey indicated that 2 million people reported using prescription painkillers nonmedically for the first time within the last year 4. Key measures of abuse of opioid drugs increased from to 4. The largest increases were in measures of adverse health consequences, such as emergency department visits, substance abuse treatment admissions, and unintentional overdose deaths 1.

The adverse consequences of prescription drugs abuse are serious, and the costs are substantial. Commonly abused prescription drugs fall into 3 categories: The National Institute on Drug Abuse NIDA warns that opioids can be highly addictive and can depress respiration and lead to death, and that injecting opioids with unsterile or shared equipment increases the risk for HIV infection and other infectious diseases 7.

Unintentional overdose deaths involving prescription opioids have quadrupled since and now outnumber those from heroin and cocaine combined. The potential for abuse is enormous because roughly million patients in the United States have chronic pain 9. The NIDA provides a listing of commonly abused prescription drugs at www. It also discusses issues related to Medicare and Medicaid, programs that provide coverage for medically necessary prescription drugs, including opioids and other pain medications, and are dealing with the problem of increasing prescription drug abuse.

It also discusses approaches taken by various state legislatures and medical boards to address this issue. The challenge for physicians and public policymakers is how to deter prescription drug abuse while maintaining patient access to appropriate treatment. The physician must be up to date on the proper use of medications and treatments, including pain medications.

Physicians have an ethical obligation to manage and relieve pain yet to do so responsibly and in accord with scientific evidence Improvement in function through the short-term use of opioids and related substances to treat acute pain and their use to ease suffering at the end of life are well-accepted medical practices. However, long-term opioid use for chronic pain is controversial because of concerns about addiction, overuse, misuse, and adverse effects.

Long-term use can also lead to opioid-induced hyperalgesia, which in turn leads to increased doses of opioids, further escalating sensitivity to pain.

Furthermore, evidence for long-term efficacy is lacking Concerns about pain being underdiagnosed and undertreated remain, particularly for ethnic and racial minorities The result is needless suffering for patients, complications that cause further injury or death, and unnecessary treatment costs.

Controlled substances include medications to treat not only pain but also sleep disorders, nerve conditions, weight loss, and other conditions. However, prescribing controlled substances, which can be addictive or abused, can subject physicians to substantial regulatory and administrative burdens. Physicians face criminal and civil penalties, including loss of licensure and consequent inability to practice for failure to comply with state and federal laws regulating controlled substances.

On the other hand, failure to adequately medicate a patient can expose a physician to malpractice charges of negligence. Physicians can also be sued for overmedication that results in addiction or serious adverse effects State medical boards also report addressing complaints for both overtreatment and undertreatment of pain. The decision to develop this policy paper was made by ACP's Health and Public Policy Committee, which is charged with addressing issues affecting the health care of the U.

Recommendations developed were informed through a literature review and input from the various College constituencies and nonmember experts in the field. The policy paper and related recommendations were reviewed and approved by the College's Governing Board in July The following statements represent the official policy positions and recommendations of the ACP.

ACP supports appropriate and effective efforts to reduce all substance abuse. These include educational, prevention, diagnostic, and treatment efforts. As physicians dealing with the health effects of this condition, we also support medical research on addiction and its causes and treatment. ACP supports a comprehensive national policy on prescription drug abuse containing education, monitoring, proper disposal, and enforcement elements. ACP supports the consideration by physicians of the full array of treatments available for the effective treatment and management of pain.

Prescribers and dispensers should check PDMPs in their own and neighboring states as permitted prior to writing and filling prescriptions for medications containing controlled substances. All PDMPs should maintain strong protections to assure confidentiality and privacy. ACP supports efforts to educate physicians, patients, and the public on the appropriate medical uses of controlled drugs and the dangers of both medical and nonmedical use of prescription drugs.

ACP favors a balanced approach to permit safe and effective medical treatment utilizing controlled substances and efforts to reduce prescription drug abuse. However, educational, documentation, and treatment requirements toward this goal should not impose excessive administrative burdens on prescribers or dispensers.

ACP recognizes that defined maximum dosage i. ACP favors establishment of evidence-based, nonbinding guidelines regarding recommended maximum dosage and duration of therapy that a patient taking controlled substance medications may receive. Patients identified by Medicare, Medicaid, private insurance plans, or law enforcement authorities as being at significant risk of prescription drug abuse may be required to participate in a drug monitoring program and undergo random drug testing.

Physicians may be required to report suspected cases of drug abuse, but should not be mandated to conduct random drug testing without the patient's consent. The financial cost of mandatory drug testing should be borne by the authority requiring the testing; neither the patient nor the physician should bear the financial cost of random drug testing mandated by a third-party authority.

ACP recommends the consideration of patient-provider treatment agreements between physician and patients as a tool for the treatment of pain. ACP recommends the passage of legislation by all 50 states permitting electronic prescription for controlled substances EPCS.

The goal of this paper is to provide physicians and policymakers with a set of recommendations to address the significant human and financial costs related to prescription drug abuse. The recommendations address detection and deterrence, as well as treatment, of this condition, and also discuss the need for increased educational efforts on the issue of prescription drug abuse both for the patient population and the physicians who treat them.

They touch on the importance of maintaining patient involvement, dignity, and privacy and the importance of limiting third-party administrative and regulatory mandates on physicians attempting to provide care and address this issue. These recommendations offered by the College aim to form a framework for patients to receive the care they require while effectively accounting for the problems associated with the use of prescription drugs—specifically, those with a significant potential for abuse.

Prescription drug abuse is found throughout all aspects of the U. Physicians and other health professionals with prescribing privileges are entrusted with the authority to use medications in the treatment of their patients and therefore have an important role in helping to ensure safe and effective use of this treatment option and the deterrence of its abuse.

This paper is intended to provide guidance to prescribers and policymakers regarding measures to effectively address the problem of prescription drug abuse and offers the following recommendations:. Prescribers and dispensers should check PDMPs in their own and neighboring states as permitted prior to writing or filling prescriptions for medications containing controlled substances.

ACP recommends the passage of legislation by all 50 states permitting electronic prescription for controlled substances. A recent analysis of preliminary CDC data suggests that prescription drug overdose may now be the leading cause of such deaths 3. The decision to develop this policy paper was made by the Health and Public Policy Committee of the American College of Physicians, which is charged with addressing issues affecting the health care of the U.

A survey in by the Substance Abuse and Mental Health Services Administration SAMHSA found that 16 million Americans age 12 years and older had taken a prescription pain reliever, tranquilizer, stimulant, or sedative for nonmedical purposes at least once in the previous year; 7. Furthermore, 2 million people reported using prescription painkillers nonmedically for the first time within the past year 4. The SAMHSA survey indicated that individuals age 12 to 25 years report the highest rates of nonmedical use of prescription drugs.

The rate of abuse of prescription drugs was 5. The survey showed that 2. In addition, the survey showed that 2. Other than marijuana, prescription and over-the-counter OTC medications account for most of the commonly abused drugs by high school seniors 7. Recent data from the National Survey on Drug Use and Health 17 indicates a decline in prescription drug abuse by young adults age 18 to 25 years.

Recent data also reflect that the dispensing of opioid medication has significantly increased in the past 5 years for individuals 60 years or older Older patients often are being treated for comorbid illnesses and are more likely to be prescribed long-term and multiple prescriptions, including opioid medications for pain.

The elderly also are susceptible to age-related changes in drug metabolism and potential drug interactions and also use OTC medicines and dietary supplements, which in addition to alcohol could compound any adverse health consequences resulting from prescription drug abuse. As a result of the above, the NIDA notes that prescription drug abuse may therefore be more dangerous in the elderly than in younger populations Some older persons improperly use prescriptions because of cognitive impairment.

It is also possible that retirees on a fixed income may abuse leftover medications of a spouse or another person in order to save money. Prescription drug abuse is a problem throughout the United States. From to , the rate of increase was higher in rural areas than in urban areas. The rate of death from drugs in rural areas increased steadily over that period. Although national data indicate the highest rates of prescription drug abuse among persons younger than age 25 years, this study indicated disproportionately higher rates of death from prescription drug abuse in rural areas in an older population age 35 to 45 years.

The authors 23 concluded:. Given the identification of older decedents in our study and nationally, this population may not be taking these medications as directed or may be abusing or addicted to prescription medications, instead of illicit drugs.

As policymakers and researchers formulate a response to the increase in nonmedical use of prescription medications, an older population should be targeted for education as well as youths. We should educate all patients, and their families, about taking medication only as prescribed, only by the individual for whom it is intended, and the dangers of combining medications without prescriber knowledge. It is also notable that prescription drugs have replaced heroin and cocaine as the leading drugs involved in fatal drug overdoses in all urban—rural categories Widespread cases of fraud also have been uncovered in the Medicaid program.

The GAO also found a disturbing amount of fraud, involving thousands of prescriptions written for dead patients or by people posing as doctors 10, At least Medicaid beneficiaries had visited 21 to medical practitioners and up to 46 different pharmacies for the same controlled substances.

Multiple factors are believed to account for the rise in prescription drug abuse in the United States. Motivations to purposely abuse drugs include the desire to become intoxicated; to counter anxiety, pain, or sleep problems; and to enhance cognition.

Unintended misuse can be due to misperceptions about drug safety, use of medications other than as prescribed, and dosage errors due to cognitive decline or impairment.

Contributing to the problem is the dramatic rise in the availability and prescription of drugs. The average number of retail prescriptions per capita increased from Between and , prescriptions for stimulants increased from 5 million to nearly 45 million and for opioid analgesics from about High-dose opioids also became more readily available as opioids were reformulated as extended-release medications to allow longer dosing intervals for treating patients in pain After reviewing the significant growth in prescribed controlled drugs in recent years and its correlation with increases in abuse and overdose, Alexander and coworkers posited that the substantial increase in the nonmedical use of opioids and related drugs is a predictable adverse effect of substantial increases in the extent of prescriptive use Overprescribing of medication by physicians for treatment of limited acute or postsurgical pain is also a contributing factor The surplus medications, coupled with inadequate instructions for disposal, serve as a ready source for drugs to abuse or divert for profit.

Society and the medical profession also need to reexamine how we view pain and pain relief As summarized by some experts: The treatment of pain with any number of approaches other than opioids can be held up as compassionate care. The profession needs to have a broader therapeutic toolkit that starts with strong patient—physician relationships and supportive systems of care. Key measures of abuse of pain-relieving opioid drugs increased from to Prescription drug abuse is common among both the young and the elderly, and it affects urban as well as rural areas.

In , about 7 million Americans reported past-month use of prescription drugs for nonmedical purposes. Commonly abused prescription drugs fall into 3 categories Figure: NIDA warns that prescription opioids act on the same receptors of the brain as heroin and can be highly addictive.

They also can depress respiration and lead to death. It further advises that injecting opioids increases the risk for HIV infection and other infectious diseases through use of unsterile or shared equipment.

The potential for abuse is enormous as there are roughly million patients in the United States who have chronic pain 9. In addition to the costs of treating the addiction and other adverse health consequences associated with prescription drug abuse, there are also other costs to consider.

These include not only the actual cost of drug purchases but also the costs of the doctor and emergency department visits that precede the dispensing of these medications. There is also the economic cost of death and lost productivity. There are criminal and civil penalties, including loss of licensure and consequent inability to practice for failure to comply with state and federal laws regulating controlled substances. Food and Drug Administration FDA is responsible for ensuring the safety and effectiveness of medicines, including prescription drugs, generic drugs, and OTC medications.

It has oversight for approval of new prescription drugs, labeling of OTC and prescription drugs, and drug manufacturing standards. It also has regulatory authority over the manufacturing, marketing, and labeling of biological products, medical devices, vaccines, food, cosmetics, and products that emit radiation. The FDA provides the public with important drug safety information that is easy to read and in an interactive format. The FDA shares information in the interest of informing doctors and patients about the issues that are under review and when FDA experts anticipate completing their review.

The Healthcare Professional Information 33 sheet is for doctors, pharmacists, nurses, and other health care professionals. In July , the FDA approved a risk evaluation and mitigation strategy REMS for extended-release and long-acting opioids as part of a federal initiative to address the prescription drug abuse and related overdose epidemic Even if they want to get rid of their habits, the withdrawl syndrome never allows them to do so.

Any drug once inside the body alters the metabolism of it. These above mentioned drugs intoxicates our circulatory system and affects our central nervous system and the brain. The brain loses its control and produces anxiety depression, changes in mood, insensible decisions etc.

The conditions produced by these drugs in our body are irreparable. Apart from this, the drug addict indulges in criminal activities like burglary or prostitution to get money for drugs even they go to the extent of murdering the parent who is refusing to give money. If a pregnant woman is alcoholic then the child will be prone to many diseases. The over of drugs may even cause death.

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- Gateway Drugs and Common Drug Abuse The oldest known written record of drug use is a clay tablet from the ancient Sumerian civilization of the Middle East. This tablet, made in the ’s B.C., lists about a dozen drug prescriptions.

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Drug addiction is a problem that has been increasing immensely among our society today. Drug addictions can only hinder or restrain us from accomplishing goals or dreams in life. People sometimes feel they are too bright, too powerful, too much in control to become addictive. Addiction can trap anyone.

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Drug abuse, also called substance abuse or chemical abuse is a disorder that is characterized by a destructive pattern of using substance that leads to significant problems or distress. Teens are increasingly engaging in prescription drug abuse. Drug abuse dates as far back as the Biblical era, so it is not a new phenomenon. "The emotional and social damage and the devastation linked to drugs and their use is immeasurable." The ripple of subversive and detrimental consequences from alcoholism, drug addictions, and 5/5(1).