DAYTON, OHIO-Researchers at the Wright State University School of Medicine have identified an emerging, dangerous drug abuse trend. OxyContin®, a powerful and frequently abused narcotic pain medication, and other prescription pain relievers are becoming new pathways to heroin and injection drug use.
The research results will appear in the March 1, 2003, edition of the American Family Physician, a leading peer-reviewed clinical journal for family physicians and other primary care providers.
The new trend represents a reversal of the classic pattern of heroin abuse in which heroin is used initially and then prescription drugs are substituted when it is not available. The research identifies an emerging population of young, white, middle class people who begin heroin use by abusing OxyContin® and other prescription medications, become dependent, and then turn to heroin when the supply of prescription drugs dries up. These younger drug abusers begin by snorting the heroin, but resort to injection when tolerance develops to the drug's effects or when the quality of heroin drops. Injection exposes the user to infection with HIV, hepatitis, and other medical problems.
Harvey Siegal, Ph.D., an author of the article and director of the medical school's Center for Interventions, Treatment and Addictions Research, describes this new trend as "perhaps one of the most frightening that I've seen in a 30-year career of studying drug abuse. It's like a 'Perfect Storm' scenario for an immediate and persistent public health crisis. We're seeing the convergence of a dramatic use in prescription drug abuse, a young, at-risk, unsophisticated population, and a compromised public health response. The result will be more addicted people, lives cut short through overdose and disease, and on-going problems for our communities."
Data for the article came from the Ohio Substance Abuse Monitoring Network (OSAM). OSAM is a drug abuse early warning system that collects information on emerging drug abuse trends by interviewing active drug abusers, treatment personnel and law enforcement agencies.
Robert Carlson, Ph.D., who directs the OSAM network, states, "OSAM identified the relationship between OxyContin® and heroin abuse before it was widely recognized by treatment providers and law enforcement. Reports from throughout Ohio continue to tell us that this is a growing problem and that treatment and prevention efforts have not been keeping up with it. This summer, OSAM investigated a prescription drug abuse-heroin epidemic in a small town in Southeastern Ohio. The community of about 15,000 people experienced at least 8 overdose deaths in a year's time and more than 50 overdoses requiring medical care. Heroin and pharmaceutical drug abuse is increasing, and I'm afraid that if we don't do something, we'll start hearing about many more epidemics."
All of the authors agree that drug abuse prevention aimed at young people needs to be expanded to effectively include prescription as well as illegal drugs. Ohio's drug abuse treatment programs need to be ramped up to meet the problem. Physicians and other health-care providers need to be equipped with the skills necessary to identify people who are seeking drugs for their euphoric effects.
Sanford Starr, chief of the Division of Treatment Planning at the Ohio Department of Alcohol and Drug Addiction Services (ODADAS), the agency that supports the OSAM network, is concerned by these findings and is grateful for the information that OSAM provides. "It gives those of us in state government the facts we need to make the most effective use of increasingly limited resources," he says. "OSAM is really proving its worth."
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