New CASA* Report: Controlled Prescription Drug Abuse at Epidemic Level: Nearly Half of Physicians Say Patients Pressure Them to Prescribe Controlled Prescription Drugs | CASAColumbia

New CASA* Report: Controlled Prescription Drug Abuse at Epidemic Level: Nearly Half of Physicians Say Patients Pressure Them to Prescribe Controlled Prescription Drugs

New CASA* Report: Controlled Prescription Drug Abuse at Epidemic Level: Nearly Half of Physicians Say Patients Pressure Them to Prescribe Controlled Prescription Drugs

WASHINGTON, D.C., July 7, 2005

More than 40% of physicians do not ask about prescription drug abuse when taking a patient’s health history and one-third do not regularly call or obtain records from the patient’s previous (or other treating) physician before prescribing controlled, potentially addictive drugs like opioids, depressants and stimulants. An alarming 47.1% say that patients commonly try to pressure them into prescribing a controlled drug. These disturbing findings come at a time when the number of Americans who abuse controlled prescription drugs has nearly doubled from 7.8 million to 15.1 million from 1992 to 2003, according to a new report by The National Center on Addiction and Substance Abuse (CASA) at Columbia University entitled, Under the Counter: The Diversion and Abuse of Controlled Prescription Drugs in the U.S.

“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. “Before physicians blame patients for the explosion in controlled prescription drug abuse, they should look in the mirror at their own prescribing practices. Physicians have an obligation to help calm America’s perfect storm of abuse of mind altering prescription drugs by carefully assessing their patients before their pens touch their prescription pads.”

CASA surveyed 979 physicians between July 21 and October 31, 2004. The survey has a margin of error of +/- 3%. Among its major findings:

  • 59.1% 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 %), patient deception or manipulation of doctors (87.8%), and forged or altered prescriptions (69.4%)
  • 74.1% 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% of physicians received any medical school training in identifying prescription drug diversion
  • Only 39.6% of physicians received any training in medical school in identifying prescription drug abuse and addiction

CASA also surveyed 1,030 pharmacists to better understand the mechanisms of diversion of prescription drugs and how medical professionals deal with this problem. Among that survey’s major findings:

  • 28.4% of pharmacists do not regularly validate the prescribing physician’s information (DEA number) when dispensing controlled drugs; 1 in 10 (10.5%) rarely or never do so
  • 61% do not regularly ask if the patient is taking any other controlled drugs when dispensing a controlled medication; 25.8% rarely or never do so
  • When a patient presents a prescription for a controlled drug, 26.5% “somewhat or very often” think it is for purposes of diversion or abuse; 78.4% become “somewhat or very” concerned about diversion or abuse when a patient asks for a controlled drug by its brand name
  • 51.8% believe that patients account for the bulk of the diversion problem. 28.9% have experienced a theft or robbery of controlled drugs at their pharmacy within the last 5 years; 20.9% do not stock certain controlled drugs in order to prevent diversion
  • Only about half received any training in preventing prescription drug diversion (48.1%) or identifying abuse or addiction (49.6%) since pharmacy school

Results of the physician and pharmacist surveys are published in Under the Counter: The Diversion and Abuse of Controlled Prescription Drugs in the U.S., a 214-page CASA report released on July 7, 2005, 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 Full Report’s Key Findings:

  • From 1992 to 2003, while the U.S. population increased 14%, the number of 12 to 17 year olds who abused controlled prescription drugs jumped 212% and the number of adults 18 and older abusing such drugs climbed 81%
  • From 1992 to 2003, abuse of controlled prescription drugs grew at a rate 2 times that of marijuana abuse; 5 times that of cocaine abuse; 60 times that of heroin abuse
  • From 1992 to 2003, the number of people abusing controlled prescription drugs increased 7 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)

*The National Center on Addiction and Substance Abuse at Columbia University is neither affiliated with, nor sponsored by, the National Court Appointed Special Advocate Association (also known as "CASA") or any of its member organizations with the name of "CASA."

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