Feeling overweight? There’s a pill for that. Winter blues got you down? There’s a pill for that. Can’t sleep? There’s a pill for that. Stressed out? There’s a pill for that.
The May 2012 IMS Health report states that the pharmaceutical market earned $955 billion, with the United States accounting for more than a third of the global market.
Prescription drug abuse is the fastest growing type of substance abuse in the United States and has been classified as an epidemic by the Centers for Disease Control and Prevention. The CDC also reports that drug overdose is the leading cause of injury death. Of those, 60 percent were related to prescription pills.
Of these medications, pain-relievers, tranquilizers and stimulants are the most abused according to a National Institute of Drug Abuse study.
LaGrange Police Sgt. Mark Cavender said LaGrange has seen a tremendous influx of narcotic abuse in the past four years with little sign of it slowing down.
Cavender said it presents a multifaceted problem as police are seeing an increase in prescription forgery, doctor shopping and street selling.
With doctor shopping, users will visit up to 10 different doctors, clinics or emergency rooms a week and get multiple prescriptions. Cavender said this not only feeds their habit, but also gives them the supply to turn around and sell it on the street.
While most drug cases are open and shut, Cavender said prescription drug abuse often slips through the cracks because of its legal availability and accessibility.
“Its completely legal for you to possess it, its completely legal for you to walk around with it in your pocket, its completely legal for you to sit at home and take whatever drugs to your heart’s content and get as high as you want to because it’s been prescribed to you,” he said.
Users and sellers have been able to manipulate the system by creating pill mills. Cavender said in these pill mills, a certified, legitimate doctor will operate on a cash-only basis and prescribe whatever medication the patient wants in return for money.
“It’s hard to combat an issue when you can go to the doctor and the pharmacy and get that drug completely legal,” Cavender said.
Over the past decade, legislation has pushed pill mills out of neighboring states, specifically Florida, which in turn has sent them up the interstate to Atlanta.
Though Cavender said he does not know of any active pill mills in the LaGrange area, buyers don’t have to drive too far to find one.
The surrounding communities are also feeling the waves from the metro areas. West Point Police reported a 34 percent increase from 2012 to 2013 in prescription drug arrests, however, Hogansville police reported that though it remains steady, they have not seen a significant rise in the problem.
Though Georgia passed the Patient Safety Act in 2011, requiring physicians to document all their prescriptions within the state, Georgia does not have a mandated prescription drug monitoring program (PDMP) requiring them to share data with other states.
An optional PDMP in Georgia became operational in May, 2013 but needs Federal funding to operate past September 30, 2014. In order to receive federal funding, Georgia must allow its prescribes to share data with agents from other states according to the Georgia Prescription Drug Abuse Prevention Initiative.
Georgia is the last state in the Southeast to get its PDMP operational, making the state vulnerable to those abusing the system.
As pill mills started popping up in Florida, Alabama and Tennessee, legislators put into effect a PDMP to require doctors and pharmacies to check patient information on prescription activity, including other states. Through this database, authorities can identify and flag those with suspicious activity.
Without this in place, law enforcement officials said it makes it even more difficult to track and bust illegal activity.
Casey Fuller with the West Point police said without a mandated PDMP, people cross state lines into Georgia to receive prescriptions.
“It’s just going to get worse because it’s harder for us to control on a local level,” Fuller said. “It’s one of the worst things to try to fight and control.”
Jamie Daniel with the Troup County Prevention Coalition said that in 2011, 12.5 million pills were prescribed in Georgia, but filled in Alabama and 8.9 million pills were filled in South Carolina.
“Because we don’t have to check it, anybody who comes from Alabama, Florida or South Carolina can get all their stuff filled here without us knowing what their problems are,” Daniel said.
Family Medicine physician Dr. C.J. Tumambing with the Emory Clark-Holder Clinic, uses the PDMP put in place by the state and said it’s a necessary tool. Tumambing said as a doctor you always have to be on the look out for doctor shoppers and a PDMP can combat this problem.
As the north has been scarred with a heroin epidemic, its ripples have yet to reach Troup County. However, with prescription drug abuse on the rise, officials and experts say its just a matter of time before the prescription drug market attracts the demand for heroin.
“Heroin is here, its just not as bad, but its coming,” Fuller said. “The more we crack down on prescription medication, the more they’re going to turn to the heroin.”
Daniel agrees and said based on drug patterns seen in other parts of the country, prescription medication will eventually lead to a heroin market opening up locally as heroin is the cheaper alternative of opiates.
Leann Murphy,coordinator of the felony drug court in Troup County, said that many opiate abusers who can no longer afford to buy pain medication turn to heroin to feed their addiction to avoid dreadful withdrawal symptoms. She said the younger age group is more likely to purchase heroin because a bag of heroin is $10-15 compared to $80 for 80 milligram of Oxycontin.
Dangers with prescription medication lie in the fact that it’s a much stronger addiction to quit than any other drug and also is easily masked as people are able to function normally while under the influence.
“People I have arrested who use multiple drugs- meth, cocaine, pills - they all say pills are the hardest thing to come off of,” Fuller said.
Dr. Tumambing likens the addiction of pills to that of smoking in that a lot of the addiction is sometimes motion. Much like those who are addicted to the motion of smoking, people become addicted to the motion of taking pills every day.
Murphy said that though only 7 percent of drug court participants report prescription drugs as their primary drug of choice, the majority of participants report prescription drugs as their secondary drug of choice.
“Many of our clients operate on the erroneous assumption that because these medications are prescribed by a doctor and approved by the FDA, they are safer than street drugs,” Murphy said.
Another danger with prescription medication is its easy accessibility. Those looking usually don’t have to go beyond their own front door.
Daniel reported that over two-thirds of pills used for abuse come out of medicine cabinets of family and friends.
Murphy also reported that clients said they have easy access to family or friend’s pills.
Because of this, the Troup County Prevention Coalition has set up a pill take-back drop-box at the Sheriff’s Office where anyone can discard any unused or expired medication, no questions asked. The drop-box has proved to be a successful solution. Daniel said that they are now in the process of placing one in the police department as well.
In addition to getting unused pills off the street, the coalition is also partnering with the Medicine Cabinet to sell a medicine safe that allows people to keep their medications safely secured.
The push for the medicine safe storage is, in part, an effort to keep medication out of the hands of teens.
Daniel said part of the reason for excessive self-medicating is, as a culture, we teach children that it’s fine to take medication liberally.
“When we have become a society that finds medication to be the answer for everything - that’s the message we’re giving to our kids,” she said. “Medication is not bad, but it shouldn’t become a fix all.”
Dr. Tumambing said an error people make with pills is thinking it’s a cure to their problems rather than just a treatment to keep the symptoms at bay.
Tumambing said in his own practice, he approaches patients complaining of pain with other options before prescribing pain pills.
“People rely too heavily on [pills],” he said. “The first step is always to plant the seed, to have people recognize that there is more they can do for themselves than any pill.”
According to Daniel, the onset age for Troup County teens at which they start using prescription pills is 12 years old. Daniel said starting kids out so young teaches them a routine of taking pills, causing a disconnect between the proper use of medication and abuse.
Both Daniel and Cavender reported a new trend among teens called “purple drink” or “lean.” This drink is a mixture of Sprite and cough syrup which teens are now drinking to get high.
Though neither personally know of any teens getting caught, both said that teens have told them that its common for their peers to bring it to school and drink it all day.
The Medicine Abuse Project reported that one in four teens reported misusing or abusing prescription drugs in 2012. This is a 33 percent increase from 2008. Of these teens, nearly half reported getting the medication from their parent’s supply according to the study.
Moving forward in finding solutions to the prescription drug problem will take a community-wide effort Daniel said.
“This is going to be an issue requiring the cooperation of all sectors of society,” she said. “The government has to allow the changes required to monitor these addictive substances. The medical community has to have support in treating those with legitimate health concerns while still having to look out for doctor shoppers and those who abuse the system. The public has to have access to education to make them more aware of the dangers of these substances.”