PRESCRIPTION DRUG ADDICTION

Addiction is a brain disease characterised by the compulsive use of substances despite the harmful circumstances. Whilst we are accustomed to the use of illicit substances which leads to addiction, there are prescribed drugs that many are addicted to, intentionally or unintentionally. Individuals may initially take the drugs for medicinal purposes but later divert towards non-medicinal purposes.

The National Institute of Drug Abuse (NIDA) has highlighted that the three common classes of prescription drugs often abused include opioids, CNS depressants and stimulants. CNS depressants includes sleeping tablets known as benzodiazepines as well as barbiturates. The CNS depressants are often prescribed for a specific purpose but using them for a long time may lead to addiction and withdrawal symptoms when abruptly stopped.

According to the World Health Organisation (WHO) about 34 million people over the world used opioids and 19 million used opiates in 2016. There were reportedly an estimated 27 million people diagnosed with opioid use disorders with a significant number being that of prescription (pharmaceutical) opioids. Prescription opioids include among others codeine and morphine; are prescribed for acute pain following surgeries and chronic pain in cancer patients. When used in high doses they can cause respiratory distress and death. Combined use with alcohol potentiates the problem even further. Persistent use of opioids leads to dependence and massive withdrawal symptoms when the drug is stopped.

There are no documented statistics on the matter in Botswana, but does that not mean the problem is not there and it could be much greater! In curbing this, there is need to up schedule most drugs from being over the counter drugs where one can easily buy without prescription. There is need to continue education and awareness on prescribers to reduce irrational and inappropriate prescribing of opioids.

Patient education should be heightened to include information on adverse drug effects like dependence. Sleep hygiene should be emphasised to clients before resorting to prescribing CNS depressants. As an example, one may report having insomnia yet he/she takes coffee or caffeine products before bed time, a prescriber may then opt to give a sleeping tablet yet it would have been wiser to address sleeping patterns.