PRESCRIPTION DRUGS PARTLY TO BLAME

It's easy to see why drugs like heroin, crystal meth and crack cocaine
garner more fear and attention from parents than other substances.
After all, they come with easy-to-vilify accessories. Needles.
Makeshift pipes. Rolled-up dollar bills and razor blades. That's the
stuff of gripping, sometimes gory movies.

But several recent reports remind us that it's the drugs that sit
benignly in the average Canadian's kitchen cupboard or bathroom
cabinet that lead to the most grief-alcohol and prescription drugs.

Many parents are aware that alcohol is the leading cause of harm among
Canadian teens. Binge drinking, in particular, has been a factor in
everything from alcohol poisoning to violence and sexual assault to
vehicle-related accidents and deaths. But what about opioids (also
known as prescription painkillers), such as codeine and oxycodone? And
what about other "helpful" medicines, such as anti-depressants and
even Ritalin, the stimulant drug most often prescribed to elementary
school kids with attention deficit hyperactivity disorder (ADHD)? Are
the contents of the family medicine cabinet being misused too?

According to a study on illicit opioid use, published in the Canadian
Journal of Psychiatry (September 2006), prescription drug misuse is on
the rise in Canada. This isn't surprising when you consider that
Canada is the world's fifth highest overall consumer of prescription
opioids (the US ranks first in the world). What is surprising,
however, is how few studies have actually been conducted on
prescription drug misuse. Since Canada is in some cases the number one
consumer of specific medicines, such as hydromorphone (Dilaudid),
you'd think a lot more red flags would have gone up a lot sooner.

We live in a "drug-rich environment," the study's researchers say, and
kids seem to have ample opportunity to buy, sell and misuse
prescriptions, whether the bottles bear their name or someone else's.
Part of our growing drug problem, they say, is a result of "generous
opioid prescription practices in the medical system" and the "ready
availability via the internet." This may partly explain why there has
been a major increase in Oxycontin abuse in Eastern Canada, and why in
some places, such as St. John's, Newfoundland, the number of users is
growing, especially among adolescents. Ritalin, too, is a substance
that some young people are willing to spend their money on. A type of
amphetamine, Ritalin can be chopped up and snorted to produce a
long-lasting high and energy, much like cocaine and crystal meth.

Does this mean we should do away with prescriptions? Not at all.
Medication has its place, and many people do benefit from
pharamceuticals. What it does mean, though, is that Canadians-and
especially Canadian parents-need to revisit their attitudes and
behaviours when it comes to drugs. The first step is to recognize that
legal substances like alcohol and prescription medications (and even
tobacco, for that matter) are indeed drugs, and that all of them can
be misused by both adults and young people.

The next step is to think about why we readily accept the use of some
drugs-namely, pills that come in a little plastic bottle prescribed by
a doctor-but rally against similar substances that do not have the
government's stamp of approval. (Not yet, anyway. Or not anymore. Keep
in mind that many illicit substances, including heroin and cocaine,
were at one time legal in Canada.)

Most important, we need to consider the real issue of why so many of
us, young and old, use substances in the first place, and why so many
of us do so in harmful and destructive ways.

Substances themselves, of course, are not the problem. That would be
like saying food is the problem when it comes to a person with an
eating disorder. The problem is far broader and more
complicated.

Without open and honest communication about what really is troubling
people and questioning the ways in which we're self-medicating
ourselves, we'll be forever throwing stones at this substance or that
and missing the bigger, more important picture.

Dan Reist

Centre for Addictions Research of B.C.

University of Victoria