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Canada and the United States lead the world in per-capita consumption of prescription opioids — the United States alone, with 5% of the world’s population, uses more than 80% of the world’s oxycodone and 65% of the hydromorphone (Palladone).
Rather than getting them from illegal dealers, most of the drugs that are abused are prescribed legally and then diverted elsewhere, as friends or family members share them or leave them unguarded in medicine cabinets.In 2012, the agency introduced a requirement that the manufacturers of slow-release opioids make educational materials available to doctors and patients.So far around 20,000 prescribers have taken educational courses, and the FDA hopes to increase that number to around 80,000 this year. “We want to get the best information to the doctors so they decide who’s going to benefit from these drugs, and who’s going to be potentially placed at risk of harm by using them.”But regulators and doctors need to strike a balance between keeping the drugs away from those who might abuse them, and ensuring that they are available for patients who genuinely need them.This is particularly true of young people, who are at the highest risk of starting to abuse prescription drugs.“For adolescents, the primary source is friends and relatives,” says Carol Boyd, who studies prescription medicine abuse at the University of Michigan in Ann Arbor.“Most do not pay, three-quarters of adolescents and young adults get them free from their friends.”Boyd’s research has found that when young people are prescribed controlled medications legally, their risk of going on to abuse those drugs goes up dramatically — by as much as 12-fold in the case of sleep medications.Slow-release oxycodone tablets, such as Oxy Contin, contain a huge amount of the drug, and so account for a disproportionate number of overdoses and deaths, says Throckmorton. “Prescription opioids have been our focus for several years,” he says.While prescription opioid abuse is widespread, it is particularly prevalent in North America and Australia, according to Kamran Niaz, an epidemiologist at the United Nations Office on Drugs and Crime.These include depressants — for example, benzodiazepines such as diazepam (Valium) and alprazolam (Xanax), used to treat anxiety — and stimulants — for example, the combination of amphetamine and dextroamphetamine (Adderall), and methylphenidate (Ritalin or Concerta), prescribed for attention deficit hyperactivity disorder.But by far the most widely abused, and dangerous, drugs are opioid painkillers, such as hydrocodone (Vicodin) and oxycodone (Roxicodone).In contrast, prescription drug abuse in the United States is so bad that the Centers for Disease Control and Prevention have described it as an ‘epidemic’ in the country.Part of the discrepancy between North America and Europe is to do with how commonly the drugs are prescribed.