The rise of prescription pill abuse in the U.S. is being well documented but it’s what is not in the Center for Disease Control’s reports that is most alarming to a former FDA staffer.
When the Center for Disease Control issued a press release this past March regarding prescription drug abuse rates in the United States, James Harris, Ph.D., a former Food and Drug Administration staffer and trained toxicologist, couldn’t help but notice there were some crucial flaws in the federal agencies explanation of the health crisis — namely the absence of the role of the black market in the sales and inherent abuse of the drug.
Talking to MintPress, Harris said he was disappointed by the CDC’s “simplistic” view of the prescription drug abuse crisis in the U.S., in which physicians were cited as being the number one direct source of prescription drugs, and a failure to include information about the power and influence of the black market on prescription drug abuse.
While an addiction to prescription pills may sound harmless to some, the reality is quite serious. Last fall, it was estimated 6.1 million people abused prescription drugs in the U.S., with the most commonly abused drugs being prescription painkillers or opioid pain relievers such as Vicodin, OxyContin, Percocet, Xanax, Valium, Adderall and Ritalin.
Harris said awareness of the black market’s estimated $25 billion prescription pill sales market is crucial — especially for parents of high school-aged children — and says he is shocked the CDC has not made journalists and therefore the public more aware of the issue, given that black market prescription sales are occurring at historic proportions.
“As an ex fed I think the feds are supposed to tell it straight and not send people into the ditch,” Harris said. “I’ve warned them about basically having a very simplistic view of the crisis,” yet the doctor says “for reasons that I can’t understand they are very serious about keeping it very simple, and in fact that over simplification is damaging.”
Concerned the agency was sending an inaccurate message to the American public about how this prescription drug abuse problem had occurred and why it was still ongoing, Harris made it part of his mission in recent years to properly educate the media and public on the issue. He has even asked the CDC directly to change it’s messaging so that the public would be better informed as to how large of an industry the illegal sale of prescription drugs had become.
In March, Harris, who co-founded Vatex Explorations LLC, a company that develops technology to combat prescription drug abuse and trafficking, including Harris’ own Divert-X system, wrote an email to the CDC shortly after the release of the controversial press release, informing agency officials of his concerns about the agency’s failure to wholly describe the issue.
What was of particular concern for Harris was that the CDC’s message centered around the idea that all of the prescription medications found in ones medicine cabinet are likely to be abused, so parents especially, needed to either lock the medicine cabinet or throw everything out.
Comparing today’s medicine cabinet to the liquor cabinet of yesteryear, Harris explained that simply cleaning out ones medicine cabinet or not accepting prescriptions from one’s physician offers no guarantee that a child, friend or loved one wouldn’t be able to obtain the drugs. That’s not Harris’ opinion either — there have been several studies in the past decade or so that have all found the street or the black market is a large source for many who abuse prescription drugs.
However the agency didn’t agree with Harris’ assessment of the information and responded via email saying “Our intention was to emphasize that physicians are increasingly important sources as the frequency of nonmedical use per person increases. And, since most of the friends/relatives who provide the opioids to nonmedical users report that they themselves got them from physicians, the prescribers are only two removes from all opioids used nonmedically.
“The point is that prescribers can do something about this problem by checking the histories of their patients in prescription drug monitoring programs,” the CDC’s Len Paulozzi wrote. “They might then avoid providing drugs for nonmedical use.”
Black Market Addictions
Though it’s a hard concept for some to grasp, turning to the black market is not necessarily an individual’s choice. The problem is that the withdrawal symptoms associated with many prescription medications are so painful and the high is so intoxicating that many users often have no choice but to turn to the black market to obtain more of the drug.
While prescription medications may not be foreign sounding and are technically legal in the U.S., the drugs are actually very expensive on the black market, which is why Harris says prescription pill dealers are most often found in middle class and wealthy neighborhoods.
The various medications all have varying street prices, which are largely dependent on the type of high a person can get from that medication. Harris says this high profitability rate from the largely opiate-heavy prescriptions on the drug market has caught the attention of drug dealers, who either try to obtain the pills themselves from a physician or ask someone else to do so.
Although Harris recognizes that ultimately the drugs come from doctors, he said physicians in the U.S. don’t currently have the tools to differentiate between a patient who really needs the medication and an individual who is faking an illness or the severity of their pain in order to turn a $20 co-pay into a several thousand dollar paycheck.
As a result, Dr. Nora Volkow, director of the National Institute on Drug Abuse, says there were 210 million prescriptions written for opiate medications in 2011 alone, even though the U.S. population was around 312 million people.
“The doctors are usually duped into prescribing to ‘patients’ who are skilled at exaggerating the magnitude and duration of symptoms,” Harris said. “This is the new supply chain for the black market, and CDC purposely sends the press in the opposite direction for reasons unknown to me.
“This hidden agenda is the story,” Harris told MintPress about the CDC. “It must be important to them because misrepresenting their own data is risky.”
In the past few years federal agencies such as the Drug Enforcement Administration and the FDA have proposed implementing more restrictions on when and how doctors would be able to prescribe narcotic painkillers, including those that contain acetaminophen or aspirin, but these proposals have often been criticized by groups such as the American Medical Association and pharmacy organizations who say the impact on patients is too great and that the policy may affect how pharmacies operate and who in the medical field can prescribe medications.
Since there haven’t been any major changes to how physicians prescribe drugs, or a crackdown on the black market, the number of prescription drug abusers in the U.S. has only increased, along with the price of the drugs.
Despite the high cost to the buyer, Harris says prescription pills are easier for teenagers to obtain than beer, which likely explains why a study published in the Journal of Adolescent Health last February found that young people abuse prescription drugs at a 40 percent higher rate than previous generations.
According to law enforcement officials in Southlake, Texas, where Harris lives, teenagers find buying beer difficult compared to prescription pills because all they have to do to get a pill is text a dealer — who could be a friend or family member — and meet up with them about an hour or so later.
The high cost for these drugs brings up another concern for Harris. In the CDC’s report, Harris points out that the agency talks about how some people obtain the pills for “free.”
“What does that mean,” Harris rhetorically asked. “Is there maybe trading of sexual favors? Is that ‘free’? There’s no cash, but it’s a cash equivalent.”
In previous interviews with MintPress, current and former drug users have shared that a user’s decision to trade a sexual favor for a drug usually occurs because they feel they either owe the dealer something, or they have no money and are so physically desperate to experience that drug, they are willing to do just about anything.
While prescription drugs may be the “pedigree” of the drugs on the black market, the high cost of these drugs has led to an increase in heroin users in the United States. Like many prescription drugs currently being abused by the American public, heroin has an opiate base, which means the withdrawal symptoms of prescription drugs can be fixed with heroin.
Dan Duncan, associate executive director at St. Louis’s National Council on Alcoholism and Drug Abuse, aid that most heroin users’ addiction starts with the use of pain pills, or at least 86 percent, according to Harris, which likely explains why both heroin and prescription drug abuse has skyrocketed in recent years. Yet, that possible connection was absent from the CDC’s report as well.
Given that a November 2013 poll from the Pew Research Center found that only 16 percent of Americans believe that progress is being made when it comes to dealing with the issue of prescription drug abuse in the country, Harris is far from alone in his thought that the CDC needs to accurately and wholly explain the issue to the media and public.
When or if that will ever happen remains unknown.
MintPress requested an interview or at least a statement from the CDC regarding Harris’ claims, and asked whether big pharmaceutical companies have any influence in how the issue is being addressed. Our request was denied, and instead, spokeswoman Courtney Lenard offered us the following:
“As the nation’s health protection agency, CDC led the way in identifying the epidemic of prescription painkiller overdoses. Prescription opioid overdoses quadrupled in the United States between 1999 and 2010. During this same time period, the amount of prescription opioids prescribed in the United States also quadrupled. We are now working to reverse the prescription drug overdose epidemic…”