Why do people abuse meds?

Discussion in 'Pharmacy' started by jafx, 05.18.14.

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  1. jafx

    jafx 2+ Year Member

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    Just looking for some philosophical insight here form others here.

    I find it odd that people are willing to snort or parachute oxy, perc, vik, etc.... as though it were socially acceptable. Yet, if they see someone on the street with track marks on their arm, they look down on that person.

    Doesn't that seem odd to anyone else? The idea of ingesting any chemical (including alcohol) that's not medically necessary is horrifying to me, so I fail to understand how anyone can do either one of the aforementioned habits.

    How do you guys stay compassionate dealing with addicts day in and day out?
     
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  3. Mad Jack

    Mad Jack Critically Caring Gold Donor 2+ Year Member

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    As you have never suffered from addiction and have never tried a mind-altering substance, you will never be able to appreciate why it is that people become addicts/drug abusers. Often, it boils down to them trying things out initially to have fun or because their friends do it or whatever- they figure they'll just try it out. But some people have addictive personalities, owing to differences in genetics and their lack of social support or coping skills. To a person with such tendencies, drugs or alcohol seems to fill a void they didn't even know was there, and creates a need akin to requiring food or drink. Their brain just tells them, "you need this substance to survive and feel alright." A lot of people don't have enough self control or the proper support systems in place (as a lack of these is what led them to drugs in the first place) so they end up stuck in a cycle of addiction.

    As to why pharmaceuticals are stigmatized less than street drugs, it's largely owing to the crime that comes along with most street drugs and the stigma that creates. A guy taking a couple Adderall he bummed off of his friend is a lot less likely to be involved in crime than a guy that shoots up heroin he buys off a shady dealer in a back alley.
     
  4. WVUPharm2007

    WVUPharm2007 "Bubs Depot!" 10+ Year Member

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    That's actually a good question. Drug addiction can come from two places ignorance and stupidity. You don't know what you are doing is habit forming or...you do and you don't care. Part of me want to feel no pity for people stupid enough to use drugs like opiates recreationally. They typically knew what they were getting into when they started, yet proclaim "don't judge me" when taken to task. Well, if your dumb ass would have listened to those old DARE/health classes that told you over and over again that this **** will make you addicted you wouldn't be in this situation, now would you? On the other hand, you need to look at it as a professional. It is a psychiatric condition, even if self-induced. And you should show them compassion simply because they are in mental anguish. Perhaps they were suffering from a deep depression that I just do't have the capacity to understand and needed some sort of release. I don't know.

    But its hard, man. The same stories every month. Pretending to talk on the phone with grandma...and everyone's grandma uses 31 gauge, 5/16", 1cc syringes. And everyone is going on a trip to Spain tomorrow morning. And so many people spill Vicodin down the drain. We tend to take the lying personally. And its hard not to. Separating the person from their disease is one of the most difficult aspects of the job to be honest.
     
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  5. jafx

    jafx 2+ Year Member

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    Thank you both for offering your opinions. I find it very interesting.
     
  6. Jibby321

    Jibby321 Ready or Not...... 2+ Year Member

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    You should check out the subreddit with the opiate users.
     
  7. zelman

    zelman 7+ Year Member

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    So, I take it we're not considering the law that "Federal law prohibits the transfer of this medication to anyone other than the patient for whom it was prescribed" or whatever it says on the adderall bottle, right?
     
  8. WVUPharm2007

    WVUPharm2007 "Bubs Depot!" 10+ Year Member

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    I'm hoping we start following the Dutch model. Giving the **** away will wind up saving money in healthcare waste, law enforcement and incaceration. In The Netherlands, drug abuse is just seen as pathetic rather than strangely appealing to the "look at me I'm edgy and alternative" types we see in America. And look at the stats...once the old addicts die off, they will be relatively opiate addict free. Over 90% of their addicts are over 40! What an amazing success!

    [​IMG]

    Source
     
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  9. Mad Jack

    Mad Jack Critically Caring Gold Donor 2+ Year Member

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    Less likely to be involved in other crime- that was an obvious implication.
     
  10. zelman

    zelman 7+ Year Member

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    Some of us (the OP specifically) have not taken any pharmacy law classes. It's implied to those in the know. Others might think selling your adderall in study hall is not a crime.
     
  11. elektroshok

    elektroshok 7+ Year Member

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    He said involved in OTHER crime. i.e. in addition to the drugs such as stealing, assault, etc....
     
  12. jafx

    jafx 2+ Year Member

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    Simply because I haven't taken pharmacy law class doesn't mean I don't have experience dealing with these individuals. I was a correctional officer in two maximum security prisons and one psych camp prior to my service in the military.

    I just wanted to get an idea of how you guys deal with it... I shudder at the thought of dealing with those pieces of human waste that I used to guard on a daily basis. I suppose I wanted to expand my perspective and try to be more compassionate.
     
  13. Reirrac

    Reirrac 7+ Year Member

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    Compassion has it's limits. In the end it is up to the addicted person to pull themselves together through whatever support they have available. As a pharmacist I expect to provide whatever legal medication treatment to help them drop the habit (ie: methadone). If the person is willing to put the effort, then I would eagerly help them. If not, then that's too bad, but I won't lose sleep over it.
     
  14. Muse600

    Muse600 7+ Year Member

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    no...don't have sympathy, be an a-hole to them, and don't fill their prescriptions.
     
  15. okokok

    okokok 2+ Year Member

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    So you're willing to replace one addiction (heroin) with another addiction (methadone) simply because one is illegal and the other isn't? It's just crazy to me that one is on the other side of the legality line and the other isn't, because they can both easily be lifelong addictions.

    I wish there was a way for people in the medical community to become better acquainted with those battling addictions. I'm not singling out the person I quoted above, but it's frustrating to me how dismissive and disgusted so many young pre-health students seem to be with those battling addictions.

    On the other hand, maybe you're what's needed to treat those patients. Tough love? I'd never be able to do it without becoming really frustrated and sad.
     
  16. Reirrac

    Reirrac 7+ Year Member

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    Heroin addiction is way worse than methadone. Methadone at least allows addicts to be more functional people. Unless there's a magic cure that eliminates addiction altogether, then methadone is preferable to heroin.

    Hey now, I'm quite familiar with the reality of addiction. While I sympathize with what the addicts and their families go though, I really cannot let their situation affect my personal psychological integrity. I'm just doing my job and doing my part to get them through their addiction for better or worse. I'd rather leave my work at my workplace rather than back home. People may call it desensitization. I call it subconscious mental shielding. If every single patient's plight affects me personally, then I would end up at the psych ward!
     
    Last edited: 05.21.14
  17. zelman

    zelman 7+ Year Member

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    No. He didn't.
     
  18. BidingMyTime

    BidingMyTime Lost Shaker Of Salt 10+ Year Member

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    I don't understand addiction--I intellectually understand it, but I still can't wrap my head around it. Being overly compassionate sounds like it will just lead to your co-dependency. I don't think it matters "why" the person is an addict....that is for them to work out with their counselor, if they ever decide to go for help. I think the pharmacists job is to treat them as any other patient, do not fill prescriptions for them if the prescription would be harmful, let them know treatment options for their problem if the person is interested, do not make judgements on them or any story they tell you--but be firm in your conviction to follow the law/good sense in how early to refill their prescriptions. Just treat them respectfully and as an individual, but always remember it is not your job to fix their problem or to force help on to them.
     
  19. sandbox19

    sandbox19

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    I think there's a lot of good points here. I also think cultural acceptance is a big part. Here in the US, we have music, television shows, movies that help to create a culture of drug use. I remember in high school seeing the "emo" or "goth" type kids smoking and that kind of addictive behavior could potentially lead to worse problems in the future even though some see it as "cool". I don't recall any songs or genre like rap even mentioning drugs in East Asia. And I'm guessing because teens are more impulsive, they're more vulnerable to falling through the cracks than an adult.

    I know in some parts of Asia, if you even BRING marijuana to their country, you will be jailed for life. The social stigma against drug abuse is very strong there and the penalties very harsh. Maybe I'm wrong but other countries I imagine resort to the death penalty as an option too. I would think that because Asian countries are more dense and urbanized, they have to be more strict to maintain public order. When you lay severe punishment on an activity, that activity becomes taboo in their society and no one dares to try to abuse drugs. In the US, we're much more acceptable of drug abuse and provide more gateways to start abusing. Harsh penalty systems do seem to work in other countries but I doubt Americans would have the stomach to take such extreme measures to solve the addiction crisis.

    Lack of social support, poverty, unemployment, depression, peer pressure, stress, inability to cope, little to no access to mental health or counseling, (maybe because of no insurance or no money) are just a few reasons why people may start abusing drugs. I'm sure most people would not want to abuse drugs but they fall into a hole and it just becomes something to look forward too. I hear that more rural, impoverished, high unemployment communities are experiencing more drug abuse.

    I used to blame just the individual and that it was solely their weakness for abusing drugs and would look down on them. But I feel the system and culture in the US has failed a lot of people and is more responsible for abuse and addiction. We're so used to having quick fixes and convenience to solve our problems and drugs play a part in that. We also prescribe a crap ton more narcotics compared to other countries exposing more people to narcotics and increasing the number of addicts. I think also the fact we share borders and are relatively closer to Central/South America exposes the US to more drug trafficking than other countries. I blame the system more because the system is also responsible for the high rates of obesity and diabetes rampaging throughout the world now too. People who stuff themselves with sugars and additives are addicted in a sense too right? Often cause we advertise it, glorify it, supply it cheap and just love stuffing our faces. And fixing the system would solve the problems more efficiently than fixing and blaming every individual. I feel it's easy to fault individuals because then we can feel elevated and above others when often it's because we're just fortunate to be born to good parents, raised in a good neighborhood but that doesn't solve the problems our society faces.
     
    Last edited: 05.22.14
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  20. jafx

    jafx 2+ Year Member

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    You've hit on an important point here. We raise weak willed simpletons in America; as a rule. |Sure there are exceptions, but it has become the norm for people to be utterly out of touch with reality.
     
  21. PharmEcon

    PharmEcon 5+ Year Member

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    Surprised that no one (at least at a quick glance) has mentioned that addiction is a physiological disease... As for why people start I think it's been covered- socioeconomic circumstance and environment are big ones.
     
  22. Digsbe

    Digsbe 5+ Year Member

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    Addiction is an irrational state of mind. It's continuing to abuse a substance despite negative consequences. People abuse meds for several reasons. Some are simply chemically dependent, they tried drugs/meds socially and became hooked and haven't come off of them. Others use them as a crutch for deeper issues as a coping mechanism. Some may take them simply because they like the high or how it makes them feel.

    It's hard to show compassion when they act rude or try to blame a self inflicted problem upon others, but at the same time I just remind myself that their state of mind is irrational and to them getting their next fix may be more important than eating their next meal. I can have compassion for the circumstances behind why they might be using drugs and recognize that for many they simply made a mistake and are now trapped in the disease of addiction.
     
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  23. tnpharm2015

    tnpharm2015

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    Honestly, I find it not necessarily easy but not difficult at all to show people with substance abuse disorders some compassion, but that is most likely because of my family's long battle with addiction. Many people don't consider addiction a disease; however, I do and I believe that a person can sometimes unexpectedly become an addict.
    Many patients with substance abuse problems self-medicate their undiagnosed depression, anxiety, and various 0ther problems because of either the social stigma of being diagnosed as "depressed" or like others have said before socioeconomic status and lack of a good support system.

    However, I do believe it is partly a choice on their part to become dependent on these medications or illicit drugs.

    At my pharmacy, we have several people who are obviously dependent on pain medications which is expected when your condition requires strong opioid medications which are highly addictive. However, there are some patients who try to get two pain scripts filled at once or get incredibly early refills (for example: one of our patients every month asks for us to refill his Norco 10's at least 2 weeks early. Every month he does this and he isn't exactly the nicest person either. He has this and various other controlled medications such as Soma to help with his nonspecific "back pain" which could be legitimate, however, his doctor is known for being generous and only made him do one X-Ray that showed hardly anything to warrant 180 10mg Norco, 90 Soma, 90 5mg Diazepam, and occasionally his loving doctor will write him a Percocet script for those "flare-ups"). These are the people who have substance abuse problems and need to seek help.

    I try to show these people compassion because they are in an altered mental state and possibly have these addictions due to genetics and other various mechanisms.
    These people must realize that, for the most part, their addiction is self-inflicted. They took that pain pill with some friends and had that great feeling of euphoria or they took the Xanax because they thought they needed it for their "depression."

    I think as healthcare practitioners, we should all show compassion for all patients, even if the horrible situation they are in now is due to them making bad choices. Many addicts try for years to get clean but keep relapsing due to not having that strong support around them and not treating any underlying mental problems that could be increasing their risk of abuse.
    We don't look down upon people with Type 2 Diabetes and stigmatize their disease even though their terrible diet, smoking, sedentary lifestyle, and more mostly caused their disease. We may look somewhat unfavorably towards patients like this but not nearly to the extent that many do to addicts.

    As Sandbox19 said, Americans are exposed to more narcotics than the rest of the world. I recently heard a statistic from one of my professors that was astounding. Americans consume 99% of the world's hydrocodone supply. That is simply insane. Some doctors give it out like candy for even the smallest things and then one person who is highly susceptible to addiction starts taking their new script for pain and begin to like the feeling of no pain and a little euphoria which leads them to take more and more and you know how that story goes.

    Wow, I definitely wasn't planning on being this long-winded ha sorry for that. I am just really interested in addiction and what other healthcare professionals think of it and how they deal with people with substance abuse disorders.
     
  24. jafx

    jafx 2+ Year Member

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    I really appreciate everyone's responses. They have been informative and somewhat eye opening.
     
  25. PassingBy245

    PassingBy245

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    That law is a joke, hardly intended for the public good.. leave it to the reader's political intuition to guess the reasons. Just keep in mind that legislation most always goes to the interest with the most money or biggest mouth -- or the most expensive bottle of C2H5OH - with flavor.
     

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