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Ayleah Hansen
Allison Fernley
ENG-1010-SP16
19 April 2016
Deadly Prescriptions: Are We Doing Enough to Reduce Prescription Opioid Abuse?
Throughout history opium has been used to treat a multitude of things; from treating
wounded Civil War soldiers with morphine in 1861 to using heroin as a cough syrup for children
in the early 1900s. Opium offers a feeling of painless euphoria, making it a great pain reliever as
well as popular for recreational use. Opium dens, similar to hookah bars, were a place where
people could go to smoke opium and relax in the 1800s. Although, morphine and heroin were
common prescriptions, in 1900 there were an estimated 250,000 American opium addicts.
(PACWRC)
Prescription drugs werent strictly regulated in the 1800s, but San Francisco passed a law
banning opium dens in 1875. This was the first anti-drug law passed in the United States. Not
long thereafter the Pure Food and Drug Act of 1906 was passed, requiring all substances
containing narcotics to be labelled appropriately. Following suit, the Harrison Narcotic Act of
1914 was passed. Under this act large doses of narcotics could only be prescribed by licensed
physicians and pharmacists. Finally, in 1924 heroin was made illegal (PACWRC).
Opium derivatives, or opioids, are still being used to treat pain related to injury or illness.
Common opioids are drugs like OxyContin, Codeine, and Percocet. Today people with cancer or
chronic pain are treated with prescription opioids, but in recent years these drugs are proving to

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be extremely deadly for Americans. Since 1999 the amount of opioid related overdoses has
almost quadrupled. This is no coincidence; in 1999 opioid prescriptions also nearly quadrupled
(CDC). Prescription drugs have become the second most abused drug in America (after
marijuana). Our government has been trying to get ahead of this problem since 2011, when the
White House initiated the Prescription Drug Abuse Prevention Planan action plan to make
prescription opioids less available to those who chose to abuse them. So far, this plan hasn't been
successful in its attempts to slow abuse, with 2014 cited as having the most drug overdose deaths
in recorded history. Six out of 10 of those deaths involving an opioid. (CDC)
The strategies that the Prescription Drug Abuse Prevention Plan sought to implement
included providing prescription drug education, setting up tracking and monitoring programs on
a retail level, providing locations for proper drug disposal, as well as closing pill mills and
preventing doctor shopping. The first initiative of the plan was to teach youth, parents, and
healthcare providers about the dangers associated with misuse of painkillers. The ideal take away
from this part of the plan would be that people wouldnt think, These drugs are legal so they
must be safe. Secondly, the plan sought to aid the states in setting up disposal centers or take
back programs to get leftover painkillers out of peoples medicine cabinets. This step is
important because 70% of those abusing prescription drugs get them from a friend or relative
who has a prescription. The set-up of monitoring programs would be used to track who is
receiving prescription opioids as well as who is providing them. The goal of this initiative is to
see who is prescribing an excess of opioids and who is receiving them; possibly leading to an
investigation on whether or not drug abuse is taking place. Finally, closing pill mills, a clinic
that prescribes painkillers with little to no legitimate reasons, would prevent people who dont
require opioids for medical reasons from obtaining them. The closing of such places would also

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result in the investigation and possible arrest of the physicians practicing there. Doctor
shopping, the act of going to multiple doctors to receive painkiller prescriptions, would be
addressed by teaching reputable physicians to recognize drug seeking behaviors to keep them
from prescribing painkillers to individuals exhibiting such behaviors. In essence, the goals of the
Prescription Drug Abuse Prevention Plan are to decrease misuse of such drugs while keeping
them available to those with a legitimate need for them. (Epidemic)
As previously mentioned, the rates of opioid overdoses continue to rise in spite of the
efforts the government is making. Utah Attorney General, Sean D. Reyes believes that the Food
and Drug Administration has a key role to play in the fight against prescription drug abuse.
Reyes is invested in this issue because the state of Utah in ranked fourth in the country for
prescription drug abuse. He believes that the FDA needs to make regulations that require
pharmaceutical companies to make opioid drugs with abuse-deterrent formulas, going as far as to
insist that generic versions must not be approved if they arent made with the same safeguarding.
These formulas would make the drugs crush resistant and harder to dissolve, this would prevent
abuse via snorting or drinking a concentrated solution. Reyes insists the necessity for warning
labels that explains the risks associated with these medications to patients and physicians.
Additionally, he believes that physicians must show preference to prescribing over-the-counter
pain relievers. Reyes insists that with 44 overdose deaths a day in America, the initiatives of the
Prescription Drug Abuse Plan arent enough, and medications made with abuse-deterrent
formulas is the next step in decreasing prescription drug abuse. (Reyes)
While Reyes offers a strategy that may aid in the fight to reduce opioid abuse, there are
instances where abuse-deterrent formulas did more harm than good. In one instance, the switch
to an abuse-resistant formula resulted in an HIV outbreak in Austin, Indiana. In 2012, Endo

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Pharmaceutical created an abuse-deterrent formula of their painkiller Opana. This change in
formulation was intended to reduce abuse by crushing and snorting the drug. The change did
record a decrease in people snorting Opana, but soon those addicted to the drug found a new
method of abusing Opana. People found a way to remove the hard coating on the drug and began
injecting it. Opana abusers began sharing needles. In 2015, 190 people in Austin, Indiana tested
positive for HIV. Many users cited the change in Opanas formula to be the reason they began
using needles, which ultimately led to the outbreak. (Dreisbach)
Setbacks aside, the government is making efforts to implement both strategies. While
they have seen some decrease in certain areas, prescription drug abuse is still on the rise. To aid
in the efforts, the Center for Disease Control and Prevention (CDC) has released new prescribing
guidelines for opioids. These guidelines require physicians to show preference to over-thecounter remedies, prescribe lower doses of opioids when unavoidable, and recommend
alternatives treatmentssuch as physical therapy. Some hospitals are trying opioid alternatives
such as acute nerve numbing and using laughing gas. (Wang)
On the other hand, there are medical professionals that disagree with all of the efforts
being made to prevent prescription drug abuse. Doctors Mark Estren and Beverly Potter argue
that all of the efforts being made are just making it harder for people with chronic pain to obtain
the relief they need to function in daily life. Some pharmacies in Florida have begun ordering
lower numbers of opioid prescriptions to avoid being labelled a pill mill and becoming subject
to investigation that could result in the closure of their businesses. When pharmacies are ordering
less than what their business demands people are being forced to go without their prescriptions.
Those going without their medicine end up in the ER, where they may be accused of drug
seeking behaviorthen denied medication again. (Estren and Potter, 88) Estren and Potter insist

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opioid drugs are safe and effective when taking correctly. They claim that the government is
overlooking the real problem, which is addiction. They insist that the only way to decrease
prescription drug abuse is to treat addiction as a behavioral mental illness. (Estren and Potter, 93)
Throughout my life I have known many people who have abused prescription drugs as
well as illegal drugs. One thing I have observed about these individuals is that when their drug of
choice is made inaccessible, they find a new one. For instance, I knew someone who was
addicted to heroin, but when it was unavailable she would steal OxyContin from family members
or go to a doctor claiming to be in excruciating pain so they would write her a prescription.
President Bush was forewarned that by implementing the Prescription Drug Abuse Prevention
Plan we would see an increase in heroin use as the availability of prescription opioids decreased.
(Crites and Markon) Some Florida areas have seen an increase in heroin overdoses as
prescription overdoses have decreased. (McLaughlin)
Prescription drug abuse is a complex issue for which there is not one simple solution and
the evidence suggests that the current efforts being made to cut prescription drug abuse are not
enough. People of all ages and backgrounds are dying because of prescription opioids, these
people could be your friends or family. Although, prescription drugs are a necessary for the
treatment of pain, something else needs to be done to discourage the misuse of these drugs. I
believe that a combination of prescription drug education, proper medication disposal, affordable
addiction treatment, and research for opioid alternatives is the ideal solution for decreasing
painkiller abuse. Solving this problem should be of high importance because the rate of
prescription overdose deaths will continue to increase if we dont address the issue differently.

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Works Cited
Dreisbach, Tom. "How A Painkiller Designed To Deter Abuse Helped Spark An HIV Outbreak."
NPR. NPR, 01 Apr. 2016. Web. 04 Apr. 2016.
"Epidemic: Responding to America's Prescription Drug Crisis." Whitehouse.gov. USA.gov, 19
Apr. 2011. Web. 20 Apr. 2016.
Estren, Mark J., and Beverly A. Potter. Prescription Drug Abuse. Oakland, California: Ronin
Publishing, 2013. eBook Collection (EBSCOhost). Web. 30 Mar. 2016.
McLaughlin, Tom. "Reports Say Heroin Use Skyrockets in Okaloosa County." Northwest
Florida Daily News. GateHouse News Outlets, 7 Nov. 2015. Web. 20 Apr. 2016.
Pennsylvania Child Welfare Resource Center Handout #5. "Prescription Drug Abuse Timeline."
The University of Pittsburgh: Pennsylvania Child Welfare Resource Center (PACWRC).
Pennsylvania Human Services. Web. 19 Apr. 2016.
Reyes, Sean D. "A Smart Way to Counter Prescription Drug Deaths." Washington Times. The
Washington Times, 21 Mar. 2016. Web. 29 Mar. 2016.
"Understanding the Epidemic." Centers for Disease Control and Prevention (CDC). Centers for
Disease Control and Prevention, 14 Mar. 2016. Web. 19 Apr. 2016.
Wang, Hansi Lo. "No Joke: N.J. Hospital Uses Laughing Gas to Cut down on Opioid Use." No
Joke: N.J. Hospital Uses Laughing Gas to Cut down on Opioid Use. 01 Apr. 2016. Web.
04 Apr. 2016.

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Reflection
1. Describe the feedback you got on your presentation, on your rough draft, and from
me. Give specific details. How did your revise your paper using this feedback?
The feedback I received from our class presentations indicated that many of my
classmates werent aware of how large the problem is today. To help people understand
the problem I added more history about opium and opium derivatives, as well as revised
the way I presented statistics. I learned from our conference where I needed to change
punctuation or wording to make it easier to understand. I made sure to add page
numbering and format my works cited page correctly.
2. How, specifically, did you revise for your peer audience given what you've learned
about them in this go-round and throughout the semester?
I learned that it is better to include too much information than to give too little. Some of
my peers may not have the same understanding of an issue as I do. For this paper, I tried
to answer questions my peers might have had before they had to ask them. I also learned
that my peers are open-minded and willing to listen to views differing from their own if
they are properly supported. With that in mind, I revised this paper to have supporting
evidence from credible sources.
3. How well do you think you have met the criteria for this paper? Give me details and
point to places where I can see you meeting the criteria.
I believe that I met the criteria very well. I have researched a topic that is relevant today;
the third paragraph explains how prescription opioid deaths have increased in recent
years. I used opposing views throughout the body of the paper to illustrate the differing
opinions on how to solve this problem. I did this by outlining the positions of various
groups (i.e. the White House, Utah Attorney General, and 2 medical doctors). In the first

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three paragraphs I provided my readers with the history of my issue, as well as what role
it plays today. I concluded with my own position on the issue. I met the page requirement
as well as did careful proofreading and editing.