References Références Referencias

Abstract

Over the past two decades, opioid medication abuse among the U.S. population has expanded to a scourge extent. While the U.S. only accommodates 4% of the world's population, Americans consume 86% of the world's opioids, 99% of the worldwide hydrocodone supply, and 66% of the world's illegal drugs. Prescription opioids are currently the second most misused class of medication following cannabis. Results of the 2010 National Survey on Drug Use and Health (NSDUH) showed that a predicted 22.6 million people aged 12 or older were current or past month illicit drug users. Nearly 7 million individuals among these used marijuana and 5.1 million used painkillers. Only 17.3% of the users of non-therapeutic opioids indicated that they received the drugs through a prescription from a physician. The widely growing use of therapeutic opioids shows hydrocodone topping all prescriptions with 136.7 million prescriptions in 2011, with all narcotic analgesics reaching more than 238 million prescriptions. Opioid analgesics are now accountable for a higher mortality rate than suicide and motor vehicle accidents. The majority deaths (60%) occur in patients who received prescriptions based on prescribing guidelines by medical boards, irrespective of the doses. In comparison, 40% of deaths occur in individuals abusing the drugs obtained through illegal means. The objective of this article is to review the available evidence concerning misuse and differentiate a legitimate user from a drug-seeking addict. We would also discuss various aspects of drug abuse in clinical practice, mainly dealing with these patients in Emergency and Psychiatric settings.