Pill Poppers vs. Pain Patients

This week the Office of National Drug Control Policy announced a "strategy to confront the illegal diversion and abuse of prescription drugs." The initiative will include prosecution of online pharmacies, increased monitoring of physicians' prescriptions, and "education" aimed at making doctors more suspicious of their patients–all of which will make it harder for people in pain to get adequate treatment. To justify the crackdown, ONDCP cites 6.2 million "current abusers of prescription drugs." The Washington Post refers to "the growing menace of prescription drug abuse," which "touches and harms more than 6 million Americans yearly."

The impression left by such statements is that all 6.2 million of these people have serious drug problems. But the number, which comes from the 2002 National Survey on Drug Use and Health, refers to people who reported any nonmedical use of prescription drugs during the previous month. It includes anyone who took Ritalin for kicks or popped a Percocet to relax. How many of these people could reasonably be called addicts?

The NSDUH does not report data on daily use. But in the 2003 Monitoring the Future Study, only 5 percent of the high school seniors who had used prescription narcotics in the previous month were daily users. The comparable figures for tranquilizers was 7 percent.

So the number of pill poppers with serious habits may be more like a few hundred thousand rather than 6 million. By contrast, the American Pain Foundation estimates that 50 million Americans suffer from chronic pain, much of it undertreated.

This is not simply a matter of numbers, of course. It also should count for something that any harm prescription drug abusers suffer is self-inflicted, whereas pain patients have no choice in the matter.