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Recurring Epidemics of Pharmaceutical Drug Abuse in America: Time for an All-Drug Strategy

The Center for Disease Control and Prevention report that prescription drug misuse is a national epidemic. While many scientists and health professionals believe this epidemic originated recently (1990s), a current perspective piece argues it actually only represents the most recent of three “waves” of prescription drug misuse that span over a century. The authors suggest placing the current epidemic in the appropriate historical context provides an opportunity to learn from the successes and failures from past approaches. For example, during the first (early 1900s) and second (1920s-1970s) wave of prescription drug misuse, the authors cite approaches that included voluntary education of physicians, pharmacists, and patients through antidrug campaigns, implementation of policies that regulate the access and supply of pharmaceuticals, and criminal-justice approaches. The authors argue that our response to the current epidemic follows a similar pattern, yet history suggests these approaches alone are not sufficient to reduce or prevent misuse. Instead, the authors suggest an “all-drug strategy” with an expanded “public health response”. This response would include:

  • Syringe exchange programs
  • Medically-assisted treatment programs
  • Community-based overdose prevention and response training with naloxone distribution
  • Innovative prevention programming to reduce initiation and escalation of misuse

Take-Away: this perspective piece argues that if we want to prevent continuous cycles of prescription drug misuse, history suggests we must implement an “all-drug strategy”. This strategy includes existing supply-side and criminal-justice approaches, but also incorporates widened access of effective treatments and harms-reduction techniques to all drug users.

Herzberg, D., Guarino, H., Mateu-Gelabert, P., & Bennett, A. S. (2016). Recurring epidemics of pharmaceutical drug abuse in America: time for an all-drug strategy. American journal of public health106(3), 408-410.

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