Worldwide Prescription Drug Abuse

APRIL 01, 2007
Cmdr John Burke

Recently, the International Narcotics Control Board (INCB) report deemed prescription drug abuse a global problem, not just one in the United States. The board members pointed out that, in many cases, prescription drugs were the abuser's first choice, and abuse of pharmaceuticals had surpassed the abuse of traditional illicit drugs in many countries. The report said that abuse in the United States had nearly doubled from 1992 to 2003, with over 15 million people abusing licit pharmaceuticals.

Most experts agree that prescription drug abuse has surpassed the abuse of all illicit drugs with the exception of marijuana in the United States. In addition, in some states, deaths due to overdose of pharmaceuticals have clearly exceeded deaths related to illicit drugs such as cocaine and heroin.

This INCB report also identified parts of South Africa, South Asia, and Europe as rising hotbeds of prescription drug abuse. They indicate that the demand is so high that residents are resorting to Internet pharmacies to help quench their thirst for their illicitly obtained medications. As in America, this makes those individuals more susceptible to counterfeit drugs, and they have no way of measuring the ingredients and dosing strength.

One response to the INCB report I found quoted the health minister from Cyprus, who said that prescription drug abuse did not exist in his nation. He went on to say that individuals in his country could get these drugs only by going to a doctor and taking the prescription to a pharmacy, and an individual could not simply walk into a Cyprus pharmacy and buy these drugs without a prescription from a physician. The health minister also indicated that officials had conducted a check of some kind and found that Internet purchases by residents of Cyprus were not a problem.

I found this an interesting assessment of the nonproblem in Cyprus and thought it sounded somewhat similar to the apparent lack of knowledge or initiative by segments of our federal government just a few years ago when assessing the widespread abuse of pharmaceuticals.

The INCB's report should not be surprising to anyone, since human beings are human beings, and addiction does not discriminate by sex, race, or any ethnic boundary. In many countries, however, even the legitimate prescribing and dispensing of controlled substances is low and scrutiny is very high, making it more difficult for residents to obtain the drugs through "doctor shopping" and other scams. This likely means more individuals are getting their prescription high through the smuggled market or the Internet, where government control is much more difficult.

Regardless, this INCB report is ultimately positive, as hopefully more and more countries and their governments begin to recognize this issue as a serious health and crime problem and do something about it now.

The only way to successfully tackle this problem is through global collaboration. International smuggling and the Internet are not individual country problems; they are a global problem and contribute to a very significant portion of the prescription drug abuse in America and likely worldwide.

John Burke, commander of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 38-year veteran of law enforcement. Cmdr Burke also is the current president of the National Association of Drug Diversion Investigators. For information, he can be reached by e-mail at, via the Web site, or by phone at 513-336-0070.