Top Prescription Drugs of Abuse?Part 1

Pharmacy Times
Volume 0

It has been several years since I reviewed the top prescription drugs of abuse in the United States. There have been some changes, and new combinations, so here is a preview of the top abused pharmaceuticals in 2004.

Hydrocodone products continue to lead the nation in prescription drug abuse. Street values can range from $4 to $8 per pill, depending on the strength and the section of the country.

Hydrocodone is among the most prescribed pharmaceuticals, and it is a CIII controlled substance. Abusers have the opportunity to commit prescription drug crimes by calling in phony prescriptions and/or adding and altering the refill numbers, unlike CII drugs.

Hydrocodone products are almost always abused orally, with addiction levels normally reaching 15 to 20 pills per day, although addiction rates can reach 75+ pills a day in more extreme cases. Hydrocodone was present in more than 40% of the criminal cases that my investigators uncovered in Cincinnati.

Among the analgesics, oxycodone pops up in second place. The fact that this drug is a CII controlled substance limits some forms of diversion, but it still remains a very popular substance with abusers. Brand names such as Percocet, Percodan, and Tylox bring top dollar, compared with many of the generic pharmaceuticals.

Oxycodone abusers are generally more hardened addicts, and they may be taking the drug orally or, in the worst cases, injecting several pills into their body at 1 time. This is done by crushing the pills, adding water, and then cooking the substance until it can be injected. Oxycodone injectors will become just as addicted as heroin addicts, and they often have telltale ?track? marks on their arms and other parts of their bodies.

Many of these oxycodone abusers, like hydrocodone addicts, will have problems with their livers if they are consuming large amounts of the drugs that are mixed with acetaminophen. Street values reach $6 to $8 per pill and even higher, depending on the location in the country. OxyContin continues to be popular with individuals who are typically long-time, polysubstance abusers.

OxyContin, in intact tablets, has very little appeal for prescription drug abusers. When the drug is chewed up, crushed, injected, or snorted, however, it becomes a popular prescription drug of abuse. Street values continue to be $.50 to $1 per mg, with the largest amount of abuse being east of the Mississippi River.

It is important to note that brand name controlled substances generally bring more money per pill than their generic counterparts. The reason is that drug abusers are used to being conned out of their money by dishonest dealers. These same abusers recognize brand name pharmaceuticals, which provide the dealers with an easier sale and an elevated price.

Physicians and pharmacists who have patients who insist on brand name controlled substances, even though they are required to pay full price without insurance, should use caution and try to make sure that the patients are not selling their medications. Also, although this is not always an easy task, the pharmacist should call the practitioner involved when patients who have insurance that would pay for most or all of the generic drug cost request brand name controlled substances.

Cmdr John Burke John Burke, director of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 32-year veteran of law enforcement. For information, he can be reached by e-mail at, by phone at 513-336-0070, or via the Web site

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