Psychiatric Times 
July 2005 Vol. XXII
Issue 8
Alarmed by escalating abuse of prescription drugs during the past five years, the National Institute on Drug Abuse (NIDA) is intensifying its research in two areas--understanding mechanisms that underlie the reinforcing, addictive and toxic properties of the drugs and developing medications with less abuse potential.
Marijuana is the number one illegal drug of abuse in the United States; in second place is the nonmedical use of prescription medications such as pain relievers, tranquilizers, stimulants and sedatives, said NIDA director Nora D. Volkow, M.D., at a recent National Institutes of Health lecture (Volkow, 2004).
"[We] need to explore why it is that we are observing such a high abuse of these medications, and how can we prevent the abuse," she said.
According to newly released findings from the 2003 National Survey on Drug Use and Health, an estimated 6.3 million people (2.7% of the population aged 12 or older) currently use psychotherapeutic drugs nonmedically. An estimated 4.7 million use pain relievers, 1.8 million use tranquilizers, 1.2 million use stimulants and 0.3 million use sedatives (Substance Abuse and Mental Health Services Administration [SAMHSA], 2004).
Particularly worrisome for NIDA is the dramatic increase in the use of opioid painkillers.
"From 1995 until now, [there has been] almost a threefold increase in the abuse of these substances," Volkow said. The steep increase is especially unsettling, because there has been a decrease in abuse of most illegal drugs during the past few years.
National Survey on Drug Use and Health researchers recently stated that the number of Americans aged 12 or older who reported having ever taken a prescription pain medication for recreational use rose from 29.6 million in 2002 to 31.2 million in 2003. Pain relievers with statistically significant increases in lifetime use included such hydrocodone(Drug information on hydrocodone)-combination products as Vicodin, Lortab or Lorcet (from 13.1 million to 15.7 million); such oxycodone(Drug information on oxycodone)-combination products as Percocet, Percodan or Tylox (from 9.7 million to 10.8 million); hydrocodone (from 4.5 million to 5.7 million); the oxycodone product OxyContin (from 1.9 million to 2.8 million); methadone(Drug information on methadone) (from 0.9 million to 1.2 million); and tramadol(Drug information on tramadol) (Ultram) (from 52,000 to 186,000) (SAMHSA, 2004).
The 2003 Monitoring the Future Survey--a survey that assesses the extent and perceptions of drug use among 8th, 10th and 12th grade students nationwide--revealed that 10.5% of high school seniors had used Vicodin for recreational use during the past year and 4.5% had used OxyContin (NIDA, 2004).
