Addiction and Its Damage No Longer an Affliction of the Young

At one time, it was primarily the young who struggled with drug use and addiction. That pattern no longer exists. New information reveals that more middle-aged Americans are continually being added to the rolls of the addicted. And prescribing patterns of medical doctors are the main source of the problem.

This new data from the Centers for Disease Control and Prevention shows that middle-aged Americans (45 to 64 years of age) losing their lives to overdoses accounted for 44% of all overdose deaths in 2013 and 2014, an increase over prior years. In addition, the proportion of adults 50 and over entering treatment for opioid addiction has increased greatly over the last few decades.

This sentence from the report from the Wall Street Journal sums up the problem:

Handful of pills

“Experts say many doctors are uninformed about the risks of opioids and are insufficiently trained in how to prescribe them.”

Inadequate Training

Surveys of prescribers show that most doctors never get the training they need to prevent drug misuse or addiction. One survey done by the National Center on Addiction and Substance Abuse at Columbia University showed that two-thirds of doctors only receive two hours or less of education on the diversion of prescription drugs (meaning to divert pills from proper medical use to uses that are not medically necessary). And only one-third of doctors considered their training on this subject adequate.

As Americans age, more of them experience injuries or surgeries and are in chronic pain. Because doctors have been carefully instructed since the mid-1990s to treat pain with opioids (thanks to the diligent efforts of pharmaceutical salesmen), painkillers like hydrocodone, hydromorphone and oxycodone have been freely prescribed, along with anti-anxiety drugs to mask the worry of being alone and in pain.

Perhaps the young become trapped in addiction by starting to use pills recreationally. Or perhaps they start with marijuana and migrate to pills when get want a new experience. For middle-aged Americans, it’s more likely that their path to addiction started in a doctor’s office with a prescription for an addictive pain pill.

No One is Mandating Retraining for Doctors

An older man in pain.

Despite the fact that this desperate situation continues to hurtle down the train tracks at high speed, no official body has yet taken responsibility for making sure medical doctors, dentists and other prescribers receive adequate retraining. For many, their standards of care came from the pharmaceutical representatives who brought addictive medications to their offices – along with lunch, invitations to conferences in fancy resorts and other rewards.

As long as prescribers are not taught how to prevent addiction when treating pain, how to identify a drug-seeking patient and how to care for a patient who is dependent on their pain medication, our problems with opioids will persist. There are more than 700,000 doctors to be retrained, nearly 200,000 dentists and a hundred thousand veterinarians (whose drugs may be diverted to humans). The sooner this retraining can start, the sooner we can see Americans and their pain being properly cared for without their becoming addicted.


Karen Hadley

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.