I assume many readers saw this article – Young, Assured and Playing Pharmacist to Friends
For a sizable group of people in their 20’s and 30’s, deciding on their own what drugs to take – in particular, stimulants, antidepressants and other psychiatric medications – is becoming the norm. Confident of their abilities and often skeptical of psychiatrists’ expertise, they choose to rely on their own research and each other’s experience in treating problems like depression, fatigue, anxiety or a lack of concentration. A medical degree, in their view, is useful, but not essential, and certainly not sufficient.
They trade unused prescription drugs, get medications without prescriptions from the Internet and, in some cases, lie to doctors to obtain medications that in their judgment they need.
A spokeswoman for the Drug Enforcement Administration says it is illegal to give prescription medication to another person, although it is questionable whether the offense would be prosecuted.
The behavior, drug abuse prevention experts say, is notably different from the use of drugs like marijuana or cocaine, or even the abuse of prescription painkillers, which is also on the rise. The goal for many young adults is not to get high but to feel better – less depressed, less stressed out, more focused, better rested. It is just that the easiest route to that end often seems to be medication for which they do not have a prescription.
Some seek to regulate every minor mood fluctuation, some want to enhance their performance at school or work, some simply want to find the best drug to treat a genuine mental illness. And patients say that many general practitioners, pressed for time and unfamiliar with the ever-growing inventory of psychiatric drugs, are happy to take their suggestions, so it pays to be informed.
Health officials say they worry that as prescription pills get passed around in small batches, information about risks and dosage are not included. Even careful self-medicators, they say, may not realize the harmful interaction that drugs can have when used together or may react unpredictably to a drug; Mr. Tylutki and Katherine each had a bad experience with a medication taken without a prescription.
But doctors and experts in drug abuse also say they are flummoxed about how to address the increasing casual misuse of prescription medications by young people for purposes other than getting high.
“A physician who treats himself has a fool for a patient.”—Sir William Osler
We are taught from the first year of medical school the danger of self treatment. I extend that thought to family members and non-patient friends. I will give advice, but defer to the treating physician.
This article about young adults trading psychoactive meds does scare me. I do understand their concenrs, but I am not convinced that they really understand the implications of medication use. We must learn more than pharmacology in order to do a good job prescribing. We should know all the indications and all the contraindications. We should know what other medical conditions the patient has.
Most of the time, the practioners of this new form of self treatment will have no problems. But I must emphasize – most of the time.
The problem with medications is that when things go bad, they can go very bad.
I understand, but cannot condone this behavior. It does actually scare me. It represents a dangerous form of arrogance and self-importance.
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6 Responses to 20 somethings play around with prescriptions
Enrico
November 18th, 2005 at 3:55 pm
I agree to a point. The “recreational” nature is of the most concern. I definitely believe in better living through chemistry, but the human body is not a precisely calibrated instrument where you take gradations of milligrams to achieve the “perfect” effect. I wonder if they are trying to remove all pain, anxiety, and discomfort from their lives. You don’t take a benzodiazepene merely because you feel tense.
I definitely don’t condone/agree with those who actively deceive their doctors to get a certain RX. Likewise, I disagree strongly with those who actively suggest that a friend to whom they give drugs not have to see a doctor if it’s something that concerns them–if it’s worth taking a prescription drug, it’s worth getting it checked by a doctor (assuming it isn’t a chronic, known problem, and even then, there are masking factors that can fool unwary physicians, much less laypeople)
I liken these people to jailhouse lawyers (woohoo! medicine and legal in one comment!): they know everything about their one case, every trivial loophole/detail in the law(s) that apply to them, etc. but couldn’t BE a lawyer of any kind. You can read a drug monograph, memorize it, and rattle off Cmax’s, 2nd/3rd level metabolites, half-lives, clearances, indications and dosages, etc. but that doesn’t mean that you really know (say it’s an antibiotic) _in the real world_ what advantages that abx has over another abx in which circumstances, in which patient populations, given which specific bugs, becuse it’s partly subjective but mostly synthesis of more than just the raw data of a disease vs. the drug.
I write about the above like I know what I’m talking about, but I don’t. It’s just how I see it at this point, because I’m sure I’m missing something. I look forward to the time when I do actively start developing these skills in a real clinical setting.
tina
November 18th, 2005 at 7:35 pm
Very grey area.
If you can’t get resonable care from overworked MDs who don’t have the time to listen or think about what is wrong with you perhaps you are actually safer making these choices yourself. I know more about the side effects and pharmacology of the meds I take than my MDs. I know my own body better than my MDs. I am sorry as that sounds super arrogant and I am not by nature arrogant. It is just a lesson that I have learned over the past year or so when my MDs screwed me over because they didn’t understand what they were doing.
We can’t get reasonable advice from our drs much of the time due to time constraints or lack of knowledge. We get much more volume (and totally questionable) advice from others who are getting treated for conditions much like what we are going through. It could be completely wrong but it also is at least something.
The trick with all of this is that there are certain areas I know very, very well-neuropharmacology and endocrinolgy. I would go as far as saying I know more than the ave GP about these areas. So I am comfortable making my own med choices here. I don’t know a damn thing about heart disease or infectious disease, thus I would consult an MD. But I really wish it was more of a consultation-where I discuss my understanding, they discuss errors in what I understand and I am free to question there ideas and make suggestions and then I leave and make my own choices.
It might be a worthwhile idea for you guys to pick your favorite condition-for instance thyroid disease, cancer, or whatever send thrills racing through your cute puffy little MD brains-and go visit an online support group for that particluar illness. What you’ll find is what we tell each other, wrong right or somewhere in the middle.
And yes I have done the above med sharing thus earing myself a spot in the eternally burning “self medication hall” of hell.
Health 2.0
November 18th, 2005 at 9:07 pm
Not a promising trend
DB’s Medical Rants: 20 somethings play around with prescriptions. One word: yikes. Fascinating article quoted though, and worth the read.
joanne
November 19th, 2005 at 11:53 am
Much of the publics self medication ‘knowledge’ comes from the overmarketing hype of prescription drugs. You cant pick up a magazine today that doesnt have several ad inserts or watch tv without being bombarded from ads ranging from sleep/anxiety/heartburn to osteoporosis meds. How many patients come into doctors offices today and ASK for a certain prescription medication for their ailment? Yes they all identify with the little sad anxious circle that is out of the loop and want ‘that’ medication to make it all better. I want a good nights sleep, well that Ambien butterfly is my ticket. Lets not forget the purple pill for my heartburn too. Brainwashing? You bet. But even with all the marketing hype what if I dont know if this product will ‘fix’ my ailment? Sure doctors can give out samples. But another real reason people self medicate or exchange meds is cost. How many Americans have no health insurance these days? Or how many insurance plans do not cover prescriptions? Many people cannot afford to go to a doctor, let alone pay for a prescription that might not do anything to alleviate their symptoms.
sophizo
November 22nd, 2005 at 10:34 pm
Being a 20-something myself, I find it horrible that so many of my generation are attempting to medicate themselves without the advice of a doctor. I don’t think most people realize that most drugs can have an effect on other aspects of your body and other drugs you take. Yes, there are plenty of websites out there that can tell you if certain drugs will interact with other drugs, but I’ll bet you any amount of money that those who self-medicate don’t check such an important thing. There are just tooooooo many things that can go wrong and permanent damage that can be done. I think these people are stupid to do this. You won’t see me taking any drugs without a Dr’s rx (for me and not anyone else)!!!
But I do understand why people do it, even if I don’t agree with their actions. There are so many reasons why Dr’s don’t or can’t listen to a patient. Time is obviously an issue, but so it the lack of doctor-patient relationship. Too many people have been forced to take their health into their own hands. Thank god there is the internet to do research.
And then there are those who think that they need help concentrating, so they take some ADHD drug because my generation has grown up being told that drugs like Ritalin will help you focus. Way too dangerous! I think I’ll stick with my 6-pack of Mountain Dew to get things done!
Basically, I’m choosing the health of my liver, kidneys, heart, and other major organs over self-medicating. I guess these people are just going to have to learn the hard way.
And to joanne…there are ways to get prescriptions free or at low cost without doing something illegal. For many drugs, the drug companies have programs for people who can’t afford the drugs. And doctors often have samples of drugs that they can give out. That’s how I’m able to keep taking one of the drugs I’m on. My doctor knows I can’t afford it, so he keeps giving me samples. Lack of money is no reason to do something illegal. There are plenty of programs out there for people to see doctors no matter if they have insurance or money. Using drugs illegally is just wrong and dangerous.
EM
November 28th, 2005 at 12:46 pm
Unused Accutane for sale! 20-something women welcomed, no questions asked.
Very sad.