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The Prescription Drug Abuse Epidemic: Incidence, Treatment, Prevention, and Policy
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CHAPTER ONE Introduction Ty S. Schepis From a variety of public health, medical, and other clinical experts (Cobaugh et al., 2014 DeVane, 2015 Kanouse & Compton, 2015 Kolodny et al., 2015) to the executive branch of the U.S. government (Newman, 2017) and the president of the United States (Ford, 2017), a consensus has emerged that prescription opioid misuse in the United States is an epidemic and a national crisis. While the attention to the topic has accelerated greatly in the past year, misuse of opioid medications, such as oxycodone (e.g., OxyContin), hydro- codone (e.g., Vicodin or Lortab), and fentanyl, and the consequences of such misuse have been increasing since the early 2000s in the United States. Increases in opioid misuse have occurred concomitantly with increases in emergency department visits (Substance Abuse and Mental Health Services Administration (SAMHSA), 2012), the number of individuals enrolling in addiction treatment (SAMHSA, 2014), and overdoses related to opioids (Rudd, Aleshire, Zibbell, & Gladden, 2016). More recent evidence points to an increase in heroin use driven by individuals who had previously misused opioids transitioning to heroin (Compton, Jones, & Baldwin, 2016) and continuing to use heroin (Palamar & Shearston, 2017). Furthermore, the United States is not the only country affected by opioid misuse, as commen- tators in Canada (Fischer, Gooch, Goldman, Kurdyak, & Rehm, 2014), Europe (Morley, Ferris, Winstock, & Lynskey, 2017), and Australia (Roxburgh et al., 2017) and a chapter of this volume can attest. Opioid misuse is not the only form of prescription misuse to be concerned about, however. Stimulant medications that are often used to treat attention- deficit/hyperactivity disorder, including methylphenidate (e.g., Ritalin or