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The Prescription Drug Abuse Epidemic: Incidence, Treatment, Prevention, and Policy
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Introduction 3 Starrels in chapter 9 of this volume, there is ample reason to believe that the use of potentially stigmatizing labels does just that: it places a negative value judgment on a person. The use of these labels has inherent ethical problems, conflicting with the important principles of beneficence and respect for per- sons, and there is evidence that such labeling is counterproductive, as it dis- courages people from seeking treatment or taking other steps to cease prescription misuse (Kelly, Wakeman, & Saitz, 2015 Scholten et al., 2017). Chapter Overview The initial four chapters cover the background material on the medication classes of interest: opioids (chapter 2), stimulants (chapter 3), benzodiazepines (chapter 4), and other misused over-the-counter medications (chapter 5). The first three chapters examine the medical uses and pharmacological properties of the medication classes, and the fourth covers such risks as mis- use, intoxication, and consequences of inappropriate use. The chapter on over-the-counter medications takes a brief look at a variety of medications, including antihistamines and laxatives. The next three chapters examine populations of special interest for pre- scription misuse: adolescents and university students (chapter 6), young adults (chapter 7), and older adults (chapter 8). For younger individuals, focus is warranted due to the uniquely elevated rates of misuse in university students and young adults and, in all cases, due to the potential for misuse to adversely affect both neurobiological and psychosocial developmental trajec- tories. After the chapters on populations of interest, the next two chapters focus on prescription misuse through the lens of two particularly impacted medical settings: primary care pain management (chapter 9) and the emer- gency department (or emergency room chapter 10). The next two subsections of the book cover prescription misuse on national scales. First, chapters 11, 12, and 13 examine policy, law, and public health related to prescription misuse in the United States. Specifically, chap- ter 11 addresses federal law and policy, chapter 12 addresses the use of pre- scription drug monitoring programs (or PDMPs) to reduce prescription misuse, and chapter 13 addresses a variety of harm reduction approaches to reduce the opioid epidemic. Chapter 14 examines prescription misuse out- side the United States, in the United Kingdom. Finally, two chapters consider larger theories that may be relevant to pre- scription misuse. Chapter 15 describes and applies three health behavior theories to prescription misuse, while chapter 16 describes criminological theory and applies it to misuse. The book ends with a final and brief chapter that points toward future directions for research and policy that may help reduce rates of both prescription misuse and the associated consequences that have so significantly affected tens of millions or more worldwide.