Despite the rising awareness and current intervention strategies, this problem continues to escalate. The Center for Disease Control reports:

  • Of the 259 million prescriptions written for opioids worldwide, the U.S. consumes more than 90 percent.
  • There were 42,982 overdose deaths in 2013.
  • More than 10 percent of adolescents age 12-18 will use prescription opioids for non-medical use this month.

This does not take into account adolescents using sedatives, stimulants and alcohol often with the opioids making for a dangerous cocktail. This indeed is an epidemic.

Understanding the trends

How do we explain these alarming trends? Is it because physicians unwittingly prescribe to the person who is addicted or over prescribes for pain? Is it the drive for profit by the pharmaceutical companies? Is it due to ineffective treatment modalities, societal “leniency,” poor parenting, genetics, the disease of addiction or the substance user themselves? Likely all of these are contributing factors, which must be addressed if we are going to effect change. However, the root cause of the substance use problems lies in what drives the demand for these substances.

"Whether we have a genetic predisposition to addiction or other mental health disorders, developmental and family of origin issues or the stress of adolescence, medications are not always necessary."

Pain, loss and general dissatisfaction are not accepted as a normal part of the journey of life and even worse are often given diagnoses such as depressive and anxiety disorders or chronic pain syndrome. It is common in our practice to see young adults prescribed sedatives and stimulants by their physician who has labeled them with some psychiatric disorder when in fact they suffer more from spiritual, developmental or substance use issues. The patient might demand a quick fix or more likely with the adolescent, the parent is demanding a pharmacologic solution. This demand is so great that even doctors sworn to “do no harm,” succumb to the pressure. Why?

A few are just bad doctors. But the majority are good physicians trying to relieve suffering, but often lack awareness of the core issues or have insufficient time to conduct a comprehensive evaluation to understand the many factors affecting the patient’s life. Further, physician’s performance evaluations are often contingent on patient satisfaction surveys. So even the best of doctors could be pressured into meeting the demand or request for a certain medication or treatment as opposed to providing the best, but unpopular, practice.

Finding a solution

What really hurts and drives the demand for a substance is much deeper. We have taught our children so poorly about the solution. Whether we have a genetic predisposition to addiction or other mental health disorders, developmental and family of origin issues or the stress of adolescence, medications are not always necessary. We have a remarkable ability to heal and accept our discomfort not as suffering, but simply as, the “ouch” of normal life.