Joseph Califano, Jr., served as President Lyndon Johnson’s chief assistant for domestic affairs and as Secretary of Health, Education, and Welfare from 1977 to 1979. Today he is the chairman and president of the National Center on Addiction and Substance Abuse at Columbia University (CASA), “the only national organization which brings together under one roof all the professional disciplines needed to study and combat abuse of all substances: alcohol, nicotine, illegal drugs, prescription drugs, performance enhancing drugs – in all sectors of society.” (

One of CASA’s concerns is the rapid growth of prescription drug abuse among all adult age groups and especially among adolescents. Based on an analysis of available federal data on drug use, CASA researchers have concluded that some 15 million people in the United States now abuse prescription drugs.

Prescription drug abuse occurs when a person uses a drug prescribed for someone else or simply for the experience or feeling a drug produces. Unfortunately, CASA has also found that this epidemic of dangerous misuse of prescription drugs is facilitated by the fact that today, most people have easy access to prescription drugs through doctors, relatives, friends, and the Internet.

Painkillers are seriously abused and, as Mr. Califano points out, the “problem with teens is a far more serious problem than anyone has ever realized.” In fact, CASA estimates a 542% increase of abuse among teens between 1992 and 2003.

Websites based around the world sell all types of powerful prescription drugs to almost anyone without regard to their age, state of health, or whether they have a prescription. At the top of the list of abused drugs are opioids (painkillers) like OxyContin and Vicodin; stimulants like Ritalin and Adderall; anabolic steroids like Anadrol and Equipoise; and central nervous system depressants like Xanax and Valium.

While the justifications for abusing these drugs vary, no socio-economic or age group remains unaffected by the problem. Stress, peer pressure, schoolwork, personal problems, psychological disorders, problems associated with aging, success, and work-related exposure to drugs (celebrities, entertainers, and athletes) are all circumstances which may lead to prescription drug abuse.

The report by CASA found that teens who abused prescription drugs were also at increased risk of abusing other substances like alcohol, marijuana, heroin, and cocaine as compared to teens who did not abuse such drugs. Abuse of prescription drugs was also implicated in almost 30% of drug-related emergency room deaths and 80% of emergency room visits.

Although the Internet presents a serious dilemma with respect to any effort to control the distribution of prescription drugs for improper purposes, the report also focuses on doctors and pharmacists as part of the problem.

The results of surveys conducted of doctors (979) and pharmacists (1030) are quite unsettling to say the least. According to CASA, 40% of the doctors surveyed said they received no medical school training with respect to prescribing controlled substances. More than 50% received no training in how to identify prescription drug abuse or addiction. Finally, 75% said they had had no medical school training with respect to identifying the diversion of prescription drugs for illegitimate purposes.

In the case of pharmacists, 40% said they had received no post-pharmacy school training in dispensing prescription drugs and almost 50% said they had received no post-pharmacy school instruction in recognizing diversion or abuse of prescription drugs.     

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