Drug Abuse Problem

The new front in the War on Drugs poses a different set of challenges for enforcement. Because most abused are in the U.S. legally, border controls are of little value. Control through eradication of supply is not available, because the products have legitimate uses that meet serious medical needs. New strategies and an arsenal of new enforcement weapons are needed.

As a start, regulators need stronger tools to oversee foreign-based Internet pharmacies. Many of these pharmacies dispense medicines without prescriptions. Because they operate outside the jurisdiction of any state, they escape the oversight of state pharmacy boards, and federal authority to control them is limited. At the same time, more resources for inspections by the Food and Drug Administration (FDA) would enable the agency to police the nation’s prescription drug supply more efficiently. canadian antibiotics

The most effective new weapon of all is likely to be education. A common misperception is that after a medication receives FDA approval, its absolute safety is ensured. Quite to the contrary: all drugs present risks, even when they are used properly. Rather than certifying complete safety, FDA approval determines that the risks are acceptable in relation to the condition being treated. When drugs are used improperly, these risks can be substantial, without the potential for a therapeutic benefit. The public should understand that legal drugs, if abused, fall outside of any FDA assurance of even relative safety and that they can present hazards as great as those of illicit substances.


Efforts to control prescription drug abuse create an additional dilemma in terms of policy. The risk of enforcement makes many physicians reluctant to prescribe needed pain medication, even when it is clearly necessary. Some physicians also fear that patients will become addicted, although only a tiny fraction of patients do when the drugs are administered properly. As a result, pain is often undertreated, even when effective medications are available, and many cancer patients and others in need of pain relief receive less than optimal treatment. A policy of enforcement must balance the needs of these patients with the need to be aggressive in discouraging drug abuse.

Some experts see the answer in new classes of painkillers that are not addictive and that target pain without producing intoxication. Although this type of advance has the potential to improve safety for patients and to reduce the incentive for abuse, the fruits of this research are probably years away.

In the meantime, fresh approaches to enforcement of laws concerning prescription drug abuse are needed. With new and more powerful drugs constantly joining the arsenal of therapies, the possibilities for abuse and for adulteration will only continue to grow. Existing regulatory gaps, such as those in the oversight of Internet pharmacies and in FDA resources, must be closed in order to effectively fight back in the War on Drugs.

It is also essential to better inform the public about the hazards of prescription drug abuse. Without these steps, a new public health threat looms from our own otherwise legitimate medications.