INTRODUCTION

For several decades, America has fought a “War on Drugs” to stem the abuse of illicit substances. Launched by President Richard Nixon in 1969, the initiative responded in part to the plight of many American soldiers who returned home from the Vietnam War with drug addictions.

Today, this battle is a two-pronged campaign: it seeks to limit the supply of illicit agents through border patrols and the eradication of crops and to suppress demand through education and rehabilitation. The underlying threats lie in addiction, which enslaves drug abusers to substances that poison them over time, and in overdoses that bring sudden health emergencies.

The War on Drugs has seen varying levels of success over time, but to the surprise of many experts, it has recently faced setbacks on a second front. The International Narcotics Control Board, an affiliate of the United Nations, recently reported that abuse of canadian prescription drugs is about to exceed that of illicit drugs worldwide. In the U.S., the aggregate abuse of painkillers, stimulants, tran-quilizers, and other prescription medications almost surpasses that of nearly all illicit drugs combined, and potential drug abusers are increasingly turning to legal substances first.

EXTENT OF PRESCRIPTION DRUG ABUSE

The statistics are startling. The Narcotics Control Board has estimated that the number of prescription drug abusers in the U.S grew from 7.8 million in 1992 to 15.1 million in 2003. Two painkillers in particular, oxycodone, sold as OxyContin (Purdue Pharma LP, a Purdue Frederick Company), and a hydrocodone/aceta-minophen combination, sold as Vicodin (Abbott), were reportedly used by as many as 7% of college students in 2005. On May 10, Purdue Frederick agreed to pay more than $630 million to resolve charges that it sought to promote, market, and sell OxyContin through illegal means.

The National Center on Addiction and Substance Abuse at Columbia University found that during the same year almost 3% of college students abused stimulants, such as methylphenidate (Ritalin, Novar-tis) and amphetamine (Adderall, Shire). According to the federal Substance Abuse and Mental Health Services Administration (SAMHSA), the misuse of pharmaceuticals rose by 21% between 2004 and 2005. Emergency departments treated almost 600,000 patients for misuse in 2005, just 15,000 fewer than the number of people treated for cocaine and heroin over-doses.

Even though recent investigations have identified growing prescription drug abuse among the young, all ages are involved. In fact, the most vulnerable group of all may be the elderly, according to the National Institute on Drug Abuse (NIDA). With most medications prescribed for elderly patients, those in this age group are most prone to misuse, both deliberate and unintentional. When all age categories are combined, NIDA estimates that 48 million Americans older than 12 years of age have used prescription drugs for nonmedical reasons at some time. For many of these people, abuse leads to addiction with long-term consequences.
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Concerns over the intentional misuse of prescription drugs are compounded by growing reports of adulteration of medications that are obtained for legitimate therapeutic purposes. The increasing prevalence of tainted medicines means that prescription drugs can present hazards to many who are not deliberate drug abusers. Data from the World Health Organization (WHO) indicate that up to half of all prescription drugs taken in the developing world are coun-terfeit.

Recent press reports document a rising tide of imitation products containing poisons that have killed thousands glob-ally. Although most adulterated medicines reach the developing world, counterfeit drugs can enter the U.S. through Internet pharmacies that ship products from overseas without regard to authenticity.