Preventing Prescription Drug Misuse: A Regulatory Perspective in the United States, Europe, and India

Prescription medicines, such as analgesics, stimulants, steroids, anti-depressants, psychotropics, and certain antibiotics are commonly mishandled in a variety of ways, including overdosing, abuse, diversion, and drug trafficking. Because of the considerable risk to public health, they are subject to strict regulatory oversight. The drugs possess abuse potential at specific dose and hence prone to abuse therefore they are categorized as Controlled substances. Therefore, they are subject to constant vigilance over the pharmaceutical supply chain. The complete clinical data as well as post marketing surveillance study of such drugs are critical to be in place as per the regulatory requirements. The countries have kept up with the times by constantly updating the system with regulatory laws and strategies to prevent cases of misuse. The current review will give a quick summary of how prescription medications and prohibited substances are regulated in the United States, Europe, and India. It will also emphasize current trends in drug usage, as well as the issues that these countries face and the preventive policies implemented to manage and prevent drug misuse. It will also make recommendations for new regulatory initiatives to address the current drug- misuse-related concerns. As a result, a review of the regulatory system in various countries will present current challenges and new lessons for countries around the globe.

Prevalence and Correlates of Prescription Drug Misuse in a Nationwide Population Survey in Taiwan

Background: Prescription drug misuse (PDM) is a critical mental health issue relating to psychiatric morbidity. This study investigated the prevalence of PDM and its associated psychopathology and psychosocial factors in the general population in Taiwan. Methods: The survey randomly selected a representative sample >15 year-olds using the stratified proportional randomization method. The measurements included demographic variables, previous experience with PDM, self-rated physical and mental health, health self-efficacy, risk factors for suicidality, and psychological distress. Results: The weighted one-year prevalence of PDM was 8.5% (n = 180) among 2126 participants. Those with psychological distress and lifetime suicide ideation (23.3%) or suicide attempts (5.0%) were significantly associated with PDM. PDM was also prevalent among those with poorer self-rated health and lower self-efficacy. Insomnia (OR = 1.52), depression (OR = 1.77), and low self-efficacy (OR = 2.29) had higher odds of PDM after adjustment in the logistic regression model. Conclusions: Individuals who misused prescription drugs had a higher prevalence of psychological distress and suicidality and lower levels of self-rated health. Prescription drug misuse problems should be screened for early prevention when prescribing medications for people with insomnia, depression, or lower perceived health beliefs or conditions.

Protective Effects of Perceived Control on Prescription Drug Misuse 10-years Later in the MIDUS Study

The current study examined if control beliefs predict prescription drug misuse (PDM) 10-years later and how problem drinking status moderates this relationship. PDM refers to taking medications without a prescription or in a manner not intended by the prescriber. Older adults are especially vulnerable to PDM due to drug sensitivity, comorbid health conditions, and high rates of polypharmacy. Participants were adults (n=2162, 56% female, mean age=54, range=30-84) who completed Waves 2 and 3 of the Midlife Development in the United States (MIDUS) study. At Wave 2, participants reported on two subscales of perceived control (personal mastery and constraints) and past 12-month problem drinking behaviors. At Wave 3, participants reported past 12-month PDM of five substances (painkillers, sedatives, stimulants, tranquilizers, and depression medications). Results indicated that at Wave 3, 10% of the sample reported misusing at least one prescription drug in the past year. Logistic Regression analysis revealed that problem drinking was associated with higher odds of PDM (p<0.001), and perceived control was associated with lower odds of PDM (p<0.05) after controlling for previous PDM and sociodemographic, health behavior, and health status covariates. However, there was an interaction effect such that perceived control was not protective for those individuals who engaged in problem drinking at Wave 2 (p<0.05). Future analyses will explore the meaning of this interaction. Identifying psychosocial protective factors, such as perceived control, predicting PDM will be critical for designing interventions that prevent the adverse consequences of PDM among this population.

Prescription drug misuse during pandemic

Prescription drug misuse is when someone takes a medication inappropriately. The prescription drug misuse is not an uncommon issue but the use of prescription drugs has significantly increased during the covid 19 pandemic. The major factors that has contributed to the increased dependence to prescription drug use during the pandemic is the increased paranoia about the virus and the drug dependency of the substance abusers. The context of the study is the increased use of prescription drugs among young adults and case reports of violence attributed by drug use. The main aim of the study is to identify the trend of prescription drug use among young adults and the factors that contribute to the misuse. The study primarily focused on young adults and recorded the responses using the questionnaire. The methodology for the proposed study was through online interaction with the participants in the form of survey through google forms. The data collection method included literature review of published articles pertaining to the topic, newspaper articles and websites. The data collection was primarily through google forms and participants response are analyzed for arriving into conclusion. Further-more data from published article, journals, data published in websites like the National Health Portal, National Institute of Health (NIH)- National Institute of Drug Abuse (NIDA), World Health Organization (WHO). Both primary and secondary data is used for data collection. An age group between 20-30 was collected. This age group was selected due to the possibility that most utilization of prescription drugs would be contributed by these groups. Mostly randomized sampling was carried out due to the limitation of collecting data one to one considering the pandemic situations. After analyzing the results, it is inferred that there is a significant increase in use of prescription drugs during the pandemic time and the study also found a trend of alarming concern of buying prescription drug without it being prescribed by the medical practitioner which hence is a serious case of social concern.