Black Beauties, Gorilla Pills, Footballs, and Hillbilly Heroin: Some Reflections on Prescription Drug Abuse and Diversion Research over the past 40 Years

Abstract

Although the problem of prescription drug abuse has endured for well over two centuries, research into the abuse and diversion of these drugs has been relatively recent. The first general population survey to document the abuse of prescription medications occurred in 1970, and subsequent studies demonstrated that the abuse and diversion of amphetamines, opioids, and sedatives has continued to be widespread. During the 1980s and much of the 1990s, prescription drug abuse took a back seat to other more pressing concerns: “freebase” and powder cocaine, the cocaine wars, crack and sex-for-crack exchanges, rising rates of drug-related street crime, and HIV/AIDS among injection and non-injection drug users. However, recent surveys suggest that the current outbreak of prescription drug abuse began during the early to mid-1990s. Although the abuse and diversion of prescription drugs was clearly an evolving problem, what seemed to galvanize the attention of the media, the government, and the public at large was OxyContin®. Currently, there is no question that the problems of prescription drug abuse and diversion continue to grow. Why this is so, however, is open to speculation. Perhaps the reason lies in the increasing numbers of prescription drugs that are being legally marketed. Or perhaps the popularity of prescription drugs is rooted in the beliefs that they are more acceptable, less dangerous, and less subject to legal consequences than are illicit drugs.