Researchers at Rush University Medical Center found prescription pain medication (PPM) abuse is a rapidly growing problem with surprising and often unpredictable distribution patterns. The research was presented at the Annual Meeting of the American Society for Anesthesiologists in Chicago, October 13, 2006.

Mario Moric, PhD, a researcher in the department of Anesthesiology at Rush, and colleagues used survey data from the National Survey on Drug Use and Health for 2002-04 to estimate the prevalence of drug abuse across the United States for various illicit and prescription substances.

Moric found that PPM abuse did not follow traditional patterns. “Individual states with high levels of PPM abuse may not recognize the problem. The prevailing assumption that only those states with high levels of traditional illicit drug abuse should be vigilant is clearly misleading.”

The researchers found distribution of PPM abuse across the United States varied greatly and differed from other seemingly similar drug abuse trends. PPM distribution differed substantially from inhalants, heroin and sedatives, was somewhat similar to cocaine and stimulants and was closely related to distribution of tranquilizers.

Furthermore, the researchers found that states with large metropolitan areas (New York, Illinois, Texas and California) did not have a high distribution of abuse, despite the common view that drug abuse is associated with the fast-paced lifestyle of city dwellers.

“Distribution of PPM abuse across the states differs from high-profile street drugs and even particular PPMs such as oxycodone, which has its own specific pattern,” Moric said. “It is for this reason that PPM abuse must be monitored separately from other illicit substances, and the most commonly abused or most problematic PPMs should be monitored individually.”

Oxycodone, in particular, was singled out by Moric’s group because of its highly addictive nature and specific distribution pattern, which differed from many other PPMs and illicit drugs. Similar to heroin in both its effect on the body and addictive nature, oxycodone is often crushed or mixed with other drugs and used for its heroin-like “rush.” Moric warned that the key to understanding and identifying abuse requires a more sophisticated understanding than that abusers simply want to “feel good.”

“As users become addicts, they undergo a fundamental neurobiological change,” Moric said. “Processes such as learning, memory, perception, arousal and motivation all drastically change, and to classify abuse purely as ‘pleasure seeking’ is a gross oversimplification.”

The surprising results from the study should offer something of a wake-up call to physicians and other health care workers everywhere in the country. “Clinicians need to be aware of the level of abuse in their area and moderate their vigilance accordingly,” Moric said.

If PPM abuse is identified in a particular area, a multifaceted response should be implemented, he said. “Drug abuse prevention, outreach and information dissemination programs by federal, state and nonprofit agencies should be notified so that public awareness can be heightened and action be taken to reduce the problem.”

According to Moric, anesthesiologists who practice pain medicine play a particularly crucial role in combating PPM abuse. “We feel that the most important function of anesthesiologists with respect to PPM abuse is in education. Anesthesiologists are the most relevant spokespersons for both the benefits of PPMs and the potential abuses,” Moric said.

16 October 2006
Rush News Room

A new study explores how boys view their fathers as the boys move from childhood into adulthood. The study, “Witnessing Marital Violence as Children: Men’s Perceptions of Their Fathers,” is by Gary Dick, assistant professor of Social Work at the University of Cincinnati, and is published in the current issue of the Journal of Social Service Research, Volume 32, issue two.

Dick says previous research suggests boys who witness a father’s violence against their mother are at risk of becoming abusers themselves, in addition to developing an ambivalent relationship with their fathers and even ending contact with them in adulthood. “Much is known about the internal and external effects that witnessing violence has on children, but we know little about the type of relationship men had with their fathers after witnessing parental aggression,” Dick writes in the study. “Understanding abusive men’s relationships with their children and how they carry out their paternal roles is an important issue in preventing violence against women.”

In a study of 104 men ranging in age from 19 to 61, Dick compared a group of men who had witnessed marital violence as children to a group of men who did not witness marital violence as children, to see if there were differences in how the men perceived their relationships with their fathers. Forty-three percent of the men studied had parents who divorced during their childhood – the mean age of the children at the time of divorce was about eight-and-a-half years old.

In examining men’s perceptions of father involvement, Dick found that men who had witnessed marital violence felt their fathers were less accessible and less responsible with daily child care tasks (school activities, taking a child to the doctor) than men who did not grow up in a violent home. The men who witnessed marital violence were also more likely to report being emotionally and physically abused by their fathers. The survey found that men who had not witnessed their father abusing their mother were more likely to report that their father verbally expressed love, affection and praise toward them and in return, these men reported warm feelings toward their fathers.

The study also asked the men to examine the moral role of their fathers, such as teaching them right from wrong or attending church with them. The men who witnessed family violence rated their fathers lower. Growing into adulthood, Dick says there were significant differences between the two groups in becoming violent toward their own intimate partners. The men who witnessed marital violence as children were more likely to use abusive tactics on their own partners.

Dick says findings from the study have implications for social workers and counselors who treat men who batter women, as social workers not only work to prevent the abuse but help men take an active, positive role in parenting their children. The study recommends future research on how men who grew up in violent households view themselves as fathers.

13 October 2006
University of Cincinnati News