Is The Current Prescription Opioid Abuse Epidemic In The US Spreading To Thailand?

The snack bowl at a “pharm celebration” consists of a mixture of prescription drugs-from Adderall to OxyContin to Xanax-and most of them come immediately from the family medication cupboard.

The ABC Information program, ‘Pharm Nation’, examines a disturbing and quickly rising pattern in teenage drug abuse: getting excessive on authorized medicine, typically obtained by mother and father’ prescriptions or from questionable sources over the Web. Presenting research exhibiting a speedy spike in pharmaceutical abuse amongst college students as younger as eighth-graders, this system visits a Houston substance-abuse therapy heart the place recovering teenage addicts and their mother and father share their eye-opening experiences. (Pharm, 03:12)

This examine will take a more in-depth take a look at the origins of the present opioid epidemic, it is roots within the US, and is spreading throughout the globe.

Right here in Thailand, I’ve skilled first-hand the proof that the epidemic is alive and properly and on the rise in Asia.

The aim of this examine is to offer information of the hazards of those medicine to physicians right here in Thailand who’re already prescribing them, and by distributing the survey situated on the finish of this text to physicians all through the Kingdom of Thailand.

My {qualifications}:

On the twenty second of Could 1988, I checked in to The Santa Barbara New Home, an Alcoholics Nameless 12-Step Restoration Heart.

Finest choice I ever made. I have been dwelling life on life’s phrases ever since with out having to take any ‘thoughts altering’ substances that impact me from the neck up.

Santa Barbara New Home is an ‘AA 12-Step Home’ for males.

Nonetheless, a majority of the residents are struggling, not simply from the illness of “alcoholism”, but in addition from the broader definition of the illness of “dependancy”. This features a very broad spectrum of physician prescribed, “thoughts altering” substances that do, in truth, impact the person from the neck up.

I come from an AA college of thought that states that we’ve to be very cautious to not take something that results us “from the neck up”.

AA is the unique twelve-step program that was created for ‘alcoholics’ who are suffering from the illness of ‘alcoholism’. The traditions and “main goal” of AA present an attention-grabbing loophole for some alcoholics who are likely to advocate for giant Pharma and the usage of prescribed drugs.

The incident:

“By far the worst day, hour, minute, second in my 27+ years of sobriety.”

After I obtained the decision from my daughter-in-law, I may solely consider the worst.

She known as at round 1:30 within the afternoon to say that my son wasn’t selecting up his cellphone and that she hadn’t been in a position to wake him up within the morning as a result of he was too, “out of it”.

I knew he’d been utilizing once more and suspected it began together with his latest knee surgical procedure. I used to be with him the earlier Saturday evening at an AA assembly I would requested him to chair and he was truly nodding out. As an alternative of dealing with my fears and confronting him immediately, I took the simpler softer route of passively checking in on him, “give it the sunshine contact”, (as my previous sponsor would warn me about issues involving household).

As I drove the half-hour or so from my workplace to their home, I could not chase the pictures of his lifeless physique from my thoughts’s eye. I prayed for his life to be spared. I promised to dedicate my whole remaining days to service in restoration.

By the point I pulled up in entrance of his home, I anticipated to search out the worst. I would already thought of what I might do if the door had been locked and I imagined all of the painful calls to household and mates. I additionally knew it had been an excellent 4 or 5 hours since anybody noticed him breath.

The door was open and once I went in, all my fears turned a tragic actuality.

His lifeless physique was mendacity face up on the mattress and his life colour was gone.

The one distinction between what I would imagined throughout my drive over and what I used to be now jogged my memory of the scene from a TV collection. The place a woman had overdosed on opiates and was choking on her vomit. The lady had all this froth popping out of her mouth. I remembered how I would thought on the time that the results of medicine and overdose had been all the time sensationalized in Hollywood, but this was what I used to be , and my son’s lifeless physique was mendacity on the mattress in entrance of me. It additionally seemed to be previous what I would seen on the tv. All that was left was that froth on his mouth. He was pale yellowish-white and he wasn’t transferring.

Again in my lively addition days, I would introduced again a complete of three folks after they OD’d, all three had overdosed on opiates, and none of which had that foam. Take into accout I have been sober for over 25 years and do not see a lot from the within anymore. I simply hear the newcomer tales and may solely think about.

I listened for indicators of any life left and frantically tried to discover a plus in his neck, nothing.

I instantly began yelling on the prime of my lungs, “get up, get up”! I assumed that may at the very least kill two birds with one stone and get some assist from the neighbors on the identical time. It did not. It turned like a ghost city, not a soul. Simply us.

I intuitively sat him up and began pushing him forwards and backwards and yelling, “spit it out, spit it out”. I heard a gurgle.

I grabbed the garbage can out of the toilet and crammed it with chilly water, rushed again and dumped it on him.

He moved so I simply stored up the screaming and pulled him from the mattress. For a second I assumed I used to be immediately given divine energy and adrenaline till I attempted selecting him up. (Like six or seven luggage of previous stale rice!)

I known as my daughter-in-law and instructed her to get an ambulance.

By then he began coming round and stored slurring, “What occurred?” and “I am unable to hear you”. After some time I assumed the “I am unable to hear you’s” had been in response to my direct questioning about what he took. He was clearly broken past opiate overdose and I knew I needed to get him to the hospital.

My son had lastly handed my backside with this illness. I do not suppose I ever actually overdosed and I am certain I by no means made it to the purpose of that froth. He is all the time in contrast his dependancy to mine and I all the time noticed that was an excuse to maintain utilizing.

Lastly, folks began exhibiting up. Neighbors, kinfolk, my daughter-in-law. The one factor lacking was an ambulance so I made a decision to surrender and drive him to the hospital myself.

Probably the most absurd issues I’ve ever witnessed in my sober life was proper earlier than we gave up on the ambulance and had been about to go to the hospital in my automobile. I would opened the fridge to get him some water and he grabbed just a little bottle of liquid and rapidly drank it. I stated, “what was that?” and he stated, “Retox”. Come to search out out it was extra Methadone.

“There in lies the rub… ”

A number of components are more likely to have contributed to the severity of the present prescription drug abuse drawback. They embody drastic will increase within the variety of prescriptions written and distributed, better social acceptability for utilizing medicines for various functions, and aggressive advertising and marketing by pharmaceutical corporations. These components collectively have helped create the broad “environmental availability” of prescription medicines usually and opioid analgesics particularly. (Volkow)

Some varieties of opioid medicine embody:


  • codeine (solely accessible in generic type)
  • fentanyl (Actiq, Duragesic, Fentora)
  • hydrocodone (Hysingla ER, Zohydro ER)
  • hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)
  • hydromorphone (Dilaudid, Exalgo)
  • meperidine (Demerol)
  • methadone (Dolophine, Methadose)
  • morphine (Astramorph, Avinza, Kadian, MS Contin, Ora-Morph SR)
  • oxycodone (Buy oxycontin in Sweden, Oxecta, Roxicodone)
  • oxycodone and acetaminophen (Percocet, Endocet, Roxicet)
  • oxycodone and naloxone (Targiniq ER)


The everyday state of affairs is that the affected person is prescribed any of the above for ache, will get hooked, cannot efficiently detox and graduates to road opioids.

All the above are available and prescribed in Thailand and I consider, with out correct Doctor information of the hazards concerned.

The five-question survey on the finish of this doc is meant to impress and encourage Physician consideration to this drawback.

In his guide, “Overcoming Prescription Drug Dependancy: A Information to Coping and Understanding”, creator Rod Colvin compiles tales from people in restoration from dependancy to prescribed drugs. The idea of an “unwitting addict” is recognized as somebody who has been prescribed ache treatment and turns into addicted. (Colvin)

Within the guide, “Managing Sufferers with Power Ache and Opioid Dependancy”, Dr Donald Taylor’s curiosity within the therapy of opioid dependancy arose from his observations of the event of dependancy in his personal sufferers with power ache, and his recognition of the truth that few ache specialists knew find out how to handle this group of sufferers.

Dr Taylor at the moment divides his follow between treating sufferers with power ache with out dependancy, sufferers with power ache with dependancy, and sufferers with out ache however with drug dependancy. He’s a Diplomat of the American Board of Dependancy Drugs and a Diplomat of the American Board of Anesthesiology, with added {qualifications} in Ache Drugs. (Taylor)

“The Lengthy Winding Street of Opioid Substitution Remedy Implementation in South-East Asia: Challenges to Scale Up”, is a examine within the South-East Asia Area which incorporates an estimated 400,000-500,000 individuals who inject medicine (PWID). HIV prevalence amongst PWID is usually 20% or larger in Indonesia, Thailand, Myanmar and a few areas of India. Opioid substitution remedy (OST) is a crucial HIV prevention intervention on this a part of the world. (Reid et al.)

Though this World Well being Group sanctioned “substitution” program is efficient within the unfold of HIV, I’ve to ask myself whether or not it would gasoline the rise of the prescription drug epidemic.

The lethal mixture of Benzodiazepines and Opioids are behind the majority of deaths within the present prescription drug epidemic. Benzodiazepines are prescribed for “Nervousness”, (worry of future), and “Melancholy”, (remorse from previous actions). There is a wholesome answer, outlaw these dangerous medicine and deal with with cognitive behavioral counseling. (Bachhuber et al.)

The article, “Expanded Entry to Naloxone: Choices for Crucial Response to the Epidemic of Opioid Overdose Mortality”, printed within the American Journal of Drugs, describes “Naloxone”, (‘Narcon’) which is utilized in overdose to immediately wash the system of opiates. The drug is now paradoxically mixed with buprenorphine to provide the identical results of an opioid and on the identical time block any true opiates. (Kim et al.)

Since “The Incident”, (now nearly a 12 months in the past), my son has had a number of seizures because of Tramadol overdose; (Tramadol is an artificial opiate that may be simply obtained right here in Thailand with no prescription). He obtained an area analysis for nervousness and despair and has all his prescriptions justified. As for me, I now go to Al-Anon, a help and dialogue group for the kinfolk of individuals affected by alcoholism… and dependancy.

The Survey

Some varieties of opioid medicine embody:


  • codeine (solely accessible in generic type)
  • fentanyl (Actiq, Duragesic, Fentora)
  • hydrocodone (Hysingla ER, Zohydro ER)
  • hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)
  • hydromorphone (Dilaudid, Exalgo)
  • meperidine (Demerol)
  • methadone (Dolophine, Methadose)
  • morphine (Astramorph, Avinza, Kadian, MS Contin, Ora-Morph SR)
  • oxycodone (OxyContin, Oxecta, Roxicodone)
  • oxycodone and acetaminophen (Percocet, Endocet, Roxicet)
  • oxycodone and naloxone (Targiniq ER)
  • different opioid ache treatment __________________________


(Please write title of drug)

Please full the next five-question survey under:

1. Which of the opioid medicine listed above are you conscious of?

2. Which of the opioid medicine listed above are secure to prescribe for ache?

3. Which of the opioid medicine listed above have you ever prescribed previously 12 months?

4. Which of the opioid medicine listed above do you are feeling there’s a threat of affected person dependancy?

5. What length do you suggest for every of the above?


  • As much as 30 days
  • As much as 60 days
  • As much as 90 days
  • As much as 6 months
  • Over 6 months


Works Cited

Bachhuber et al. “Growing Benzodiazepine Prescriptions and Overdose Mortality in the US.” American Journal of Public Well being. 106.4 (2016): 686-688. Internet.

Colvin, Rod. “Overcoming Prescription Drug Dependancy: A Information to Coping and Understanding.” Omaha, Neb. Addicus Books. 2008. Print.

Engdahl, Sylvia. “Prescribed drugs.” Farmington Hills, Mich.: Greenhaven Press, part of Gale, Cengage Studying. 2014. Print.

Haerens, Margaret and Lynn M Zott. “Prescription drug abuse.” Detroit: Gale, Cengage Studying. 2013. Print.

Kim et al. “Expanded Entry to Naloxone: Choices for Crucial Response to the Epidemic of Opioid Overdose Mortality.” American Journal of Public Well being. 99.3, (2009): 402-407. Print.

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