An unlikely foursome gathered in Vanderbilt Hall yesterday to discuss the present dangers and prevalent issues with prescription drug abuse, particularly as it pertains to college students: President Bill Clinton, NYPD Commissioner Ray Kelly, and the Director of the National Institute of Drug Abuse, Nora Volkow, who all sat alongside John Sexton and addressed a sizable crowd littered with plucky Clinton Foundation interns.
The Clinton Foundation was promoting its Clinton Health Matters Initiative, which is among Clinton’s several post-political career philanthropic projects. By promoting healthier lifestyles in communities across the country, the Initiative promises a “five year commitment to put the United States on a path to eliminating the chronic prescription drug abuse challenge by the beginning of the next decade.” The NYPD also plans to be more active on New York’s college campuses during orientation week this fall to raise that same awareness in incoming freshmen.
Presiding over the forum, Sexton said that “college is a time of great tumult in the development of the individual.” The worry for Sexton and other school officials is that college is also a time of many different temptations, one of which is prescription drug use.
“Over 7% of college students nationally report misuse of pain medication… almost 1 in 10. NYU is below those numbers. We put in enormous effort on this issue; we are very very careful about prescribing pain medication.”
Sexton emphasized that the caution with which the University pharmacy distributes pain medication is only part of a “very aggressive campus-wide effort on student wellness in general… It starts with the Reality Show. Indeed, the Wellness Exchange and the Student Health Center do offer a wealth of resources, counseling services, an impressive 24/7 accessibility… and I dare anyone to come up with a better, more entertaining-informative health PSA than the Reality Show.”
But now that it’s finals season, Sexton says, “I can feel the tension. This is the time when the temptations come. Be there for each other… watch out for each other.”
Nora Volkow, the director of NIDA and a graduate of NYU, offered her professional insight, bringing the conversation into a more concrete and quantifiable realm of discussion. “The abuse of prescription medications has changed the landscape in terms of how we approach [addiction].”
“The notion of chronic pain is not a trivial one,” but according to Volkow, part of what complicates the process of tightening regulations on the production and distribution of prescription medications is that we must at once try to not jeopardize those who need them and protect those that may be vulnerable to addiction.
Opioids for patients with severe and chronic pain and stimulants for the treatment of attention and hyperactivity disorders are two categories of prescription drugs that NIDA pays particular attention to in its research and efforts to maximize effectiveness and minimize risk.
Yet even among those who need these prescriptions medications, Volkow noted, “we’re now seeing patients who are following the guidance of physicians and are becoming addicted.” The line between where the drug is relieving and where it becomes rewarding is quite thin.
“We’re seeing significant increases in high schools and predominantly in colleges of the use of stimulant medications by students with the perception that it’s going to help them cognitively… especially in competitive conditions,” said Volkow, citing a tripling of admission of stimulant use over the past six years.
Volkow also referenced a fascinating study released last month that measured Adderall usage via Twitter mentions and tracked their geographic locations with the locations stamps on those tweets. The study found that Adderall usage peaked during finals seasons (May and December) and was highly concentrated among colleges in the northeast United States.
Commissioner Kelly commented on this spike in young adult prescription med abuse in the last decade by saying that there has been a “formalizing of the recognition of pain.”
Conceding that there’s an all-around general attitude of permissiveness about prescription medications, Volkow said that “we’ve created a culture where we expect that we will be able to solve any problem, frustration, boredom, pain… with a pill.”
Clinton added that the FDA, under pressure from advocates, has begun moving toward improving scheduling for prescriptions drugs. “Scheduling determines how many pills can be prescribed at once for a particular person,” Clinton said.
“Usually we read about the problem from the pharmacy point of view… but I wonder whether there’s more room here for the FDA [itself] to slow the flow of these medicines.”
The ability of individuals to go ‘doctor shopping’ for additional prescriptions “is a classic cause of why we desperately need comprehensive electronic health records in America,” Clinton said.
Sexton added that “there are students who are getting to us [to our universities], who wouldn’t have gotten to us before, because of these medications… but being alone on their own for the first time presents dangers. Universities need to be acutely aware of that.”
“I sense that the pressure cooker that has been created around universities and colleges by parents, societies and students themselves, has [seen a] release. Less of an obsession with semester to semester numerical achievement and more willingness on the part of students to view their education as preparing them for life, instead of worry about a particular grade for a particular course,” Sexton said.
Sexton admitted that prescription drug abuse is a problem that exists in some capacity on our campus and it’s an issue that demands “constant vigilance.”
Sexton suggested moving this agenda into the public awareness by a seemingly on-the-fly proposition of a brownie points system. “Bronze, silver, gold, platinum… where universities and school could get a badge of honor saying that this university in terms of wellness is ‘platinum standard.’ You have folks out there making cost and price of an education the only issue… if you want resources spent on this kind of thing, you have to create a rewards system for it.”
Photos by Jess Bernstein.