Prescription drug abuse will soon exceed the use of illicit narcotics, report warns

~ The number of Americans abusing prescription drugs nearly doubled from 1992 to 2003.

VIENNA, Austria -- Abuse of prescription drugs is about to exceed the use of illicit street narcotics worldwide, and the shift has spawned a lethal new trade in counterfeit painkillers, sedatives and other medicines potent enough to kill, a global watchdog warned Wednesday.

Prescription drug abuse already has outstripped traditional illegal drugs such as heroin, cocaine and Ecstasy in parts of Europe, Africa and South Asia, the U.N.-affiliated International Narcotics Control Board said in its annual report for 2006.

In the United States alone, the abuse of painkillers, stimulants, tranquilizers and other prescription medications has gone beyond "practically all illicit drugs with the exception of cannabis," with users increasingly turning to them first, the Vienna-based group said.

Unregulated markets in many countries make it easy for traffickers to peddle a variety of counterfeit drugs using courier services, the mail and the Internet.

"Gains over the past years in international drug control may be seriously undermined by this ominous development if it remains unchecked," Narcotics Control Board president Philip O. Emafo said.

Discount medications that seem to be authentic often turn out to be powerful knockoffs concocted from recipes posted on the Web, he added.

"Instead of healing, they can take lives," Emafo said, characterizing the danger as "real and sizable."

Up to 50 percent of all drugs taken in developing countries are believed to be counterfeit, the board said, citing estimates from the World Health Organization.

Buprenorphine, an analgesic, is now the main injection drug in most of India, and it is also trafficked and abused in tablet form in France, where the Narcotics Control Board estimates 20 percent to 25 percent of the drug sold commercially as Subutex is being diverted to the black market.

Painkillers top choice

The number of Americans abusing prescription drugs nearly doubled from 7.8 million in 1992 to 15.1 million in 2003, the Narcotics Control Board said. Among their prescription drugs of choice: the painkillers oxycodone, sold under the trade name OxyContin, and hydrocodone, sold as Vicodin and used by 7.4 percent of college students in 2005.

Although the number of U.S. high school and college students abusing illicit drugs declined in 2006 for a fourth consecutive year, "the high and increasing level of abuse of prescription drugs by both adolescents and adults is a serious cause for concern," it said.

Counterfeiters are exploiting intense demand for prescription drugs that can give a "high" comparable to cocaine, heroin or methamphetamine, the watchdog group said.

It singled out Scandinavia, where demand for flunitrazepam -- a sedative sold as Rohypnol and widely known as a "date rape drug" -- increasingly is being met by unauthorized production, and North America, where widespread abuse of prescription drugs, including the narcotic fentanyl -- 80 times as potent as heroin -- has been blamed for a spike in deaths.

"The very high potency of some of the synthetic narcotic drugs available as prescription drugs presents, in fact, a higher overdose risk than the abuse of illicit drugs," Emafo said.

Exact figures were unavailable, he said, because few countries "are aware to what extent drugs are being diverted and abused" and are not tracking the trend. Nations should pay closer attention and share data on counterfeit drug seizures, the group urged.

Other findings in the annual report:

-- Cultivation of opium poppy in Afghanistan hit a record high last year, the Narcotics Control Board said, echoing assessments by the U.S. government and the U.N. Office on Drugs and Crime. "The drug control situation in Afghanistan is deteriorating," the report said, criticizing a proposal to legalize cultivation as "simplistic, not feasible and based on the wrong premise."

-- Iran has emerged as the world's No. 1 abuser of opiates, and 2.8 percent of the population now uses illicit cocaine and heroin, most of it from Afghanistan. Emafo said the Iranian government "is aware of the problem ... (and) is taking appropriate action to protect the health of its citizens."

-- Bolivia plans to introduce a drug control policy that would broaden the marketing and use of coca leaves -- a step the Narcotics Control Board warned could violate international drug conventions. The Bolivian mission to the U.N. in Vienna lodged a protest Wednesday, insisting the country has a right to commercially produce coca for legal products such as flavoring.

-- The Narcotics Control Board defended its opposition to so-called "safe injection rooms," where addicts are given clean needles. In Germany and other European nations, such centers have been credited with helping curb the spread of AIDS. "We do not believe in injection rooms," Emafo said. "That cannot be treatment ... this is not healthful."