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Health Report: Medicine Abuse Increasing


The growing problem of abuse and misuse of legally obtained drugs is at the top of this week's RFE/RL Health Report. Correspondent K.P. Foley also filed stories on new tools in the campaign against tuberculosis, and on a U.S. study that concludes that nothing beats a good night's sleep.

Washington, 11 April 2001 (RFE/RL) -- Public health and law enforcement officials say they are concerned by increases in the deliberate misuse of prescribed medications in the nations of the developed world -- mostly in Europe and the United States.

In a report released in Washington on 10 April, the U.S. National Institutes of Health (NIH) said the misuse of prescription drugs -- particularly among people over 60, among adolescents, and among women -- is troubling because the number of abusers is already large and continuing to grow.

Alan Leshner, director of the NIH's Institute on Drug Abuse, told reporters that several million people are abusing legally obtained drugs such as pain killers.

"According to best estimates, in 1999 some four million Americans age 12 and older used controlled central nervous system depressants, stimulants, or opioids for non-medical reasons."

The International Narcotics Control Board, a United Nations agency, says in its annual report that the abuse of prescription sedatives and stimulants "is becoming a socially acceptable habit as controlled substances are readily used and prescribed to treat suffering from either psychological or social problems."

The Control Board cautioned European physicians against the overuse of medications to treat insomnia, anxiety, obesity, and various types of pain. The Control Board said, "easy availability leads to over-consumption of such substances either in the form of drugs or by fueling a culture of drug taking to deal with a variety of non-medical problems."

The U.S. government's Leshner said pain killers, stimulants, and sedatives are not harmful in themselves and most often are useful.

"When used appropriately as prescribed, these drugs are indispensable in relieving a wide variety of medical conditions but if they're misused they can be extremely dangerous and, under certain circumstances, they can even be deadly."

In an effort to stem the increase in prescription medication misuse, the U.S. and several private organizations of physicians, pharmacists and drug companies announced a public health initiative to raise awareness about the problem and promote additional research.

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Unnecessary Injections Cause Illnesses, Waste Money

Public health officials say doctors and other health care workers administer about 9 billion unnecessary injections a year. The officials say this not only wastes money, it also leads to avoidable illnesses and deaths.

Keith Sabin of the U.S. Centers for Disease Control and Prevention told the Reuters Health News Service that the superfluous shots cost the world economy about $4.5 billion a year. Sabin says surveys taken in Eastern Europe show that the average person takes as many as 15 injections a year. He says 70 percent of those shots are delivered with unsafe and unsanitary equipment.

The percentages are even higher in Asia and Africa. Sabin says that as a result, an extraordinarily high number of people are infected with the three leading blood-borne viral infections: HIV, hepatitis B, and hepatitis C. Sabin said the conclusion is that unsafe injections make more people sick, and the more cases of infections means it's ever more likely that there will be more unsafe shots administered.

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Researchers Agree That Naps Don't Compensate For Lost Nighttime Sleep

A research study in the United States concludes that there is no substitute for a good night's sleep.

That was one of the principal findings experts talked about at a conference in Washington last month on the "Science of Mind-Body Interactions." Researchers said more people than ever before are complaining about not getting enough sleep at night. Lack of sleep, the experts report, reduces daytime productivity. Daytime sleepiness is also responsible for a growing problem of road accidents caused by drowsy motorists. Naps, it seems, do not help much.

David Dinges of the University of Pennsylvania School of Medicine reported on an experiment involving 90 people who lived in a laboratory for 14 days each. Different members of the group were monitored after taking naps that lasted from 15 minutes a day to more than two hours. Dinges said that naps, regardless of length, can't completely make up for lost sleep.

"Total sleep time is the absolute-preeminent determinant of waking capability. And, chronically living on short nocturnal sleep and a daytime nap to try to refill the tank every day, a little bit, exponentially, to hold the line, doesn't seem to really work."

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WHO Issues New TB Control Guidelines

The World Health Organization (WHO) has issued new guidelines for controlling the spread of forms of tuberculosis (TB) that are resistant to drug treatment. The guidelines call for aggressive application of what are known as second-line drugs.

The WHO reports that test projects have been established at six sites in South America, Eastern Europe, Russia, and Southeast Asia.

At a meeting in London last week, WHO experts stressed that the problem of TB variants that survive treatment by isoniazid and rifampicin -- the two most powerful anti-TB drugs -- has reached extraordinarily high levels in some areas. WHO says the multi-drug-resistant TB threatens the TB control programs of many nations.

WHO and its international partners are testing a treatment initiative called "DOTS-Plus." DOTS stands for "directly observed treatment, short course." It requires that TB patients be directly monitored by a health care worker as they take their daily dose of medication for a period of about four months. The "plus," in DOTS-Plus is the addition of more drugs to attack the multi-drug-resistant TB.

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