Abuse at UNC
Allen O’Barr, director of UNC Counseling and Psychological Services, has noticed a trend in prescription drug requests on campus.
“(Prescription requests) have been steadily going up, but it spiked in 2014-2015 in the high 20 percentile,” he said. “More people (are) coming in distressed and wanting medication to make it better.”
With the stresses of college and a recent push for mental health awareness, more students are utilizing CAPS as a resource.
With more potential for abuse, the University established safety measures to prevent misuses of prescription drugs.
There is no formal number for how many students at the University are abusing prescriptions, but O’Barr said cases do exist.
Timothy Platts-Mills, assistant professor of emergency medicine in the UNC School of Medicine, said sometimes it can be hard to know whether an emergency room patient is in pain or is trying to get prescription medicine.
Platts-Mills said the emergency room sees about 200 patients a day, and pain is a common complaint.
Platts-Mills said physicians are trained to find acute life-threatening illness or injury.
“I think there is a lot of provider variability ...” he said. “Some providers tend to be very sympathetic to the pain ... and some providers tend to be very suspicious.”
Platts-Mills said he gives patients the benefit of the doubt and tries his best to treat pain.
O’Barr said there have never been as many people who can write prescriptions in CAPS as there are now.
Even so, there are not many — for example, only four CAPS psychiatrists can write prescriptions.
O’Barr said he’s seen a few instances of people abusing prescriptions, including students making copies of valid prescriptions in attempts to get more drugs and trying to fake symptoms to get medication for attention deficit hyperactivity disorder.
To combat those issues, O’Barr said the department has started to print prescriptions on special paper that cannot be copied by a machine.
If a patient is seeking medicine for ADHD, they must first get a full psychological workup from either an outside psychologist or the psychology department on campus.
Only then can psychiatrists at CAPS write a prescription.
Amy Sauls, director of pharmacy for Campus Health Services, said the pharmacy has implemented preventative measures to protect the organization as well as the people seeking their services.
“(We) definitely see a lot of students on benzodiazepines and amphetamines,” she said. “We don’t use a lot of opioids here — that is a problem in community pharmacies.”
In the UNC Pharmacy, students filling some prescriptions sign a Stimulant Medication Contract that says the pharmacy will not replace lost or stolen medication, Sauls said.
This is a means to prevent people from getting rid of their medication, either by sharing, selling or consuming it, and then claiming they lost the medication to get more.
Sharing prescription drugs can be dangerous, Sauls said.
“You don’t know the medical history of someone you’re sharing (prescriptions) with,” she said. “So, you could be putting their life in danger.”
The North Carolina Controlled Substance Reporting System tracks who gets a prescription for opioids and how much they receive.
However, the database has shortcomings. Platts-Mills said the database does not let providers know whether the patient has a chronic pain problem, and the system negatively impacts lower-income people.
He said people without health insurance are more likely to be marked as abusers in the system because they do not have access to a regular provider and thus rely heavily on getting prescriptions from emergency rooms.
The decision to give prescription drugs to a patient is not always cut and dried, Platts-Mills said. It is not simple to say that a particular person is abusing drugs and so should not receive drugs they need.
“We have the challenge of both being responsive to the patient’s pain and the treatment of pain, but also to their safety.”
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