Pharmacy Student Prescription Drug Culture
The fall of 1981 saw me off to University of the Pacific as a pre-pharmacy freshman. My very first night in the freshman dormitory, after settling in and meeting my roommate and a few others in the hall, a group of us headed out to a party at one of the fraternities across campus. It was not difficult to locate, with students covering the lawn, stairs and doorways, all with the famous red plastic cup in their hand.
After entering the party, getting a beer, and talking with a few students, I met a first year professional pharmacy school student. We chatted for a bit; however, within five minutes he was reaching into his pocket and offering me a T4 (acetaminophen & codeine 60mg) tablet. This was just so matter-of-fact that I didn’t even question it. He just said it would help relax me a bit.
Throughout my time as a pre-pharmacy, and then pharmacy school student I was aware of classmates who, while at their intern job, would take a couple pills here and there. Maybe they would slip a couple tablets of a benzodiazepine or some hydrocodone/apap (which was only C3 back in the day) in their pocket while they were filling a prescription. It just seemed like it was so normal.
While I was working as a pharmacist intern, the pharmacist in charge of the store filled himself a prescription for some sleep medication as well as pain medication because he was going out of town on a vacation. He put his brother's name (who happened to be a dentist) on the label as the prescriber and let me know he would tell him about it when he saw him next. I could sense that he was a little uncomfortable with it; however, he did it anyway, which, again, seemed to normalize the process.
During my final year of pharmacy school I had my clinical rotations in Hawaii. I recall, my first rotation was an outpatient pharmacy at a chain store in Kailua. This is where I stole my first controlled substance as a healthcare professional. I recall filling a prescription for diazepam 10mg tablets and quickly pocketing two tablets before setting the prescription up to be verified, as if this was just one of the benefits of working in a pharmacy.
This is the culture I was trained in as a pharmacy student. My first day in college was more than 40 years ago. I am unsure if the culture among pharmacy students is similar to when I was in school; however, based on the following quote from the board of pharmacy, I have a strong suspicion that it is.
As stated on the California State Board of Pharmacy website, “A recent study indicated that 46% of the pharmacists and 62% of the pharmacy students studied had used controlled substances at some time without a prescription. That does not mean that everyone who has used drugs improperly becomes a substance abuser, but highly educated and trained health professionals are not immune to alcoholism, other chemical dependencies or mental illness. Indeed, their greater access to abusable substances may increase potential risk.”
Unfortunately for me, this culture followed me into my professional practice. I became one of the 10-15% of pharmacists who developed a substance abuse disorder, of which I have written extensively about in my book and previous articles. I am open to discussing this topic with anyone.
As we know, culture does not change quickly. Only through awareness, education and continued communication can we slowly change our cultural behavior patterns.