Black Beauties, Gorilla Pills, Footballs, and Hillbilly Heroin: Some Reflections on Prescription Drug Abuse and Diversion Research over the past 40 Years

• Date: 01 January 2009
• Author: Theodore J. Cicero,James A. Inciardi
• Published date: 01 January 2009
• DOI: 10.1177/002204260903900109
• Subject Matter: Article

BLACK BEAUTIES, GORILLA PILLS, FOOTBALLS,

AND HILLBILLY HEROIN: SOME REFLECTIONS ON

PRESCRIPTION DRUG ABUSE AND DIVERSION

RESEARCH OVER THE PAST 40 YEARS

JAMES A. INCIARDI, THEODORE J. CICERO

Although the problem of prescription drug abuse has endured for well over two

centuries, research into the abuse and diversion of these drugs has been relatively

recent. The f‌i rst general population survey to document the abuse of prescription

medications occurred in 1970, and subsequent studies demonstrated that the

abuse and diversion of amphetamines, opioids, and sedatives has continued

to be widespread. During the 1980s and much of the 1990s, prescription drug

abuse took a back seat to other more pressing concerns: “freebase” and powder

cocaine, the cocaine wars, crack and sex-for-crack exchanges, rising rates of drug-

related street crime, and HIV/AIDS among injection and non-injection drug users.

However, recent surveys suggest that the current outbreak of prescription drug

abuse began during the early to mid-1990s. Although the abuse and diversion of

prescription drugs was clearly an evolving problem, what seemed to galvanize the

attention of the media, the government, and the public at large was OxyContin®.

Currently, there is no question that the problems of prescription drug abuse and

diversion continue to grow. Why this is so, however, is open to speculation.

Perhaps the reason lies in the increasing numbers of prescription drugs that are

being legally marketed. Or perhaps the popularity of prescription drugs is rooted in

the beliefs that they are more acceptable, less dangerous, and less subject to legal

consequences than are illicit drugs.

© 2009 BY THE JOURNAL OF DRUG ISSUES

JOURNAL OF DRUG ISSUES 0022-0426/09/01 101-114

__________

James A. Inciardi, Ph.D., is the Co-Director of the Center for Drug and Alcohol Studies at the

University of Delaware, and is the author of more than 450 articles, chapters, and books in the areas

of substance abuse, criminology, criminal justice, history, folklore, public policy, HIV/AIDS, medicine,

and law. Theodore J. Cicero, Ph.D., a Professor in Psychiatry at Washington University School of

Medicine, has a 40-year long interest in two aspects of substance abuse: the neurobiological and

neuroendocrinological substrates of tolerance and dependence; and studies in humans directed at the

abuse of prescription opioid analgesics.