When going to a doctor for help, most of us assume that the drug the doctor gives us will work and will be safe. In other words, the drug's been tested, the correct dosage determined, and any reasons why it should not be taken have been isolated. However, that is often not the case. In fact, more than one in five medications are prescribed for something other than their approved use, and nearly 75% of those don't even have strong scientific evidence that they're appropriate. This practice, though legal, is causing a number of problems - including an increase in the number of people suffering from prescription drug addiction.

How does this happen? When the FDA approves a drug, it is for specific uses only. But as the FDA does not control the practice of medicine, a doctor is free to prescribe the drug for anything else he judges appropriate. This is called ‘off-label' prescribing, and is perfectly legal in the U.S.

So, what's the problem?

First, one of the criteria used by the FDA in the approval process is an assessment of whether the benefits of the drug outweigh the risks.

In the case of OxyContin, for example, the risk of prescription drug addiction is extremely high - it is, after all, the equivalent of morphine or heroin. The FDA approved OxyContin to treat moderate to severe pain for an extended period of time. Initially, the company's promotion focused on treatment of chronic pain in cancer patients - and that's the severity of condition for which it was intended.

It was not intended as an everyday - take it when you need it - painkiller. It wasn't even approved for use after surgery unless the pain from the surgery was expected to be severe and last for a long time.

However, within a year of its release in 1995, Purdue Pharma started marketing OxyContin as the ‘first choice' painkiller - the "one to start with and stay with." They spent billions on promotion and marketing campaigns, including hiring hundreds of sales people to personally visit thousands of doctors, dentists, nurses and other healthcare professionals to promote the off-label use of OxyContin. They even promoted it that way directly to patients.

The sales people's pay was based in part on how their actions affected sales of OxyContin.

During this promotion, Purdue's sales people also played down the risk of prescription drug addiction. As a result, it's fair to say that hundreds of thousands of people, if not millons, were prescribed the drug inappropriately. As a result, drug addiction treatment centers are now seeing more people for prescription drug addiction than for addiction to street drugs and one of the major drugs they have a problem with is OxyContin.

In these cases, the benefits do not outweigh the risks.

Cardiac drugs, anticonvulsants, antiasthmatics, allergy drugs and many others are also prescribed off-label 40% to 50% of the time. Psychiatric drugs, many of which can also cause prescription drug addiction and dependency, are at 31%.

Despite the risks, the FDA announced earlier this year that it is looking at relaxing the restrictions on drug companies being allowed to do off-label promotion. The issue is not yet finalized.

Prescription drug addiction can be addressed successfully in a drug addiction treatment center, although it's advisable to ensure the specific facility you choose is experienced with prescription drug rehab. However, to avoid prescription drug addiction and other drug-related problems, it's a good idea to ask your doctor whether the drug he's prescribing for you is off-label and make sure you fully understand the risks so you can make the right decision.