Dr. Manny: How prescription drug abuse is helping to fuel violence in America

June 19, 2015: Police tape surrounds the parking lot behind the AME Emanuel Church as FBI forensic experts work the crime scene in Charleston, S.C. (AP)

My heart aches and my soul is full of sadness for the nine innocent lives lost in Charleston, South Carolina, and the community left reeling due to yet another senseless crime. This horrific mass murder will no doubt be remembered in American history, just like the many others that have come before it, and unfortunately the probable ones yet to come.

While we know that accused killer Dylann Roof was fueled by hatred and racism, I wonder if there is a pattern in some of these tragedies. In conjunction with what other experts will tell us, I believe that an epidemic of drug abuse in this country is helping to fuel the violence. I am not talking about marijuana, cocaine or heroin – I am specifically singling out prescription drug abuse.

It is alleged that Roof was taking Xanax and Soboxone. A high school classmate even referred to him as a “pill popper.” The Wall Street Journal reported that in a police incident report from February, Roof was found to have strips of Suboxone -- a pain drug used to treat opiate addiction -- on him, but did not have a prescription for the drug. From what we know thus far, Roof was not under any kind of psychiatric care, either.

Now, I don’t know for sure whether or not Roof had a prescription for Xanax, or if he purchased it off the street like his former classmate inferred, but the drug has been linked to many potential dangerous side effects without careful monitoring. Xanax may cause a person to become depressed, irritable, an insomniac, to have difficulty concentrating, and to act in an aggressive manner. When psychiatrists and physicians prescribe Xanax, they are aware of these side effects, and determine the proper dosage to prescribe to patients based on any underlying mental illnesses. However, when the drug is purchased off the street, there could be undiagnosed disorders like bipolar disorder or another mental illnesses that could cause the above-mentioned side effects to come to life, often in tragic ways.

Suboxone is another powerful drug that requires a degree of professional monitoring. This is typically prescribed for narcotic addiction because it contains both a narcotic element, along with an anti-narcotic ingredient. The combination of this drug and Xanax could create a poisonous cocktail that may spell trouble for the user.

Many of these drugs are sold on the streets by people who have obtained them illegally. A National Household Survey on Drug Abuse indicated that an estimated 36 million U.S. residents aged 12 and older abused prescription drugs at least once in their lifetime. In breaking that number down, it found that 2.7 million of those individuals were aged 12 to 17, and 6.9 million were aged 18 to 25. Those purchasing the drugs are unaware of potential side effects or the dangers that they may pose to others while on the medications.

Make no mistake about it, these are powerful drugs intended to treat many mental illnesses. Most of them, if they are taken as intended, do provide great relief to patients. However, there are instances of violence that have occurred while suspects were under the care of a psychiatrist and were taking the prescriptions legally.

Let’s look at James Holmes, the accused killer who opened fire on a movie theater in Aurora, Colorado, killing 12 and wounding 70. Holmes had been prescribed a generic version of Zoloft, which is used to treat depression, panic disorder and obsessive-compulsive disorder, and Clonazepam, which treats anxiety and panic attacks. Zoloft has the potential to cause suicidal ideation, while Clonazepam also carries the potential for serious side effects.

Next, let’s consider Eric Harris, who along with Dylan Klebold, opened fire on April 20, 1999, at Columbine High School, murdering 13 classmates before killing themselves. Harris had been prescribed the powerful antidepressant Luvox.

One in 10 Americans now takes antidepressant medications and many others illegally acquire these drugs for recreational use. I am certainly not suggesting that one in 10 of us is a killer. What I am saying, is that when these powerful medications are given, they must be medically supervised, and all of the side effects must be considered by the prescribing doctor. When there is no medical supervision, or lax guidance, these drugs can enhance aggressive behavior and further fuel irrational thinking. The illegal prescription drug abuse on the streets is far too great for us to ignore.

As the nation once more looks for answers to an unthinkable tragedy, many will race to call for better gun control and background checks. Others will want social answers and call for better ways to mend the racial divide that exists in some of our communities. But what I ask our leaders is to also address the epic level of untreated mental illness in our country, which when paired with illegal drug abuse, has only left us reeling time after time.

We all need to work together. Just recently the Justice Department arrested 243 people across the country and charged them with submitting fake billing for Medicare which totaled $712 million. Among those arrested are 46 doctors, nurses and other licensed medical professionals. In one case, a doctor in Michigan prescribed unnecessary narcotics in exchange for patients’ identification information to generate false billings.

Uncontrolled drug abuse in people that already possess racism and hatred in their hearts makes for an incredibly dangerous situation.

Each and every one of us will play a role in righting this wrong, and it begins with caring for each other. If you notice changes in any of your loved ones, friends or colleagues, then you must speak out. Too often after the fact we hear of all the warning signs that were there for us, whether it was the lack of compassion for your fellow man, drug abuse or mental illness, it is our responsibility to get them help. Let us hope that this hate crime will make every single American know how to love and respect and care for each other, because that will be the definitive cure that will make us stronger and better people.