Transcript Prescription/OTC Medication Abuse
Prescription and OTC Drug Abuse
Jennifer Swift Lake Erie College of Osteopathic Medicine Wegmans Pharmacist, Pharm D.
Stephen Tarbell University of Buffalo Pharmacy Candidate 2011
Quick Quiz
1 in 5 teenagers have tried this:
A. Prescription Pain Medications B. Marijuana C. Chewing Tobacco
Prescription Pain Medications
Examples
:
• Vicodin • Oxycodone/ Oxycontin • Morphine • Tylenol with Codeine
Quick Quiz
14% of teenagers have been offered this:
A. Acting Audition B. Cocaine C. Prescription Medication for Non-Medical Use
“Pharming” Parties
• New form of a party – people bring in medications, dump them all into a bowl, and then you take a handful of pills and take them all at once. • Even if you only do this once you may possibly cause permanent damage to your body if not death. • CBS 4 News: Hollywood FL
Are Medications Safe?
• Life saving remedies when used
correctly
• Very dangerous if used
incorrectly
Who abuses Medications?
• Abusers of prescription products can range from school age children to celebrities.
• Suspicion of medication abuse has been alleged in the death of • Michael Jackson • Anna Nicole Smith • Elvis Presley
Medication Dangers
• Between 1999 and 2004 nearly all
POISON
deaths were due to
DRUGS
, and the most coming from the
abuse
of
PRESCRIPTION ILLEGAL
drugs. and • In 1999 12,186 DEATHS • In 2004 20,950 DEATHS
Are prescription medications safer than illegal drugs?
• 41% of teens believe they are safer • Prescription medications
can
be just as dangerous if not MORE DANGEROUS than illegal drugs • Must be used only under supervision of a healthcare professional
• On the label of a prescription: • “
Caution:
”
Federal law
prohibits the transfer of this drug to any person
other
than the
prescribed
.”
patient
for whom it was • Medications are NOT to be shared!!!
What is the most commonly abused pain killer?
•
VICODIN
• contains Hydrocodone/ APAP • most commonly abused pain killer at 18%
Vicodin
•
Hydrocodone causes
• Dizziness • Drowsiness • Slows breathing • Hallucinations •
Tylenol causes
• Liver toxicity if >4,000mg/ day
Oxycodone/ Oxycontin
• •
Uses
• Control pain after an operation • Dental pain • Moderate to severe pain
How it works
• In brain and spinal cord to block perception of pain
Oxycodone/ Oxycontin •
Adverse Reactions
• Slows heart rate • Increase or decrease blood pressure • Fainting • Dry mouth • Blurred vision • Cardiac arrest (heart stops)
Oxycodone/ Oxycontin •
Adverse Reactions continued
• Muscle twitching • Sweating • Hallucinations • Headaches • Circulatory depression • Slurred speech
Morphine • MS Contin • MSIR • Avinza • Kadian • Oramorph • Roxanol
Morphine • Acts in the brain and spinal cord to relieve pain • High likelihood for • addiction • tolerance • physical and psychological dependence
Morphine •
Effects on the body
• Slows heart rate • Shortness of breath • Confusion • Drowsiness • Kidney failure • Muscle twitches • Nausea/ Vomiting • Dry mouth • Blurred vision • Unconsciousness • Death
Over-the-Counter (OTC) Medications • • •
Cough and cold medications
• Delsym/ Robitussin
Pain relievers
• Tylenol • Ibuprofen
1 in 10 teens have abused OTC cough medicine to get a high
Dextromethorphan • •
What is it?
• morphine derivative • works in the cough center (medulla) of the brain
Side effects
• altered time perception • visual hallucinations • brain damage • seizure • loss of consciousness • irregular heart beat
Dextromethorphan
Normal dosage: 120 mg/day, 60mg/dose Plateau 1 st 2 nd 3 rd 4th Dose (mg) 100 –200 200 –400 300 – 600 500-1500 Behavioral Effects Mild stimulation Euphoria and Hallucinations Distorted visual perceptions and Loss of motor coordination Dissociative sedation
Tylenol
Tylenol •
Active ingredient
• Acetaminophen • APAP •
What is it?
• Pain reliever • Fever reducer •
Overdose
• 4,000mg • Liver toxicity • Common cause of liver transplants
Tylenol • •
Acetaminophen is found in many over-the counter products
• Benadryl • Cepacol • Coricidin • Dayquil • Dimetapp • Excedrin • Midol • Nyquil • Theraflu • Triaminic • Vicks • Zicam
Tylenol •
Acetaminophen is also found in many prescription products
• Percocet • Darvocet • Fioricet • Tylenol with Codeine • Endocet • Vicodin • Lortab • Ultracet
Liver
Advil/ Motrin •
Active ingredient
• Ibuprofen •
What is it?
• Anti-inflammatory • Pain reliever • Fever reducer •
What is causes
• GI bleeding
Common Street Names •
OxyContin
• Ocs, oxy, 40 (a 40mg tablets), 80 (an 80mg tablet), Blue, Hillbilly heroin, Kicker •
Dextromethorphan
• Dex, DXM, Skittles, Robo, Syrup, Triple-C, Tussin, Vitamin D
Effects of Drug Abuse
•
Short term drug abuse
– feels “good” – seems harmless •
Medication abuse may include
– trouble sleeping – dependence – social withdrawal – trouble breathing – organ damage – death
Fact from Fiction
• Easy to look at medications as the cure-all, especially watching TV commercials, but they are far from it.
• Medications should
only
be used when necessary.
• Media should be looked at cautiously • Important to listen to the quick talking at the end – side effects, precautions • If you ever have a question or wonder if a medication may be right for you, speak to your doctor or pharmacist.
How do you know if someone is abusing medications?
• Change in sleep patterns • Change in attitude • Social withdrawal • Easily agitated • Sudden weight loss/gain • Out of the ordinary spending of money
Help is Available!!!
•
www.checkyourself.com
- allows teens to gauge their dependence and provides outlets of help •
www.dxmstories.com
- discusses abuse of the OTC cough syrup Dextromethorphan •
www.drugfree.org
• 1-800-862-HELP(4357) - hotline that provides you with treatment programs in your area
Real Life Stories
• Eddie was a 22 year old young man who began abusing a prescription medication called Xanax. At times Eddie would take 15 pills at once. One time while waiting for friends he fell asleep on a street corner. Eddie was found and decided to go to rehab.
• After completing a 28 day rehab program Eddie relapsed and overdosed on 67 pills of Xanax. • Eddie died at the age of 22, leaving his parents, girlfriend, and two young children.
Real Life Stories
• Mark Daniel Bauer was an avid weightlifter. He took prescription drugs, that were not prescribed to him to relieve his chronic back pain. • Mark overdosed on morphine, oxycodone, and acetaminophen. Mark died on May 24, 2004. • He was 18 years old.
Real Life Stories
• Nathaniel Bell was charged with committing first degree murder after stabbing Jose Felix-Martinez. The motive —Nathaniel had ingested large amounts of an OTC medication that contains dextromethorphan (Delsym) as well as cocaine and alcohol.
Real Life Stories
• Savannah Kissick was celebrating New Years Eve using painkillers and sedatives. She was rushed to the hospital that night and died soon after. Savannah was 22 years old. • Savannah’s friend Sarah Shay also overdosed on prescription drugs while partying with friends. Her friends dropped her body off at a local hospital and fled the area. She had already passed away. She was 19 years old.