Transcript Teen Drug Abuse in the Formative Years of 12-18 Ernest Mrazik, Jr.

Teen Drug Abuse in the
Formative Years of 12-18
Ernest Mrazik, Jr. RPh, MBA
Generation RX Champion 2012
Real Danger
“Abusing prescription (RX)
and over-the-counter (OTC)
drugs can be just as
dangerous, addictive and
even deadly as using ‘street’
drugs”
National Institute on Drug Abuse, 2008
Troubling Indicators of
Medicine Abuse
• Unintentional drug poisoning now the leading
cause of accidental death in US, overtaking car
crashes
• Emergency room visits related to Rx/OTC abuse
now almost equal to ER visits due to all “street
drugs”
• Rx drugs are now the most commonly abused
drugs among 12-13 year olds
Centers for Disease Control and Prevention, The Three Leading Causes of Injury
Mortality in the United States, 1999-2005, 2008; Drug Abuse Warning Network;
Substance Abuse and Mental Health Services Administration, National Study on Drug
Use and Health, 2007
Columbia University National Center on
Addiction and Substance Abuse
• 12 to 17 years olds abuse prescription drugs more than they
abuse ecstasy, crack/cocaine, heroin, and methamphetamine
combined.
• 60% of teens who abused Rx pain killers did so before 15.
• There are as many new abusers (initiates or first-time users)
age 12-17 of prescription drugs as there are of marijuana.
• 90% of all adults with substance abuse disorder started using
under age of 18 and half under age of 15.
• Children who first smoke marijuana under age of 14 are 5
times more likely to abuse drugs as an adult than those use
marijuana at age 18.
Rx New Step in Drug Ladder
heroin,
meth, crack
cocaine
shrooms,
Ecstasy
Prescription/over-the-counter drugs (Rx/OTC)
liquor,
marijuana
cigarettes, beer/wine
Rx abusers are more likely to add a 3rd rung in the progression
The Teen – Rx Abuse
Connection
Rx Medications are All Around Us…and Teens Notice
 Patients leave the doctor’s office with a
prescription in hand in 7 out of 10 visits.
 Direct-to-consumer advertising on TV and in
magazines is pervasive.
 Many people don’t know how to safely use these
medications or ignore their doctor’s instructions.
RX ABUSE PREVENTION TOOLKIT - from awareness to action
As a result…
Rx drugs are part of teen culture. Teens:
 Normalize this form of drug abuse.
 Take these meds for legitimate reasons – with or
without a prescription – to stay awake, remain
alert or to go to sleep.
 Purposely abuse these drugs to get high. They
participate in “pharming” and “bowling” parties.
 Are often unaware that these activities can lead to
disastrous results.
RX ABUSE PREVENTION TOOLKIT - from awareness to action
Teenagers don’t know
that abusing Rx drugs can:
 Increase blood pressure or heart rate.
 Damage the brain and other organs.
 Lead to accidental overdose / poisonings.
 Cause physical dependency and / or addiction.
 Disrupt breathing (respiratory depression).
 Lead to risks associated with mixing multiple drugs
or combining with alcohol.
 Cause seizures and even death.
RX ABUSE PREVENTION TOOLKIT - from awareness to action
Parent/Child
Conversation
• Most teens (62 percent) report that their
parents have talked to them about drugs and
alcohol in the past year.
• But only 17 percent of teens say their parents
have talked to them about prescription drug
abuse.
The Partnership at Drugfree.org, Partnership Attitude Tracking Study, 2011
Postings on Social
Networks
• Detailed instructions and
conversations about DXM
abuse;
• Blogs and videos with
postings of how and when
kids will take DXMcontaining cough
medicines;
• Footage of kids while
“high.”
Opiate Withdrawal
• Dilated pupils, rhinorrhea (runny nose)
• Tachycardia, hypertension
• Nausea, Vomiting, diarrhea, abdominal
cramps
• Goose bumps, sweats, muscle/bone/joint
aches
• Insomnia, anxiety, headache
Sedative-Hypnotic Withdrawal
•
•
•
•
Tremors, diaphoresis (sweats), nausea
Anxiety, hyperreflexia, seizures
Insomnia
Hallucinations (seeing or feelings things,
not hearing voices)
• Delirium tremens
Opana and Oxycontin users
switching to Heroin
• Oxycontin new safe tablet arrived on the market August 2010
and Opana formulation change soon followed.
• Researchers found the percentage of Oxycontin users fell from
35.6% before the new formulation was introduced to 12.8%
almost 2 years later.
• Primary abuse of other powerful opioids such as fentanyl,
hydromorphone, oxymorphone, and heroin (doubled).
• Almost a quarter of drug users (24%) said they found a way
around the tamper-resistant mechanism in Oxycontin
(microwave), but the vast majority (66%) said they switched
to another opioid instead.
Marijuana Potency
Effects of Synthetic
Marijuana
• Onset: Three to five minutes
• Length of duration: One to eight hours
• Short-term effects: In addition to physical
signs of use, users may experience:
– Dysphoria – the opposite of euphoria
– Paranoia – similar to PCP/Angel Dust
– Delusions, hallucinations and increased agitation
• Long-term effects: Unknown
Source: Prosecuting Attorneys Association of Michigan
CONNECTICUT PACT360
• CT one of top 10 states for dependence on illicit drugs among
young adults ages 18-25.
• Heroin is the most commonly cited drug by the CT DEA.
• Once the supply of prescription opioids is cut off or the
abuser’s tolerance requires very high doses, abusers move on
to Heroin, since it is much cheaper.
• Example: Oxycontin 80mg tablet cost $80 but a day’s worth of
Heroin is only $20.
• Heroin is readily available in the suburbs.
SAFEGUARD
Keep track of your meds
Parents (and other family members) are in the best position to reduce access
to prescription drugs by locking up medicines and properly disposing of expired
or unused medicines.
 Monitor all medications in the home—prescription and OTC medicines.
 Safely store medicines out of children’s reach and sight.
Consider locking them up.
 Get rid of old or unused medicines.
RX ABUSE PREVENTION TOOLKIT - from awareness to action
SAFEGUARD
Guidelines for Rx drug disposal
FEDERAL GUIDELINES
 Refer to October 15, 2009 FDA Guidelines for Disposal by Flushing.
 Do not flush down toilet or drain unless label or accompanying patient information
specifically instructs you to do so.
 Dispose of Rx drugs not labeled to be flushed through community drug take-back
programs. If a program is not available, dispose of medications appropriately:
1. Take medication out of its original packaging and place it into a disposable
container with a lid or into a sealable bag.
2. Mix drugs with an undesirable substance (e.g., cat litter or used coffee
grounds).
3. Place sealed container with the mixture and original packaging (be sure to
remove all personal information from the packaging) in the trash.
Office of National Drug Control Policy. Proper Disposal of Prescription Drugs. 2009.
Available at: www.whitehousedrugpolicy.gov/publications/pdf/prescrip_disposal.pdf
RX ABUSE PREVENTION TOOLKIT - from awareness to action