How to Avoid Problems with Prescription Medication

1. How to Avoid Problems with Prescription Medication Presented by: Eric Henderson Counseling Services 10-424 512-2752

2. Statistics • A 2005 survey by the Partnership for a Drug Free America found that 19% of US teenagers reported having taken prescription drugs to get high • USA Today March 2010-Military doctors wrote almost 3.8 million prescriptions for pain relief for service members in 2009, that is up more than four times what was prescribed in 2001, 1 in 4 soldiers admitted abusing prescribed drugs, mostly pain relievers • National Institute on Drug Abuse-18% of adults 60 years and older may suffer from prescription drug abuse, they tend to use prescription medication three times as frequently as the general population and have the poorest compliance rates in regards to following directions for the medications

3. Statistics • National Survey on Drug Use and Health-In 2007, 6.9 million people aged 12 and older had used prescription medication for non medical reasons prior to the month they were surveyed • In 2008, 15.2 million people aged 12 and older had taken a prescription medication for non medical purposes at least once in the year prior to them being surveyed • 56.5 % reported that they got the drug most recently used from someone they knew and that they did not pay for it

4. Prescription vs. Over the Counter • Prescription • Licensed medication that is regulated by legislation to require a prescription before it can be obtained • Can be authorized by medical practitioners, dentists, optometrists, and veterinarians • All medication should have an insert containing information on the intended effect of the drug and how it works in the body, as well as side effects. Other information would be how the patient should take the drug, cautions for it’s use, and warnings about allergies • The FDA is charged with implementing laws regarding the safety and effectiveness of prescription drugs in the US

5. Prescription vs. Over The Counter • Over The Counter • Used to treat conditions not necessarily requiring care from a professional • Meet higher safety standards for self medication by patients • Lower strengths of drugs are approved for OTC, higher strengths would need a prescription (ibuprofen) • No prescription needed

6. Role of Patient • When visiting the doctor, provide a complete medical history and a description of the reason for the visit to ensure that the doctor understands the complaint and can prescribe appropriate medication • If prescribed medication-follow the directions carefully and learn about the effects that the drug could have, especially during the first few days when your body is adjusting to the drug • Be aware of potential interactions with other drugs or substances (alcohol)

7. Role of Patient • Do not increase or decrease doses or abruptly stop taking a drug without consulting a health care provider first • NEVER use another person’s prescription

8. Role of Pharmacists • Explain how to take a medication appropriately • Provide clear information about the effects the medication may have • Provide advice about any possible drug interactions

9. Role of Health Care Provider • Identify prescription drug abuse when it exists • Help the patient recognize the problem • Set goals for recovery and refer for appropriate treatment • Conducting appropriate screenings about any medications and/or OTC medication the patient may be on • Be aware of requests for refills before the quantity prescribed should have been used and rapid increases in the amount of drug needed-which may indicate the development of tolerance

10. Commonly Abused Prescription Medications and OTC • Opioids-usually prescribed to treat pain • CNS (Central Nervous System) Depressants-used to treat anxiety and sleep disorders • Stimulants-prescribed to treat ADHD and narcolepsy • Dextromethorphan-ingredient in OTC cough and cold medications

11. Opioids-Prescription Pain Relievers • Codeine, OxyContin, Percocet, Vicodin • Tablets and capsules • Prescribed to treat pain • When abused, they are swallowed, snorted, or injected • Short term effects • Relief from pain • Feelings of euphoria or feelings of well being that affects-this feeling is what leads to abuse • Drowsiness, slowed breathing • Large single dose-severe respiratory depression that can lead to death

12. Opioids-Prescription Pain Relievers • Long term effects • Taken as prescribed-manage pain effectively • Abuse can result in physical dependence and/or addiction • Dependence can lead to withdrawal if use is stopped or reduced • Withdrawal symptoms-restlessness, muscle and bone pain, insomnia, vomiting • Tolerance can occur with long time usage in which patient needs higher doses to achieve the same or similar effects

13. CNS (Central Nervous System) Depressants • Mebaral, Quaaludes, Xanax, Valium, Nembutal, Ambien, Sonata, Lunesta (sleep medications) • Multi-colored tablets and capsules, some can be in liquid form • Prescribed for sleeping problems and anxiety • When abused, swallowed or injected • Short Term Effects • Can cause euphoria • Slows normal brain function which can result in slurred speech, shallow breathing, sluggishness, fatigue, and disorientation

14. CNS (Central Nervous System) Depressants • Short Term Effects cont. • First few days person usually feels sleepy and uncoordinated, but as the body adjusts these symptoms begin to disappear • Higher doses cause impairments in memory, judgement, coordination, irritability, paranoia, and suicidal ideation. • Some people can become agitated or aggressive if used more than prescribed • If taken with other substances, such as alcohol, effects could be slow breathing, slow heart and respiration, and possibly can lead to death

15. CNS (Central Nervous System) Depressants • Long Term Effects • Continued use can lead to physical dependence, if use is reduced or stopped abruptly withdrawal symptoms can occur • Because these drugs work to slow brain activity, stopping use without consulting doctor could lead to seizures or other harmful consequences • Tolerance can also develop with these drugs which can then also lead to addiction

16. Stimulants • Adderall, Dexedrine, Ritalin, Concerta • Tablets and capsules • Prescribed for narcolepsy, ADHD, and short term treatment of obesity • When abused, they may be swallowed or injected. Injection is dangerous as insoluble fillers in the tablets can block small blood vessels. Stimulants have been abused for both performance enhancement and recreational purposes “getting high”

17. Stimulants • Short Term Effects • Increases dopamine in the brain, which increases blood pressure and heart rate, constricts blood vessels, increases glucose, and increases breathing • Effects can feel like an increased alertness, attention, and energy along with a sense of euphoria • There is a potential for heart attack or lethal seizures

18. Stimulants • Long Term Effects • Stimulants can become addictive in that people begin to use them compulsively • High doses taken repeatedly over a short time can lead to feelings of hostility or paranoia • High doses may result in dangerous high body temperatures and an irregular heartbeat • Potential for heart attack or seizure

19. Dextromethorphan (DXM) • Active ingredient in OTC cough and cold medications • It is taken orally, such as tablet or capusle • In order to experience mind altering effects of DXM, excessive amounts of liquid and gelcaps must be consumed • Youth are the primary abusers due to their accessibility • Consequences for Abuse • Impaired motor function • Numbness • Increased heart rate and blood pressure • Rare occasion-brain damage due to lack of oxygen to brain

20. Assessing Abuse-4 Simple Questions • Have you ever felt the need to cut down on your use of prescription drugs? • Have you ever felt annoyed by remarks your friends or loved ones make about your use of prescription drugs? • Have you ever felt guilt or remorseful about your use of prescription drugs? • Have you ever used prescription drugs as a way to “get going” or to “calm down” in excess of how they are prescribed?

21. Signs and Symptoms of Abuse and Addiction • Signs and Symptoms of Prescription Drug Abuse • Neglecting responsibilities at school, work, home-flunking classes, skipping work, neglecting your kids, because of your drug use • Engaging in risky behaviors-such as driving under the influence, using dirty needles, having unprotected sex • Use is getting you into legal trouble-arrested, stealing to support habit • Causing problems in your relationship-fights with your partner or family members, an unhappy boss, loss of old friends

22. Signs and Symptoms of Abuse and Addiction • Signs and Symptoms of Prescription Drug Addiction • Drug tolerance-need to use more of the drug to experience the same effects you used with smaller amounts • Take drugs to avoid or relieve withdrawal symptoms • Lose control over use-use more than you planned, even though you told yourself that you would not, you feel powerless • Life revolves around the use-spend lots of time thinking or using drugs, how to get them, and recovering from their effects • Stop activities you enjoy such as hobbies, sports, and socializing • Even though it causes major problems in your life-black outs, mood swings, depression, you continue to use

23. Warning Signs-People You Care About • Physical • Bloodshot eyes or pupils • Changes in appetite or sleep patterns • Sudden weight loss or gain • Deterioration of physical appearance and grooming habits • Unusual smells on breath, body, clothing • Tremors, slurred speech, impaired coordination

24. Warning Signs-People You Care About • Behavioral • Drop in attendance and performance at work or school • Unexplained need for money or financial problems. May borrow orsteal to get it • Engaging in secretive or suspicious behaviors • Sudden change in friends, hangouts, or hobbies • Frequently getting into trouble

25. Warning Signs-People You Care About • Psychological • Unexplained change in personality or attitude • Sudden mood swings, irritability, angry outbursts • Periods of unusual hyperactivity, agitation, or giddiness • Lack of motivation, appears lethargic, “spaced out” • Appears fearful, anxious, or paranoid with no reason

26. People You Care About • Speak up • Take care of yourself • Don’t cover for the drug user • Avoid self blame

27. Treatment • Prescription Drug Treatment Hotline 1-800-611-9551 • www.drugabuse.gov/drugpages/prescription.html • Turning Point at Miami Valley Hospital • 937-208-4673, Hotline 937-224-4646 • Self pay, Medicaid, Medicare, Private insurance, Sliding Fee • Crisis Care-Alcohol and/or Drug Assessment and refer for treatment • 937-224-4646

28. Treatment • Gail Schlemelesky-Private Practice, 937-866-1420, West Carrollton • Nova House-732 Beckman St., Dayton, Ohio, 937-253-1680 • Inpatient • Outpatient • Intensive Outpatient

29. Treatment • Sinclair Addiction Group • Building 10 Room 423 May 17, 24, June 7 • Take classes at Sinclair in regards to drug addiction/drug use