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 and
ILLEGAL drugs.
• 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 patient for whom it was
prescribed.”
• 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
Dose (mg)
Behavioral
Effects
1st
100–200
Mild stimulation
2nd
200–400
Euphoria and
Hallucinations
3rd
300– 600
Distorted visual
perceptions
and
Loss of motor
coordination
4th
500-1500
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-thecounter 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.
Take Home Point
Don't Become Part of
the Statistic!!!