Prescription and Over the Counter (OTC) Medicine Abuse Training By Stephanie VanDerKooi, MPH, CPS-M May 4, 2011 Goals for Today Learn what prescription and over the counter drugs are being abused Learn who is abusing Review Data Identify what you can do as a professional to help prevent these problems in your community 1 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. 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. 2 As a result… Next to marijuana, the most common illegal drugs teens are abusing are prescription medications. Twenty percent of U.S. high school students say they have taken Rx drugs without consulting a doctor. 1 in 5 teens has abused Rx drugs. 1 in 3 teens say there is “nothing wrong” with abusing Rx medications “every once in a while.” Every day, almost 2,500 teens abuse an Rx medication for the first time. RX ABUSE PREVENTION TOOLKIT - from awareness to action Teens’ Rx Drugs of Choice For Abuse How they work Abused by teens to: Drug names Strong pain relievers Used to relieve moderate-tosevere pain, these medications block pain signals to the brain Get high, increase feelings of well being by affecting the brain regions that mediate pleasure Vicodin, OxyContin, Percocet, Lorcet, Lortab, Actiq, Darvon, codeine, morphine, methadone Stimulants Primarily used to treat ADHD type symptoms, these speed up brain activity causing increased alertness, attention, and energy that comes with elevated blood pressure, increased heart rate and breathing Feel alert, focused and full of energy—perhaps around final exams or to manage coursework, lose weight Adderall, Dexedrine, Ritalin, Concerta Used to slow down or “depress” the functions of the brain and central nervous system pressure, increased heart rate and breathing Feel calm, reduce stress, sleep Valium, Xanax, Ativan, Klonopin, Restoril, Ambien, Lunesta, Mebaral, Nembutal, Soma Sedatives or tranquilizers RX ABUSE PREVENTION TOOLKIT - from awareness to action 3 OxyContin Effects High similar to Heroin rush Prescription Oxycontin designed for a 12 hour release to patient. Abusers are crushing up tablets and snorting them getting all the opiates at once. This quickly leads to addiction 4 OxyContin Facts Cont.. 1 in 20 High School Seniors admit trying Oxycontin. Highly addictive with severe withdrawals sweats, chills, vomiting, headache Often a Gateway drug to heroin because its cheaper. Several companies launching crush proof alternatives to Oxycontin. Access to RX Drugs Where are they getting these from? Medicine Cabinet Home Friends Other relatives (grandparents) School Kids at school sell and share 5 What can you do to prevent RX Drug Abuse? Educate yourself on this topic CADCA www.cadca.org White House Epidemic Responding to Americas Prescription Drug Abuse Crisis www.whitehousedrugpolicy.gov Educate your community Parents, youth, and patients about the dangers of abusing rx drugs Safe and proper storage and disposal. What can you do to prevent RX Drug Abuse? Monitor Become aware of legislation to monitor RX drugs. Proper Medication Disposal Develop convenient drop off locations “community take back programs” Ex. Ottawa County Health Department Work with existing programs to help advertise Participate in the DEA Drug Take Back Days Enforcement Provide law enforcement with tools to eliminate improper prescribing practices and doctor shopping behavior. 6 Prescription Drug Abuse Resources www.cadca.org www.theantidrug.com/resources www.whitehousedrugpolicy.gov www.nida.nih.gov www.samhsa.gov www.dea.gov Streetdrugs.org Over the Counter Drug (OTC) AbuseGoals For Today Learn what OTC Drugs are Identify who is using Identify why are they using these drugs Learn what you can do to prevent this from becoming a problem in your community 7 Over The Counter Drug Abuse-Cough Medicine Dextromethophan (DXM)-active ingredient FDA approval 1950’s to relieve cough symptoms. Over 100 OTC medicines that contain DXM Alka Seltzer cough and cold Coricidin Robotussin Dimetapp Sudafed cough products Slang terms for Cough Medicine Abuse Skittling Tusssing Robo tripping Triple cs Dex Dex trip 8 “Lean” – “Purple Drank” “Lean” or “Purple Drank” Recipe Rx Cough Syrup with Codeine and Promethazine. Cherry Bubble up or Sprite Two watermelon Jolly Ranchers Ice cubes 9 “Lean” or “Purple Drank” Effects Altered level of consciousness Sedative Effect Alcohol often added Out of body experience, euphoria Sweats, fever, confusion Cough Medicine Abuse- Side Effects Delusions Panic attacks Memory problems Blurred vision Stomach pain, nausea, and vomiting High blood pressure and rapid heartbeat Numbness of fingers and toes Drowsiness and dizziness Fever and headaches Rashes and itchy skin Loss of consciousness 10 Cough Medicine Abuse Access Points? Local grocery stores, pharmacies, chain stores, gas stations, etc. Buy them from several different stores Friends Medicine Cabinets Local Story- ”Care Baskets”-Heidi Denton Cough Medicine abuse Scope of the Problem 3.8% of 8th graders, 6% of 10th graders, and 5.9% of 12th graders are abusing cough medicine (National Institute on Drug Abuse, 2009) Becoming very common in teen culture, especially on the internet. Hundreds of websites that promotes DXM-containing medicine telling how to achieve the best highs based on their height and weight! 11 Cough Medicine Abuse: Warning Signs Empty cough medicine boxes or bottles in the trash, backpack, school locker Purchase or use of large amounts of cough medicine when not ill Missing boxes or bottles of medications from the cupboard Changes in friends, physical appearance, or sleeping, or eating patterns Declining grades Loss of interest in hobbies What can you do to Prevent OTC Abuse? Educate yourself on this topic Educate the community www.stopmedicineabuse.org Communicate the dangers to your children & other kids Host Town Hall, attend PTA meetings, Health Fairs, etc. Monitor your teens internet use Safeguard your medicine cabinets Lock your cabinet Know your inventory 12 More information www.dxmstories.com www.stopmedicineabuse.org www.doseofprevention.org Fivemoms.stopmedicineabuse.org www.whitehousedrugpolicy.gov www.nida.nih.gov www.abovetheinfluence.com (Teen based) Questions Any questions?? To get this PowerPoint presentation please go to the Lakeshore Coordinating Council’s website. www.lakeshoreca.org/training.aspx 13 Contact Information: Stephanie VanDerKooi, MPH CPS-M Health Educator Ottawa County Health Department 12251 James Street Ste 400 Holland MI 49424 616-393-5776 [email protected] 14