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Nonmedical use of Rx Drugs- Facts & Stats
 

Nonmedical use of Rx Drugs- Facts & Stats

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    Nonmedical use of Rx Drugs- Facts & Stats Nonmedical use of Rx Drugs- Facts & Stats Presentation Transcript

    • Nonmedical Use of Prescription Drugs 1
    • 1. What is Nonmedical use of Prescription Drugs?2. What are the Myths about Prescription Drug Use?3. What are Stimulants?4. What are Depressants (Narcotics & Sedatives)?5. Are Over-the-Counter Drugs Dangerous?6. What is the reality of prescription drug misuse? 2
    • 1. What is the meaning of Nonmedical Use of Prescription Drugs (Rx)? “Not prescribed for you” OR “You took the drug only for the experience or feeling it caused” (excludes Over-the-Counter medicine) Office of Applied Studies, SAMHSA Anesthetic and Life Support Drugs and Drug Safety and Risk Management Advisory Committees November 13, 2008 3
    • Where do nonmedical users get pain reliever prescription drugs? http://www.theantidrug.com/pdfs/prescription_report.pdf 4
    • Which prescription drugs are being abused? In 2005, 6.4 million Americans Age 12+ used a Rx for nonmedical purposes in past month 0.3 million Sedatives 1.1 million Stimulants 1.8 million Anti-Anxiety Medication 4.7 million Narcotic Pain Relievers Depressants Stimulantshttp://www.google.com/search?hl=en&rlz=1G1GGLQ_ENUS310&q=In+2005%2C+6.4+millio SOURCE: 2005 National Survey on Drug Use and Health (NSDUH), published Sept 2005 byn+Americans+Age+12%2B+used+a+prescription+drug+for+nonmedical+purposes+in+past+ Dept of HHS / Substance Abuse and Mental Health Services Administration (SAMHSA) month&btnG=Search&aq=f&oq=&aqi= 5
    • Nonmedical use of prescription drugs ranks 2 nd only to marijuana as the most prevalent category of drug abuse. Depressants Stimulants http://www.oas.samhsa.gov/2k6/pain/pain.cfm SOURCE: 2004 National Survey on Drug Use and Health (NSDUH) published Sept 2005 by the Dept of HHS / Substance Abuse and Mental Health Services Administration (SAMHSA) 6
    • 2. What are some Myths about Rx Use?•Prescription Drugs are “much safer” to use thanillegal drugs. •“I think prescription drugs sound safer, even if theyre not, just because they came from a company, and they were prescribed to someone for a legitimate reason.” Gilbert Quintero. Journal of American College Health. July-August 2009 v58 i1 p64(7).•There’s “nothing wrong” with using prescriptionmedicines without a prescription “once in a while.”•Prescription Drugs are not addictive.•There are fewer side effects than street drugs. 2005 Partnership and Attitude Study (PATS) www.usdoj.gov/dea/concern/hydrocodone.ppt http://www.theantidrug.com/pdfs/prescription_report.pdf 7
    • FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONALINSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 8
    • StimulantMedication 9
    • 3. Prescription Drug: STIMULANTS Amphetamines, Methamphetamines Amphetamine Congeners & Diet PillsIntended Use: Narcolepsy, Obesity, Attention-deficit hyperactivity disorder (ADHD), Milder stimulants to lose weight.Nonmedical use: Surge of pleasure, rush or flash, burst of energy, to stay awake, Anorexia, Euphoric EffectPhysical effects: include increased blood pressure, heart rate and pulse rates, insomnia, loss of appetite, and physical exhaustion.Drugs causing similar effects cocaine, crack, methamphetamine, khat http://www.getsmartaboutdrugs.com/drugs/amphetamines.html?v=0&t=0&p=1&f=0&df=0&dt=0 http://www.drugabuse.gov/ResearchReports/Prescription/prescription4.html#HowDo 10
    • Prescription Drug STIMULANTSSigns of AbuseNervousness, insomnia, over confident, aggressive, paranoid, lossof appetite, violent, euphoria, increased blood pressure.Signs of WithdrawalApathy, long periods of sleep, irritability, depression, disorientation.Signs of an OverdoseAgitation, increased body temperature, hallucinations, convulsions,apathy, long periods of sleep, depression, disorientation & possibledeath.Signs of Long-term UseHeart disease, mental imbalances, paranoid, aggressive, twitching,malnutrition, dehydration & psychotic, deplete energy sources &severe depression. http://www.usdoj.gov/dea/pubs/abuse/chart.htm 12
    • Prescription Drug STIMULANTSHow Stimulants can Kill:1-Brain damageIncreased blood pressure increases the risk of a rupturedblood vessel in the brain. Narrowing of blood vesselsreduces blood flow around the brain.2-Heart attackIncreased oxygen demand by the heart (because ofincreased motor activity) accompanied by reduced bloodsupply (narrowing of blood vessels) can lead to heart attack.3-OverheatingOne function of dopamine is to regulate body temperature.Altering dopamine levels with stimulants can affect thebodys ability to cool itself. Combined with increased motoractivity, this can lead to a dangerous increase in bodytemperature, resulting in organ failure and death. http://learn.genetics.utah.edu/content/addiction/drugs/overdose.html 13
    • Rates of Emergency Department visits, by drug,type of use and age- ADHD Stimulant Medicine 2008 DATA
    • ADHD Stimulant Medicine- Adderall® and Ritalin®While students feel smarter and moreintelligent, the use of stimulantsdoesnt make them "smarter" or"better", it just makes their bodysorgans worker harder and can actuallylead to the inability to concentrate orthink clearly for any length of time. See Adderall Misuse on College Campuses 15
    • Illegal Comparisons and/orNot considered legitimate for medical use: STIMULANTSCocaine- Slangs: Coke, Blow, Toot, Snow, Nose, Big C,Methamphetamine- See next slideMethyldioxymethamphetamine- MDA,MDMA Slangs: Ecstasy, rave, lovedrug, XTC, Adam *No one other drug is quite like MDMA, but MDMA producesboth amphetamine-like stimulation and mild mescaline-like hallucinations.*tweaking- severe paranoid, hallucinatory, hyper vigilant thinking, & greater suicidal depression Crack Pipe Ecstasy Cocaine Crack Cocaine Paraphernalia http://www.whitehousedrugpolicy.gov/streetterms/ByType.asp?intTypeID=3 http://www.usdoj.gov/oig/special/9712/appb.htm 16
    • Methamphetamine (Desoxyn®) vs. Methamphetamine (Meth) pg. 2 Desoxyn®: There is only one product currently marketed in 5 mg tablets. Desoxyn® has very limited use in the treatment of obesity, and attention deficit hyperactivity disorder. Desoxyn® Slangs: Yaba (pill form) Meth Illicit Use: Meth abuse is also manifested by extreme anorexia, memory loss and severe dental problems.Meth Powder •Slangs: Batu, Black Beauties, Chalk, Chicken Feed, Tina, Crank, Crystal, Glass, Go-Fast, Hiropon, Ice, Meth, Trash, Methlies Quick, Shabu, Poor Mans Cocaine, Shards, Speed, Stove Top, Tweak, Ventana, Vidrio, Yellow BamCrystal Meth Meth speed ball- Methamphetamine combined with heroin http://www.oas.samhsa.gov/2k8/methamphetamineTX/meth.pdf http://www.deadiversion.usdoj.gov/drugs_concern/meth.htm http://www.getsmartaboutdrugs.com/drugs/methamphetamine.html?v=0&t=0&p=2&f=0&df=0&dt=0 17
    • Methamphetamine (Desoxyn®) vs. Methamphetamine (Meth) pg. 2•Currently, methamphetamine is primarily producedby utilizing diverted pseudoephedrine combinationproducts. (Now behind the counter at stores.)•Meth changes brain chemistry, and after extendeduse, the brain can no longer respond to dopamine(feel-good chemical produced by the brain).•Psychotic symptoms can persist for months andeven years after use of these drugs has ceasedand may be related to their neurotoxic effects. http://www.deadiversion.usdoj.gov/drugs_concern/meth.htm http://www.tcada.state.tx.us/ http://www.kalispell.com/stopmeth/what_is_methamphetamine.htm http://www.drugfree.org/Files/Meth_Fact_Sheets 18
    • Tolerance and Cross-ToleranceTolerance- Decrease in susceptibility to the effects of adrug due to its continued administration. (An increase inthe amount of drug is necessary to get a similar high… theoriginal “high” is almost impossible to feel again.)Cross-tolerance- Tolerance or resistance to a drug thatdevelops through continued use of another drug withsimilar pharmacological compound.These factors increase the health risk when using drugs. http://www.merriam-webster.com/medical/cross-tolerance 19
    • DepressantMedication 20
    • 4. Prescription Drug Depressants Sedative-Hypnotics & Narcotics/OpioidsSimilarities- Slowed breathing, high potential fortolerance & dependence (addiction).** Alcohol is a depressant and illegal for people underthe age of 21 in the United States. http://www.getsmartaboutdrugs.com/drugs/narcotics.html?v=0&t=0&p=2&f=0&df=0&dt=0 21
    • 4. Prescription Drug Depressants- Sedative/HypnoticsIntended Use-•To relieve Anxiety, Tension, Panic attacks, Acute stressreactions, Seizures, Sleep disorders, Epilepsy, Anesthesia(at high doses).•Muscle Relaxants- overall suppresses the Central NervousSystem.Nonmedical Use-•To relieve agitation, induce mild euphoria, lower inhibitions.•Often use in conjunction with other drugs.•Very similar to the emotional and physical effects of alcohol.•Blackout, brownouts, suicide attempts.•Date Rape Drug http://www.drugabuse.gov/ResearchReports/Prescription/prescription3.html#HowDo 22
    • 4. Prescription Drug Depressants- Sedative/HypnoticsSigns of Abuse- Slurred speech, disorientation, drunkenbehavior without odor of alcohol, impaired memory of events,interacts with alcohol.Signs of Withdrawal- Headaches, tremors, musclestwitching, nausea and vomiting, anxiety, restlessness,yawing, inability to focus, sleep disturbance, dizziness,delirium, convulsions, possible death. Can be fatal andshould be medically supervised.Signs of an Overdose- Shallow respiration, clammyskin, dilated pupils, weak and rapid pulse, coma, possibledeath. http://www.usdoj.gov/dea/pubs/abuse/chart.htm 24
    • Prescription Drug Depressants- Sedative/Hypnotics Signs of Long-term Use- Disrupt the transfer of information from short to long-term memory. Benzodiazepines: impair the ability to learn new information. Alcohol- a CNS depressant, overdose is common, has damaging effects on every organ system, most dangerous psychoactive drug. ( Also, tolerance to alcohol results in tolerance to minor tranquilizers.) Sign of Abuse by Gary Fisher & Thomas Harrison 25
    • Illegal Comparisons and/or Not considered legitimate for medical use: Depressant- Sedative/Hypnotics Benzodiazepines: Flunitrazepam- Rohypnol® (banned in the US but legal in over 60 countries) A small white tablet with no taste or odor when dissolved in a drink.•Slangs- Forget-me pill, Mexican Valium, R2, Roche, roofies,roofinol, rope, rophies, date rape drug•Short Term effects: The drug creates a sleepy, relaxed, anddrunk feeling that lasts 2 to 8 hours. Other effects may includeblackouts, with a compete loss of memory, dizziness anddisorientation, nausea, difficulty with motor movements andspeaking. http://www.drugfree.org/Portal/Drug_guide/Rohypnol# 26
    • Prescription Drug Depressants- Narcotic/OpioidsIntended Use-Postsurgical pain relief, Management of acute or chronicpain, Relief of cough and diarrheaNonmedical Use-•Deaden emotional pain•Get a rush•Induce euphoria•Prevent withdrawal symptomsThere is no limit to the development of opiod tolerance. http://www.drugabuse.gov/tib/bupren.html 27
    • Lifetime Nonmedical Use of Selected Pain Relievers, Age 12 or Older: 2007 Vicodin®, Lortab®, or Lorcet® Hydrocodone 8.1 Darvocet®, Darvon®, or Tylenol® Propoxyphene (Darvocet and Darvon) 7.6 with Codeine Percocet®, Percodan®, or Tylox® Oxycodone 4.7 Hydrocodone Hydrocodone 3.1 Codeine 2.7 OxyContin® Oxycodone 1.8 Demerol® 1.0 Morphine 0.9 Methadone 0.6 Ultram® 0.5 0 2 4 6 8 10Office of Applied Studies, SAMHSAAnesthetic and Life Support Drugs and Drug Safety and Risk Percent Using in LifetimeManagement Advisory CommitteesNovember 13, 2008 28
    • Nonmedical Use of Pain Relievers in Past Year among PersonsAged 12 or Older, by Sub state Region: Percentages, AnnualAverages Based on 2004-2006 Office of Applied Studies, SAMHSA Anesthetic and Life Support Drugs and Drug Safety and Risk Management Advisory Committees, November 13, 2008 29
    • 30
    • Prescription Drug Depressants- Narcotic/OpioidsSigns of AbusePinpoint pupils, sluggishness, shallow breathing andsuppressed cough, slow pulse, low blood pressure,constipations, dryness of mouth, euphoria, numbness,slurred speech, sunken eyes.Signs of WithdrawalFlu-like symptoms, muscle cramps, dilated pupils, coughing,high blood pressure, rapid pulse, diarrhea, sweating, runnynose, anxiety, severe depression, loss of appetite, irritability,tremors, panic and vomiting. Symptoms are unpleasant anduncomfortable but rarely dangerous.Signs of an OverdoseSlow and shallow breathing, clammy skin, convulsions,coma, possible death. A single dose can be lethal to aninexperienced user. http://www.getsmartaboutdrugs.com/drugs/narcotics.html?v=0&t=0&p=2&f=0&df=0&dt=0 31
    • Prescription Drug Depressants- Narcotic/OpioidsToleranceDevelops physical tolerance rapidly when the drugs arerepeatedly administered and psychological tolerance isexhibit later at a slower rate. This tolerance results in theindividual’s using doses that would kill a nontolerant person.Cross-ToleranceOccurs between natural and synthetic opioids but there is nocross-tolerance to CNS depressants (sedative/hypnotics).Signs of Long-term UseSevere constipation, women’s period delayed, sexual desiredulled. Heavier users- eyelids droop and the head nodsforward, coordinating slowed. High tolerance and addiction. 32
    • How can one OxyContin pill kill you?Taking a large single dose could cause severerespiratory depression or death.Typically, opioids should not be taken with alcohol,antihistamines, barbiturates, or benzodiazepines.These other substances also suppress breathingand their effects in combination with opioids couldlead to life-threatening respiratory depression.*There is always the possibility of a lethal reactionto any drug. http://www.drugabuse.gov/ResearchReports/Prescription/prescription8.html http://www.nida.nih.gov/infofacts/PainMed.html http://www.drugabuse.gov/infofacts/PainMed.html 33
    • Neurotransmitters brains major "workhorse" Many of the drugs being abused affect either glutamate or GABA or Excitatory both to exert tranquilizing signal Inhibitory or stimulating effects on signal the brain.Under normal conditions, excitatory and inhibitorysignals are in balance, resulting in controlled, regularbreathing. A combination of heroin and alcohol can be especially dangerous. Opioids and Heroin increases alcohol both suppress Alcohol decreases the inhibitory effects the excitatory effects of GABA. (Increases breathing, but by different of glutamate the calming effect.) mechanisms. Under the influence of alcohol or opioids, excitatory and inhibitory signals are out of balance, suppressinghttp://learn.genetics.utah.edu/content/addiction/reward/pathways.html the impulse to breath
    • Illegal Comparisons and/or Not considered legitimate for medical use: Opioids Heroin•Heroin is processed from morphine (a naturally occurringsubstance extracted from the seed pod ). It comes in severalforms, the main ones being "black tar" from Mexico (primarilysold in the western United States) and white heroin fromColombia (primarily sold on the East Coast.)•Slangs: Smack, junk, tar, Mexican brown, cheese, Harry,skag, Rufus, Perze,”H”, horse, dava, boy Vick, Watson 387•Following this initial euphoria, the user goes "on the nod,"an alternately wakeful and drowsy state. Mental functioningbecomes clouded due to the depression of the CNS. http://www.drugfree.org/portal/drug_guide/heroin# http://www.tcada.state.tx.us/research/slang/terms.pdfhttp://www.getsmartaboutdrugs.com/content/drugs.aspx?duid=27eccf9b-2ceb-4f72-9076-25a11387c2f2&v=1&t=0&p=1&df=1&f=0&dt=0 35
    • Narcotic Prescription Drugs Only -Unintentional Overdose Deaths According to the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, unintentional overdose deaths* involving prescription opioids increased 114 percent from 2001 (3,994) to 2005 (8,541), the most recent nationwide data available. *Does not include people prescribed drugs who died nor intentional overdoses (suicides). http://www.usdoj.gov/ndic/pubs33/33775/execsum.htm#Figure1 36
    • Over-the-Counter Medicine 37
    • 5. Are Over-the-Counter Drugs Dangerous?•Some over-the-counter (OTC) drugs, primarily cough andcold remedies that contain dextromethorphan (DXM), a coughsuppressant, are used to get high. Products with DXM includeNyQuil®, Coricidin®, and Robitussin®, among others.•Slangs: CCC, Dex, DXM, Poor Mans PCP, Robo, Rojo,Skittles, Triple C, Velvet•Illicit use of DXM is referred to on the street as "Robo-tripping," "skittling” or “dexing."•In 2006, about 3.1 million people aged 12 to 25 had used anOTC cough and cold medication at least once to get high, andnearly one million had done so in the past year. (SAMHSA, 2008) http://www.theantidrug.com/pdfs/prescription_report.pdf http://www.nida.nih.gov/infofacts/PainMed.html http://www.getsmartaboutdrugs.com/drugs/dextromethorphan_dxm.html?v=0&t=0&p=1&f=0&df=0&dt=0 38
    • 5. Are Over-the-Counter Drugs Dangerous? (con’t.)•Retailers are required of non-prescription products containingpseudoephedrine, ephedrine and phenylpropanolamine to placethese products behind the counter or in a locked cabinet.(Methamphetamine is primarily produced by utilizing divertedpseudoephedrine combination products.)•Pseudoephedrine products include- Drixoral, Zyrtec-D 12-Hour,Advil Allergy Sinus, Mucinex D, Children’s Motrin Cold, Sine-AidIB, Claritin-D 24 Hour, Sudafed 24 & 12 Hours, Afrinol. Photo shows chemicals, waste materials, & empty pseudoephedrine blister packs. http://www.usdoj.gov/ndic/pubs1/1837/1837p.pdf http://www.usdoj.gov/ndic/pubs36/36407/index.htm#foota 39
    • 7. What is the Reality of Prescription Drug Misuse? 40
    • The reality is that brothers,grandparents, friends, moms, uncles… are dying everyday due to misuse of prescription drugs. In 2009, Florida’s Medical Commission reportedprescription drugs such as oxycodone, Xanax and Valium were present in 79 percent of the 8,653 drug-related deaths. Don’t regret ignoring the problem. 41
    • At the age of 22, Josh was prescribed OxyContin after a back injury. He got hooked and overdosed three times, before a he took a combination of three prescribedJosh’s doctors were aware of his drugs that killedaddiction problem and continued him -one dayto prescribed him narcotic drugs. before his 25th birthday. 42
    • On August 18th, 2006, Emily,only eighteen years of age andthree days from her first day incollege, was killed accidentallywhen she consumed OxyContinthat had been prescribed for arelative.Emily was not an experienceddrug user, and all it took wasone encounter with this drug.She had no chance to learn fromthis one-time experience. Hadshe any idea how deadly thisdrug was, she would still bealive. 43
    • Patrick Stewart died on July 9, 2004 at 24 years of age after ingesting just one OxyContin® . He had no other drugs in his system and only a small amount of alcohol. He was a SDSU graduate, a graphic designer and a certified personal trainer. His friends described Patrick as "the one who puts you back on your bicycle after you fall off". He made the tragic mistake of believing someone at a 4th of JulyClose friends say that Patrick celebration when he was told thathad never before taken an OxyContin was "sort of like a muscle relaxant, that it was prescription and FDAOxyContin, did not know it was approved, so therefore safe".equivalent to "heroin in a pill". 44
    • Robby L. Garvin 24 years old Died 6-11-2006Death caused by Methadonetoxicity. Robby died 40 hoursafter he took his first dose of thisdrug that was prescribed to himfor pain. Robby was neverinformed by the prescribingdoctor or the pharmacy thatfilled this prescription of thedangers and possible death thatMethadone may cause. 45
    • If you suspect someone is abusing and/or addicted to drugsbe proactive and persistent… addicts tend to lie and bedishonest as a means of continuing their habit, and as adefense mechanism. They are often even lying tothemselves that they have a problem. Seek Professionaland Medical advice. Don’t regret ignoring the problem.For additional information on prescription drug abuse,addiction, support groups, and recovery please visitwww.StopRxDrugAbuse.org 46