Non Medical Use of Prescription Drugs October 2016
Nonmedical Use of Prescription
Betsy Jones, MPA, APS
Coalition Coordinator Partnership for Success Grant
Circles of San Antonio Community Coalition
San Antonio Council on Alcohol and Drug Abuse
The Growing Problem
• The US has 4.6% of the world’s
population, and we consume 80%
of the world’s opioids. 83% of the
world has no access to these
• In 1997, drug distribution was the
equivalent of 96 mg of morphine
per person. In 2007, it was >700
mg per person, an increase of over
The Growing Problem
• The demographic most likely to die from Rx misuse is adults, 45-65.
• More pain
• More diagnosed mental health issues
• More access to prescriptions
• More types = more danger of fatal combinations
• 1 in 15 adults and teens who take Rx drugs without a prescription will
try heroin within 10 years.
• According to cdc.gov, over 28,000 people died in 2014 as a result of
opioid use, and at least half of those deaths involved prescription
• Over 20% of Americans have used prescription drugs for nonmedical
• They belong to someone else.
• They are taken in a way the doctor didn’t recommend, or
for a different reason.
• They are taken to get high.
Three ways prescription drugs are abused:
• Prescription drugs are safe because they’re legal
• It’s okay to share if…
• It’s only once in a while
• They don’t need it anymore
• I take it for the prescribed reason
• It was prescribed for me in the past
• Illicit drug abuse is declining among
teens but Rx abuse is rising
• Teens abuse Rx drugs more than any
illicit drug except marijuana.
• And teens abuse Rx drugs more than
cocaine, heroin, and
• 41% believe Rx drugs are safer (than illicit drugs)
• 37% see less shame in abusing Rx drugs
• 31% perceive fewer side effects in Rx drug use
• 20% say their parents would mind less if they got caught with Rx
• Take only as prescribed.
• Do not share. (Sharing is not caring!)
• Do not hoard.
• Lock them up, even if you live alone.
• 40% of houseguests admit to snooping
• 50% of those arrested for burglary say
they are on the lookout for Rx drugs when
they break into a home.
• ADHD drugs are abused to boost mental and physical performance,
gain energy, lose weight, or for euphoric effects.
• Little evidence that “study drugs” are effective.
• Elevated temp/heart rate
• Used to treat anxiety or sleep disorders
• Slow brain activity; depress central nervous system
• Abused to experience euphoria, relaxation, or to enhance other drugs
• Sometimes used to lessen withdrawal from other drugs
• Negative effects include amnesia, reduced reaction time, impaired
judgment, confusion, tolerance, loss of coordination, seizures on
any natural or synthetic substances that produce opium-like effects
natural pain relieving substances derived from the opium poppy
How effective are opioids?
• Studies have found that opiate pain relievers are often no more
effective than ibuprofen or acetaminophen-based painkillers.
• In prescriber surveys, however, doctors answer overwhelmingly that
they believe opioids are the most effective way to relieve pain.
• Opioids affect the emotional aspect of pain more than the physical
and we must develop a healthy respect for that if we are to use them
• The average medical school provides
9 hours of education on pain, and
negligible education on addiction or
• 40-60% of people with back pain will
receive a prescription for opioids at
some point, even though--
• The American Academy of Neurology
recommends AGAINST using opioids
for back pain.
The Addiction Process
• Energy, determination, confidence, well-being
• Body’s reaction
• Decreases opioid receptors, serotonin, norepinephrine, dopamine
• Increase in pain, anxiety, depression, isolation
• More pills needed – whether prescribed or illegally obtained
• Continued changes in neurotransmitters and receptors, cells making new
• After one month, MRI will show noticeable difference in brain activity
• Adaptations lead to worse feelings, physical and emotional, when not taking
Physical withdrawal: after one week
• Pain is much worse
• Anxiety (fear)
• Emotional instability
• Rapid heart rate
• Sweating, diarrhea, vomiting
Withdrawal: after longer periods
• Craving opioids
• More pain
• No “life motivation”
• Only motivation is to get the drug
• Drug use is the only activity that can stimulate the dopamine and give
Rates of opioid overdose deaths, sales, and
treatment admissions, 1999-2010
Unused prescription drug disposal
• Do not throw away or flush
• Take them to a drop box or take-back
event. Encourage your pharmacy and
local law enforcement to host an
What we’re doing in San Antonio
• DEA Takeback events
• San Antonio Water Systems Med Drop events
• Chasing the Dragon collaboration
• Circles of San Atnonio Rx Workgroup
• Permanent droboxes
• National Institute on Drug Abuse (NIDA). Advancing Addiction Science.
• Alarm.org. Home Safety FAQs. http://www.alarm.org
• Potter, Dr. J. (2016, June 9). Think health science: Advances in pain management. Lecture
presented at TPR Presentation in UT Health Science Center, San Antonio, TX.
• Teater, Dr. J. (2016, Sept 22). The illusion of opiates. Lecture presented at When the
Prescription Becomes the Problem, Challenge of Tarrant County, Hurst, TX.
• National Vital Statistics System. DEA’s Automation of Reports and Consolidated Orders
• Coalition Against Insurance Fraud. Prescription for Peril.
• WISQARS, 2000 & 2010; CDC and NCHS, National Vital Statistics System.