Adrian G, a pharmacist to promote pharmacy practice and to raise an awareness of common drugs at risk for abuse in our community.

1. The Community Pharmacist
Dispensing Good Medicine…
Preventing Drug Abuse
Adrian Goram, PharmD, CPh
Pharmacist
Publix Pharmacy
Pensacola, FL
Pensacola
BizNet Meeting
May 1, 2014
7:30am

2. Disclosure
 I am here today as a pharmacist to
promote pharmacy practice and to raise
an awareness of common drugs at risk for
abuse in our community.
 I am currently employed by Publix
Pharmacy, Pensacola, FL.
 No financial compensation was provided
for this presentation.

3. Objectives
Describe the practice of good medicine
Identify several prescription (Rx) and Over
the Counter (OTC) drugs and drug classes
commonly abused
Describe the pharmacist’s efforts to fight
drug abuse

5. Local Pharmacy Practices
Sacred Heart
(Pensacola & Destin)
Baptist
(Pensacola & Gulf
Breeze)
West Florida
Santa Rosa
Medical
FWB Medical
Walgreens
Wal-Mart
Sam’s Club
CV S
Rite-Aid
A & E
Cantonment
Drugs
Ensley Drugs
Pensacola
Apothecary
Rx Express
Publix
Target
Kroger
Winn Dixie

6. Pharmacists Do More Than Just
Dispense Pills
Drug Indication?
Side Effects?
Compliance?
What if I miss a
dose?
OTC
recommendation?
CAN I DRINK?
COUNSEL
Right patient
Right drug
Right dose
Right amount
DISPENSE
Drug Allergies
Food Allergies
Drug Interactions
Contraindications
SCREEN
Patient
Healthcare
Provider
Drug
Dose
Supply
Valid Rx
Valid MD
Insurance
COST
VERIFY

7. Excessive Alcohol Use: Common
Denominator for Rx & OTC Abuse
Which teenage gender drinks the most?
 Boys
 Girls

8. Excessive Alcohol Use: Common Denominator
for Rx & OTC Abuse
Ref: Partnership for a Drug Free America 2009
Which teenage gender drinks the most?
 Boys 52%
 Girls 59%
For a full report go to:
www.dcf.state.fl.us/programs/samh/publications/fysas/08Survey/EscambiaCounty.pdf
www.dcf.state.fl.us/programs/samh/publications/fysas/10Survey/county_slideshows/Santa%20Rosa%20County.pdf

9. Tampons, Skittles & Gummy Bears
Soaked withVodka

10. Alternative Alcohol Sobriety Test

11. Prescription (Rx) Drug Abuse:
A Widespread Concern AmongTeenagers
 The rate for Rx drug abuse is the fasting growing
epidemic in the U.S.
 48 million teenagers (>12 years old) used Rx
drugs for illicit or recreational uses.
 Nearly 14% met the criteria for abuse or
dependence.
 Nearly 3 million youths (age 12-25 years) become
new Rx Abusers each year
 Females; the most frequent abuser of Rx drugs
across ALL age groups
Ref: Chertoff JL:PharmCon 0798-0000-11-095-H01-P

12. Common Triggers for Rx and OTC Drug Abuse
Strong Media
Influence
Internet Savvy
Strong Peer
Pressure
Stress
BULLYING
Ease of Access
Easily
Concealed
Cheap &
Legally
Purchased
Thrill Seekers
Sheer
Boredom
Dysfunctional
Family Issues

13. Three Pharmacologic Classes of Rx Drugs Commonly Abused
OPIOID
ANALGESICS
BENZODIAZEPINES AMPHETAMINES
Pain Relievers Anti-Anxiety
Sedatives/Tranquilizers
Stimulants
OXYCODONE
OxyContin, Percocet
ALPRAZOLAM
Xanax
METHYLPHENIDATE
Ritalin, Concerta
HYDROCODONE
Norco, Lortab,Vicodin
Vicoprofen
CLONAZEPAM
Klonopin
AMPHETAMINE +
DEXTROAMPHETAMINE
MIXED SALTS
Adderall
MORPHINE
MS Contin,Avinza, Kadian
DIAZEPAM
Valium
DEXTROAMPHETAMINE
Dexedrine
HYDROMORPHONE
Dilaudid
***NON-BENZOs***
Sleep Aids
CODEINE ZOLPIDEM
Ambien
METHADONE
Dolophine
ESZOPICLONE
Lunesta
FENTANYL
Duragesic

14. A Recent Study of Nearly 9 Million Drug
Abusers Report:
5.3 Million
Abuse Pain
Relievers
2 Million
Abuse
Tranquilizers
1.3 Million
Abuse
Stimulants

15. Three OTC Drug Products Commonly Abused
Pseudoephedrine
(PSE)
Caffeine Dextromethorphan
(DXM)
Cough/Cold Products
Sudafed,Allergra-D
Claritin-D, Zyrtec-D,
Mucinex-D,Alka-Seltzer-D,
Tylenol Sinus
No Doz
Vivarin
Awake
Cough/Cold Products
Mucinex-DM
Robitussin DM
Corricidin DM
Pain Relievers
Co-Advil,
Pain Relievers
Goody’s Powders,
BC Powders,Anacin,
Excedrin,Vanquish
Weight Loss
Hydroxycutt, Diet Fuel
Beverages
Coffee, Energy Drinks, Red
Bull, Monster, etc.

16. Four Pivotal Areas to Prevent Rx Drug Abuse
Ref: Epidemic: Responding to America’s Prescription Drug Abuse Crisis 2011
Education Tracking &
Monitoring
Proper Drug
Disposal
Enforcement

17. PARENTALVIGILENCE
• Inspect your kid’s bedrooms, Internet accounts,
laptops, cellphones, etc.
• Changes in behavior, habits, friends, hangouts,
etc.
• Home drug test kits
• Referral source to Law Enforcement and Drug
Addiction &Treatment Centers
• HEALTHCARE PRACTITIONERS
• MDs, Dentists, RNs, NPs, PAs
• Compliance to evidence-based guidelines
Federal & State Supported
Prescription Drug Monitoring
Programs (PDMP)
Monitoring and Tracking of PSE Sales
Patients who “Doctor Shop”
Unethical and Suspicious Prescribing:
• Narcotics & Pill Mills
• Forgeries, Stolen Prescription Pads
• Self-Medication
• Beyond the respective scope of practice

18. CleanYour Medicine Cabinet
• 70% of illicit users of pills were retrieved from
family & friends, as compared to 5% from drug
pushers
• Properly dispose of unwanted & expired pills
• DO NOT FLUSH IN TOILET
• Place disposed meds in a zip-lock sealed bag or
Tupperware-like container filled with cat litter or
coffee ground then place in trash
• ANNUAL PRESRIPTION DRUG TAKE-BACK
DAY Collects all
unwanted pills at a participating pharmacies
•www.deadversion.usdoj.gov/drug_disposal/takeback
•CHARITABLE MED DONATION DROP OFF?
Partner with local law (Narcotics)
enforcement
Identify Pills
Share data among pharmacies for unlawful
or unethical activities:
• Doctor Shopping
• Unscrupulous Prescribing Patterns
• Forgeries
• Stolen Prescription Pads
• Increased Customer Traffic for PSE Sales

19. Local Drug Abuse & Treatment Centers
Meridian
1920 N. J St.
(850) 469-3502
Teen Challenge of Pensacola
(www.pensacolamen.teenchallenge.cc)
8600 Hwy US 98
(850) 453-4300
Lakeview Center Pathway
(www.bhcpns.org)
6425 Pensacola Blvd
(850) 453-7722
New Beginnings Recovery Homes
(www.newbeginningsrecovery.com)
820 Gerhardt Dr (850) 439-1522
Acceptance Counseling
3W. Garden St
Lakeview Center Medication
1800 N Palafox St
(850) 466-3400
Drug & Alcohol 24 Hour Helpline
(850) 944-7802
Drug & Alcohol Rehab in Florida
at Twelve Oaks
(www.twelveoaks.crchealth.com)
2068 Health Core Dr.
Navarre, FL
(850-763-6340)