Your name date Generation Rx keep

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Generation Rx – keep your family safe

There’s a reason for the prescription When sharing isn’t caring.

America’s biggest drug problem isn’t on the streets… …it’s in our medicine cabinets.

Prescription medication abuse – on the rise • Between 6 and 7 million Americans have abused prescription medications in the past month. • Everyday, approximately 2, 700 young people between 12 and 17 years of age abuse a prescription painkiller for the first time. • Four out of the top five drugs abused by 12 th graders are prescription medications

Case Report Julia is a 16 year-old at your school. She does well in her classes and has a lot of friends. She wants to be a veterinarian when she grows up. Julia is involved with after-school activities and just got a well-paying job babysitting. She is excited because she just got a new car and her parents are letting her drive it to prom next week.

Case Report, cont. A few days ago, Julia attended a party at a friend’s house. Alcohol and prescription medications were available at the party and several of Julia’s friends were experimenting, or “pharming” with the pills. Julia’s friends who were “pharming” did not know the names of the medications they were taking; they were waiting to see what would happen when they took a few pills at a time and chased them with alcohol.

Case Report, cont. One of Julia’s friends asked her if she wanted to take a few pills and “chase it with a beer. ” She grabbed a few pills and swallowed them with alcohol. What happened next?

Example of frequently abused prescription medications Painkillers Oxy. Contin®, Vicodin® Sedatives & tranquilizers Valium®, Xanax® Stimulants Adderall®, Ritalin®

Other medications frequently found in medicine cabinets are for: • • High blood pressure Diabetes Infections Supplement use (i. e. , vitamins) Cough and Cold Headache/Fever Heartburn/Upset Stomach/Diarrhea

Which pills did Julia take?

All medications have side effects Examples can include: • • Headache Upset stomach Drowsiness Anxiety Diarrhea Vomiting Loss of bladder/bowel function • • Unconsciousness Addiction Cardiac arrest Respiratory arrest Seizure Coma Death

What will happen to Julia?

Signs of prescription drug abuse • Complaining of vague symptoms to get more medication • Lack of interest in treatment options other than medications • Mood swings • Seeing several doctors/visiting several pharmacies to get more pills • Past history of addiction • On and off relief from anxiety • Using more than what is prescribed • Using prescription pills prescribed for someone else

Warning Signs of Commonly Abused Prescription Drugs • Depressants (including Vicodin, Xanax, Valium, etc. ): Contracted pupils; drunk-like; difficulty concentrating; clumsiness; poor judgment; slurred speech; sleepiness. • Pain Medication (Oxy. Contin, Percocet, Vicodin): drunklike; difficulty concentrating; clumsiness; poor judgment; slurred speech; ; sweats; constipation; sleepiness; *abuser may appear “normal” after long-term use • Stimulants (Ritalin, Adderall): Dilated pupils; hyperactivity; euphoria; irritability; anxiety; excessive talking followed by depression or excessive sleeping at odd times; may go long periods of time without eating or sleeping; weight loss; dry mouth and nose.

Warning Signs of Commonly Abused Illicit Drugs • Hallucinogens (LSD, PCP): Dilated pupils; bizarre and irrational behavior including paranoia, aggression, hallucinations; mood swings; detachment from people; absorption with self or other objects, slurred speech; confusion. • Heroin: Contracted pupils; no response of pupils to light; needle marks; sleeping at unusual times; sweating; vomiting; coughing, sniffling; twitching; loss of appetite.

Adderall abuse "Two years ago this November, one of my friends (and ex-boyfriend's roommate) died of a Dilaudid overdose. *** had worked as a tech at a hospital for several years and had just gotten into pharmacy school at ***. He was cute and charming and smart. . . but he also loved to have a good time. We all knew he drank too much and was a recreational user of hydrocodone and percocet, but it honestly always seemed so harmless. His GPA was a full point higher than mine and as I said, he'd just gotten into pharmacy school. We also knew he abused Adderall, but it was college---we knew fifty people abusing Adderall; it was hardly even worth noting. I wish we hadn't been so quick to dismiss ***'s drug use as harmless. One morning I got a phone call that *** was in the hospital; he was brain dead. His other roommate had found him in his bedroom the afternoon before when *** was supposed to have left for work and hadn't. He was slumped over in his computer chair; he'd vomited and apparently aspirated. He was blue, not breathing, and his pulse was weak and slow. The roommate frantically called 911 but there was nothing they could do. On subsequent evaluation, the police found 6 little vials of Dilaudid, a tourniquet, and some Nubane. No Dilaudid was missing from the pharmacy where *** worked, but the investigators were able to piece together what happened: after preparing injections, the Dilaudid vials were discarded in the trash by the pharmacist. . . who never noticed that *** was taking the used vials out of the trash. By collecting several vials, he was able to get enough of the medication to reconstitute it and inject it. We have no idea how long he had been doing this. It's hard to even fathom how someone so smart acted so stupidly; a detail I've always found heartbreaking is that on his computer screen when he died was a Google search of "dilaudid overdose. PLEASE, please. . if anyone you know is messing around with drugs and you're worried about them, say something. I know my friends and I will always regret we didn't. "

Mixing drugs can have fatal outcomes • Heath Ledger (1979 -2008) – Oxy. Contin and Vicodin (opiates) – Valium, Xanax, Restoril (depressants) – Doxylamine (sedating antihistamine) • Anna Nicole Smith (1967 -2007) – Chloral hydrate, clonazepam, oxazepam, Valium (depressants) – Benadryl (sedating antihistamine) – Topamax (anticonvulsant) • Michael Jackson (1958 -2009) – Propofol and Lidocaine (anesthetics) – Ativan, Versed, Valium (depressants) – Ephedrine (stimulant) • Elvis Presley (1935 -1977) – Morphine, Codeine, Demerol (opiates) – Valium and Ethchlorvynol (depressants)

MYTH- prescription medications are safer than street drugs • Majority of teens report that prescription drugs are easier to get than illegal drugs. • Many believe that abusing prescription drugs is much safer than illegal “street” drugs.

MYTH- prescription medications are safer than street drugs • Majority of teens report that prescription drugs are easier to get than illegal drugs. • Many believe that abusing prescription drugs is much safer than illegal “street” drugs. TRx. UTH – this myth is DEAD WRONG! • Unintentional drug poisonings are now the 2 nd leading cause of accidental death in the U. S.

TRx. UTH and consequences • Health, legal, social and personal development problems. • Thousands of emergency department visits every year are related to prescription medication misuse or abuse. • Drug treatment admissions for prescription drug addictions have increased dramatically in recent years.

The good news? • Most teens are NOT abusing prescription drugs! • Most teens DO make good choices – keep doing encouraging good behavior • Giving accurate information → more informed decisions

What can I do? • Store prescription drugs in locked and secure locations. • Dispose of prescription drugs properly and participate in a medication disposal day in my community. • Model safe medication-taking practices for others. • Talk with my kids, grandkids, nieces, nephews and neighbors. • Tell a friend about the dangers of prescription drug abuse. • Make a presentation to a rotary, PTA, faithbased organization or other about this issue.

Where can I learn more? National Council on Patient Information and Education (www. talkaboutrx. org) National Institute on Drug Abuse (www. nida. nih. gov) Office of National Drug Control Policy (www. whitehousedrugpolicy. gov) Parents. The Anti-Drug (www. theantidrug. com) Partnership for a Drug-Free America (www. drugfree. org) Stop Medicine Abuse (www. stopmedicineabuse. org/) created by the Consumer Healthcare Products Association Substance Abuse and Mental Health Services Administration (www. samhsa. gov) The Ohio State University College of Pharmacy Generation Rx Initiative (www. pharmacy. ohio-state. edu/outreach/generation-rx)

Developed by The Ohio State University College of Pharmacy This program is made possible with a grant from the Cardinal Health Foundation