Transcript DFWP Prescription Drug Module 9.2007

Your Company’s Commitment to a
Drug-Free Workplace
Employee Education
Prescription Drugs: The Hidden Problem
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
1
What’s the big deal?
“How could it be bad if it’s medicine?”
“But my doctor told me to take it.”
“They’re legal and certainly not as dangerous as
street drugs.”
Prescription (Rx) drugs are so powerful that we
have controls on who can prescribe them and
how they should be used.
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
2
Scope of the Problem
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Between 1992 – 2002, the US population
increased 13% and the number of Rx
prescriptions filled increased 154%1
In 2005, 32.7 million people in the U.S. had used
pain relievers non-medically in their lifetimes2
Today, more adults and teens report abusing
these drugs than the number abusing all illicit
drugs combined – except marijuana
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
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Problem,
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continued
Nearly 1.3 million ER visits in 2004 were associated with
drug misuse/abuse -- nearly half involved Rx drug
abuse3
o
31.9 % - opiates
o
29.1 % - benzodiazepines
o
5.7 % - muscle relaxants
Among youth …
o
The word “pharming” has been coined to describe
the abuse of Rx drugs to get high
o
1 in 5 teens admit abusing Rx drugs in their lifetimes1
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
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Problem,

continued
Among Older Adults
o
o
Persons 65+ years comprise only 13% of the
population, yet account for approximately 1/3 of all
Rx drugs prescribed in the U.S.
Older patients are more likely to be prescribed longterm and multiple prescriptions, which could lead to
unintentional misuse
Pharmaceutical drug abuse crosses all age, race,
and socio-economic boundaries.
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
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The “Visible” Abusers
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Elvis Presley
Sonny Bono
Nicole, Lindsey & Paris
Bret Favre
Anna Nicole
Stevie Nicks
Elizabeth Taylor
Matthew Perry
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
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Rush Limbaugh
Melanie Griffith
Barry Bonds (?)
McCauley Calkin
The Osbournes (well
… at least 3 of them)
On and on …
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Why Rx drugs?
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For some, there is less risk of overdose
(strength/purity are known and predictable)
Often paid for by insurance
Cheaper than cocaine and heroin
Less risk of detection
Lack of enforcement
More accepted by society
Easier to obtain legally
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
7
Kids Say Rx Drugs …
4
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Are easy to get from parents’ medicine cabinets
Are available everywhere
Are not illegal drugs
Are easy to get though other people’s prescriptions
Are cheap
Are safer to use than illegal drugs
Are less shameful to use
Are easy to purchase over the Internet
Have fewer side effects than street drugs
Can be used as study aids
“Parents don’t care as much if you get caught”
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
8
Most Commonly Abused
Rx Drugs
1.
Opiates
2.
Depressants
3.
Stimulants
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
9
Opiates/Opioids
EXAMPLES: OxyContin®, Darvon®, Vicodin®, Demerol®
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Prescribed for management of acute or chronic pain, relief of
cough, etc.
Possible negative effects: tolerance, respiratory depression or
death following a large single dose
High prevalence of addiction
o
o
After prolonged use, nerve cells in brain -- which would otherwise
produce natural painkillers (endorphins) -- cease to function
Body stops producing endorphins
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
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Depressants
EXAMPLES:
Barbiturates -- e.g. Nembutal®, Mebaral®
Benzodiazepines -- e.g. -- Valium®, Librium®, Xanax®, Halcion®
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Often referred to as “sedatives” or “tranquilizers”
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Prescribed for anxiety, tension, panic attacks and sleep disorders
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Possible negative effects: tolerance and seizures after reducing or
discontinuing use
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Probability of addiction after prolonged use is high
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
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Stimulants
EXAMPLES: Dexedrine®, Ritalin®
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Prescribed for narcolepsy, ADHD, depression, obesity and
asthma
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Possible negative effects: addiction, irregular heart beats,
seizures, and feelings of hostility or paranoia
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Treatment of stimulant addiction is based on strategies
proven effective for treating cocaine or methamphetamine
addiction
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
12
Mixing Rx Drugs:
RECIPE FOR DISASTER
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Rx drugs should be used in combination only
under a physician's close supervision
Combining Rx drugs with herbal remedies
(e.g. echinacea, St. John’s Wort) can cause
interactions that are potentially dangerous
Don’t forget about over-the-counter meds that
you are taking, too (including creams and salves
– they enter the bloodstream, too)
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
13
Mixing Rx Drugs
with Alcohol
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SAFETY: Rx drugs can have a multiplying effect when
used with alcohol
(1 + 1
doesn’t always equal 2)
HEALTH: Alcohol + Rx drugs can damage bodily
systems (e.g. Tylenol + alcohol can affect kidneys)
EFFECTIVENESS: Alcohol can wipe out intended
effects of the Rx drugs (e.g. antidepressants and
antibiotics)
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
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Where do abusers get
Rx drugs?
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59.8% - from a friend or relative for free
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16.8% - from a single physician
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4.3% -
from a drug dealer or other stranger
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0.8% -
from the Internet
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
15
Benefits of Internet
Rx Drug Sales
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Access for the disabled or otherwise homebound
Convenience of shopping 24/7
Wide selection of pharmaceutical products
Cheaper
Privacy for those who don’t want to discuss
medical needs in a public place
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
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But there are
MANY concerns
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In 2007, there was a 70% increase in the number of
websites that advertise or sell Rx drugs
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84% Internet sales are made without a prescription1
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The Internet provides a marketplace for unapproved
drugs
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Ordering Rx drugs over the Internet w/o a valid
prescription is likely to be illegal (“pill-mills”)
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Buyers may receive counterfeit, contaminated, or
adulterated products
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
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Concerns,
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There needs to be a legitimate “doctor-patient”
relationship. Without it …
o
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continued
person is apt to “self-diagnose”
may be increased chance of allergic reaction to
medication
necessary and on-going follow-up may not occur
(especially important if drug is being taken for the 1st
time)
Purchasing online is one of the major sources for Rx
drugs being abused by young people
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
18
Tips for (legitimately)
Buying On-Line
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Check with the National Association of Boards of
Pharmacy (NABP) to see if provider is legitimate
and in good standing (www.nabp.net)
Look for a seal identifying the site as a “Verified
Internet Pharmacy Practice Site” (VIPPS)
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
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Tips,
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continued
Look for easy to understand privacy and security
policies
Be aware of sites that advertise a “new cure” for a
serious disorder or a quick cure-all for a wide range
of ailments
Talk to your health care provider before using
medications for the first time
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
20
Tips,
continued
Don’t buy from those who …
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offer a Rx drug for the 1st time without a physical
exam
sell without a prescription
sell drugs not approved by the FDA
do not provide access to a registered pharmacist to
answer questions
do not provide a U.S. address and phone number to
contact if there’s a problem
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
21
Impact on the Workplace
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Excessive absenteeism
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Decreased productivity
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Danger to self and co-workers on the job
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Damage to personal and work relationships
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Excessive use of medical benefits
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
22
How does addiction begin?
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Often starts “innocently”
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Person is prescribed a Rx drug for a legitimate ailment
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Tolerance to the drug develops
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He/she begins using it for “non-medical” reasons – not for
the reason it was prescribed
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User experiences behavioral, physical, social and
emotional changes
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An overwhelming need for the Rx drug develops
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The addiction progresses similarly to alcoholism
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
23
Signs of Addiction
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Preoccupation with getting it and using it
Requesting refills before the quantity prescribed
should have been used
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Needing more to get desired effects
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Being under the influence at inappropriate times
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Repeatedly trying to cut back or stop
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
24
Signs,
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continued
Engaging in “doctor shopping” – moving from doctor
to doctor to get multiple prescriptions
Experiencing withdrawal
Continued use despite social, emotional or
physical pain
Doing whatever it takes to get it and use it
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
25
You might notice a friend
or family member …
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Cutting back on social & recreational activities
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Trying to avoid you
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Lying to you about their use
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Changing his/her eating patterns
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Not seeming to care about other people or things
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
26
If there is a problem …
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Recognize and “own” the problem and you’re half-way
home!
Reach out for professional help
o
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Check resources in company policy
Consult your Program Administrator
Seek help for a friend, family member or co-worker
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
27
Prevention Tips
With your doctor …
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Provide a complete medical history to him/her
Be sure your doctor and pharmacist are aware of ALL Rx
(and OTC) drugs you are taking
Ask questions about what you are being prescribed and
why
Learn about the effects that the drug could have –
especially as your body is adapting to the drug
Tell your doctor your specific job responsibilities and ask
about workplace safety
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
28
Tips,
continued
When taking the medication …
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Carefully follow dosing instructions
Read & follow warning labels on the bottle
Do not increase or decrease doses or abruptly stop taking
without speaking with your doctor
Remember … mixing meds can be a recipe for disaster
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
29
Tips,
continued
In general …
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Understand and carefully follow your company’s rules
about Rx drug use
NEVER use another person’s Rx drug
NEVER give yours away to someone else (not even to a
family member)
Unless you are a doctor, you can’t diagnose or prescribe
Clean your medicine cabinet & discard:
o
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outdated drugs
those that are no longer needed for the condition that they
were originally prescribed for
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
30
EPA Disposal Guidelines
(released Feb. 2007)
1.
2.
3.
4.
5.
6.
Take unused, unneeded or expired Rx drugs out of their
original containers
Mix with an undesirable substance (e.g. used coffee grounds,
kitty litter)
Put in impermeable, non-descript containers (e.g. empty cans
or sealable bags)
Throw containers in trash
Flush down toilet ONLY if the accompanying patient
information specifically says it is safe
Return unused, unneeded or expired Rx drugs to
pharmaceutical take-back locations
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
31
Remember …
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When used correctly, Rx drugs play a very important role in the
management of pain & other health-related conditions
Addiction rarely occurs among those who use as prescribed
The risk for addiction exists primarily when Rx drugs are used in
ways other than prescribed
Selling or buying controlled substances without a legitimate
doctor’s prescription is a violation of law
Think workplace safety
When in doubt … ask!
o
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Doctor
Pharmacist
Program Administrator
Take advantage of your helping resources!
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
32
Citations
1 –White Paper, “You’ve Got Drugs! IV: Prescription Drug Pushers on the
Internet,” released at a US Senate Judiciary Committee hearing on rogue
online pharmacies, 2007
2 – National Survey on Drugs Use and Health, 2005
3 – National Drug Abuse Warning Network (DAWN) report, 2005
4 - The Partnership Attitude Tracking Survey (PTS): Teens in grades
7 – 12, 2005
5 – Quest Diagnostics – Drug Testing Index, 2007
© Copyright 2007 by D. Mason. All rights reserved.
REVISED 09/07
33