Sunday, March 15, 2009

Introduction


According to the DEA “opioid painkillers now cause more drug overdose deaths than cocaine and heroin combined.” If that doesn’t get your attention how about this from the DEA “nearly 7 million Americans are abusing prescription drugs*—more than the number who are abusing cocaine, heroin, hallucinogens, Ecstasy, and inhalants, combined.” Yes both of the previous statistics end with the word COMBINED! Prescription drug addiction and abuse has become a hot topic in recent years. According to the DEA there has been an 80% increase in prescription drug abuse since 2000. These statistics are astounding. Prescription drug addiction and abuse is a subject that needs to be addressed by the public as well as the medical community. The general public needs to know the consequences of abuse, and parents need to know how easy it is for their CHILDREN to acquire these drugs WITHOUT a prescription. Parents also need to know that abusing prescriptions is just as dangerous as abusing illegal drugs. On the other hand nurses need to understand how to recognize and deal with a patient that is abusing. Nurses also need to know how education can help stop this trend!



http://www.usdoj.gov/dea/concern/prescription_drug_fact_sheet.html
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What Do the Experts Say?

CDC-Centers for Disease Control and Prevention
The unintentional poisoning deaths have increased from 12,000 to 20,000 between 1999 and 2004. It has exceeded overdoses of cocaine and heroin combined. Most are due to opioid painkillers, sleeping pills, antidepressants, and tranquilizers. Pharmaceutical companies advertising is persuading people to buy prescription drugs for all their ailments. Prescription drugs are far too easy to obtain. CDC and FDA will work together to support research into preventing adults’ unintentional drug overdoses. CDC will provide $350,000 a year for two years to support this.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5605a1.htm

FDA-Food and Drug Administration
Safety of prescription drugs is based on the idea that a person is using the drug as it was prescribed by the doctor. It is important for a doctor and patient to discuss if they have had a substance abuse problem in the past before a prescription medication is started. Prescription drugs should not be stopped without the doctor’s approval because they could lead to withdrawal symptoms.
http://www.fda.gov/fdac/features/2001/501_drug.html

NIDA-National Institute on Drug Abuse

There is a growing concern about the non-medical use of prescription drugs among ages 18-25. An increase was seen from 5.4 in 2002 to 6.4 in 2006. Painkillers, Vicodin and OxyContin are major contributors to this increase. In 2006 the National Survey on Drug Use and Health (NSDUH) did a survey and found that an estimated 7 million people or 2.8% of the population 12 years and older had used prescription psychotherapeutic medications non-medically.
Drug cravings (addictions) are uncommon among those who take the medication as prescribed. It’s when they start taking more than is necessary that the problem arises. The development of physical dependence does not always lead to addiction. This organization is looking into research about why people become addicted.
http://www.nida.nih.gov/infofacts/nationtrends.html
http://www.nida.nih.gov/infofacts/PainMed.html

Who Is Involved?


According to the NIDA the most under-reported drug problem in the nation has been prescription drug abuse. Not only is it under-reported it is also the least understood. Anyone who is prescribed prescription drugs or has the ability to obtained them are potentially at risk for prescription drug abuse. However, the major group involved in prescription drug abuse is teenagers. They think it’s not a problem to take prescription drugs because they were prescribed by a doctor. Some will use Ritalin, an ADHD medication, to suppress their appetites or help them stay awake so they can study. They can get these from their siblings or even friends. Anyone who takes prescription drugs has the potential to become addicted. This is why doctors make the patient come in for a check before renewing their prescription. Prescription drugs can be obtained illegally just like street drugs from a drug dealer. But a great deal of prescription drug abuse by teens starts at home.

The elderly are also at risk. The most common form of prescription drug abuse among elderly may be misuse of medication. This is due to the fact that elderly are less likely to comply with the directions on the prescription bottles. Difficulty reading the small print, confusion about dose, or confusion on frequency are also leading causes of prescription drug misuse.

Women are also at higher risk then men to become addicted to prescription drugs. Both men and women abuse prescription drugs at the same rate but women are twice as likely to become addicted. An explanation for this is that women are more likely to go to the doctor when they are feeling anxious or are in pain. According to the NIDA over the past two decades females between the ages of 12-17 and 18-25 have shown the largest increase of prescription drug abuse.

Doctors can inadvertently play a role in drug abuse by giving more refills than necessary simply because they can’t say “no” to a patient.



http://www.prescription-drug-abuse.org/
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What is the Controversy of this Issue?


There are many patients who ask how prescription drugs lead to abuse and addiction. They often misinterpret what prescription drugs mean. The leading cause of why patients abuse and get addicted to prescription drugs is because patients are not well informed of what prescription drugs mean. According to the Rx list website a prescription drug is “A drug requiring a prescription, as opposed to an over-the-counter drug, which can be purchased without one”. Commonly patients think that prescription drugs are supposed to be safe since they are not sold over the counter, however, it is the opposite. The main reason why physicians prescribe drugs is because they know that those drugs need careful monitoring. If the physician is not following up on the patients it can lead to problems like toxicity, side effects, abuse, and addiction. Another major cause of abuse and addiction is that patients do not always follow rules on how to take medications.

Abuse and addiction is becoming more and more common every day not only are adults abusing medication but children as well. Many of the times patients think that the only way they can be healthy and feel better is if they take their medication. This usually leads to an urge of taking medication for any situation in which they might not feel good. We as future nurses should inform patients how to avoid abusing drugs because it can save their life!

ASK US HOW WE CAN HELP!!


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How Did Prescritption Drug Abuse and Addiction Begin?


Believe it or not prescription drug abuse and addiction has been around a very long time. It began back when doctors started to prescribe medicine. It is more common now because people are allowed to get more refills therefore getting more addicted to the drug. Some of the most common drugs that people become addicted to are opioids, CNS depressants, and stimulants.

  • Opioids are used to relieve pain. The most commonly abused opioids are Morphine, Codeine, Vicodin, Darvon, and Oxycontin.
  • CNS depressants are used to relieve anxiety and other problems related to the central nervous system such as panic attacks and insomnia. Valium and Xanax are commonly abused CNS depressants.
  • Stimulants as their names say are drugs that stimulate the central nervous system by speeding up the function of the brain. These are commonly prescribed for ADHD. One of the most common stimulants is methylphenidate which is “prescribed to increase alertness and physical activity.


http://www.streetdrugs.org/stimulants.htm
http://www.dependencyfree.com/prescription-drug-warning.html
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- If you would like to learn more about opiods, CNS depressants, and Stimulants, their adverse side effects, and their treatments visit this website.
http://www.nida.nih.gov/Infofacts/Painmed.html

- This website contains statistics among teenagers and prescription drug abuse.
http://www.hhs.gov/asl/testify/t060726a.html

- Addiction recovery website- if you anyone who is or may become addicted visit this website for more information on what you can do to help.
http://www.holisticdrugrehab.com/

Who Should be Concerned With This Issue?

Both consumers and nurses should care about the dangers of prescription drug abuse and addiction.

According to the Miriam Webster Dictionary: a nurse is one who looks after, fosters, or advises. A nurse is also a person who cares for the sick.


A nurse’s job is not only to treat, but to care. It is an important job of a nurse to care AND know about the dangers of prescription drug abuse and addiction. If a nurse is well-educated about prescription drugs, side effects, and the problems with addictions, they will be able to educate patients as well. Educating patients about this may not stop all people from using and abusing, but will surely eliminate some. Many people “accidentally” become addicted because they are not aware of how addictive the drug can be, dosages, and frequency. If a patient knows all the facts, then they will be less likely to abuse. If a patient deliberately wants to abuse a drug, and there is know stipulations to stop prescribing the drug, then there is nothing the nurse can do.

Consumers should also care about the dangers of prescription drug abuse and addiction.

According to the Miriam-Webster Dictionary: a consumer is one that consumes; or one that utilizes economic goods.


Consumers, the people that take the prescription drugs, should definitely be concerned about the risks of prescription drug addiction. Many people, especially the elderly, accidentally overuse prescription drugs, then end up becoming addicted. People often misread and misunderstand information which can lead them to taking too much or too often. If patients are advised correctly, then this could reduce the accidental overuse of drugs. Also if patients are aware of the dangers of abuse and addiction, then they may be less likely to overuse. Many people, especially kids, believe prescriptions are less dangerous than street drugs, but if they are used improperly, then they definitely are not!

Consumers and nurses BOTH should be involved when it comes to concerns about prescription drugs. As consumer and a future nurse, how do YOU feel about prescription drug abuse and addiction?

http://www.merriam-webster.com/dictionary/consumer
http://www.merriam-webster.com/dictionary/nurse
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Why Should Consumers and Nurses Educate Themselves on this Issue?


Prescription drug addiction and abuse is a very real and important issue. It is imperative that nurses and consumers educate themselves on this subject.


First consumers need to be informed because many have the false belief that since prescription drugs are legal, they are less dangerous than illegal drugs. According to Tom Hedrick, Director and Founding Member, PDFA in the Iowa Prescription and Over the Counter Drug Abuse Roundtable, "aggressive marketing builds consumer awareness of product availability and benefits, but not the negative consequences of misuse or abuse; and that messages about “appropriate” use do not educate people about the negative consequences.” The ultimate negative consequence you might be surprised to learn…DEATH!

Consumers need to be aware that these drugs can also be both psychologically and physically addictive. Once addicted many people build up a tolerance which requires a larger dose to achieve the same effects. People need to understand that they need to inform their doctor or nurse if this occurs.

Parents need to educate themselves on how easy it is for their children to acquire these drugs. The Center on Addiction and Substance Abuse at Columbia University (CASA), in cooperation with Beau Dietl & Associates (BDA), conducted a study on prescription drug abuse in Americas. According to BDA, “only six percent of the sites selling drugs required a prescription to either be mailed (two percent) or faxed (four percent); there were no mechanisms in place to block children from purchasing these drugs.” Even if you aren’t a parent this should scare or alarm you.

Not only do consumers need to be educated on the ease of access but also on the dosage amounts. Elderly people typically misunderstand the dosages. Therefore we must also look out for our parents or grandparents to ensure they understand and are following the correct instructions from their doctor. By educating themselves consumers should be able to identify the risk factors and alert the abuser or consult a health professional for assistance.

As a nurse you also need to be educated about this issue because you may encounter an individual that is suffering from addiction or abuse. You need to be able to recognize the signs and symptoms and to inform the doctor of your concerns. However according to the National Center on Addiction and Substance Abuse at Columbia University many physicians find discussing the topic difficult. As a nurse you may be the only other person who can intervene and discuss it with the patient.


You must also learn the negative consequences of prescription drug addiction and abuse and be informed enough to help prevent it by educating your patients before there is a problem. You also need to know that it can be extremely easy for people to acquire prescription medications. If you are treating a person that is abusing prescriptions you need to know. The patient may obviously be reluctant to tell you. It goes without saying that you will need to be aware if the patient has any complications from drug interactions.

http://www.fda.gov/fdac/features/2001/501_drug.html
http://www.state.ia.us/government/odcp/docs/Prescription_Drug_Abuse_Roundtable.pdf
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Why is Prescription Drug Abuse and Addiction an Important Issue?


Prescription drug abuse and addiction is not only a popular topic, but an important one as well. According to the National Institute on Drug Abuse, approximately 28 million people, about 20 percent of the U.S population, have abused prescription drugs!

Prescription abuse is not only popular, but dangerous. Addiction, accidental overdoses and bodily damage is not only dangerous, but deadly.
“Prescription Drugs, Abuse, and Addiction”, Nora D. Volkow

According to “The Dark Side of Prescription Drugs”, the two most popular abused prescription drugs are benzodiazepines and opioids. Opioids are used for pain relief and benzodiazepines are basically tranquilizers used to treat anxiety. Dependence on drugs often results in addiction and abuse. Dependence happens when you take a prescription so often and for so long that you grow a tolerance, therefore, you must increase dosages to feel the same effect. Addiction also happens when you have been taking a certain drug so long that you feel like you must keep taking it to feel good, otherwise you will go into withdrawal.

You would think that prescription abuse would be most common with middle age people right? Wrong! The elderly are actually at a large risk for drug abuse. The National Clearinghouse for Alcohol and Drug Information states that 17 percent of adults over the age of 60 abuse prescription drugs; this age group makes up about 30 percent of prescription drug abusers! The elderly population is at such a large risk because the elderly often does not follow directions when taking a prescription. They can misunderstand the dosage and frequency; this can put them at risk for “accidental” abuse and addiction. Women are also at a big risk for becoming dependant on prescription drugs. Women are more likely than men to be treated for pain and anxiety, therefore, are more likely to become dependant on these drugs. Women are TWICE more likely than men to become addicted! Now, the younger generations are a whole different story…
“The Dark Side of Prescription Drugs”, Patty Geier

The 2002 National Survey on Drug Use and Health gave up a ton of statistics over abuse among kids. Beginning at age 12, kids are “trying” prescription drugs to get high and self-medicate. One may wonder how does a kid so young get their hands on prescription drugs like this? Well kids often get drugs from friends, peers, and in their OWN homes (in the medicine cabinet). They are easy to get a hold of, and kids get the misconception that they are safer than other drugs, and they’re not!

Statistics from the 2002 National Survey on Drug Use and Health
• 11 % of teens
• Painkillers are the most common drug used and abused by younger kids
• Stimulants are the most common drug abused by older teens
• Girls are more likely to abuse prescription drugs than boys

Statistics from the 2005 survey by the Partnership for a Drug Free America
• 1 out of 6 teens have abused pain medication
• 1 out of 10 teens have abused tranquilizers and stimulants
• 1 out of 11 teens have overused cough medicines
• Prescription drug abuse is highest in ages 18-25
• The youngest prescription drug abusers are ages 12-13

“Prescription Drugs Among the Youth", Perry Nelson
Prescription drug abuse and addiction is not only a “hot topic” because it is dangerous, but because it is so popular and common in not only adults, but is increasingly becoming more popular among the young generations.



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