Drug Awareness of the Month: Prescription Drug misuse

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Submitted by the Harm Reduction Pillar, Swift Current and District Drug Task Force

There's a growing list of prescription drugs that kids loot from medicine cabinets to get high. In many cases, the medicine cabinet at home has replaced the local drug pusher as the source of teenagers' drugs of choice.

How Prevalent is the Problem?

In a survey conducted by the Partnership for a Drug-Free America, nearly 20 per cent of adolescents ages 12 to 18 admitted to having used prescription drugs at least once to get high. This same survey revealed that 10 per cent of this group used cough syrup to get high at least once. Prescription and over-the-counter medication abuse now rivals that of illegal drug use among teens.

Teenage girls are more likely to experiment with prescription drugs. Teenage boys continue to use illegal drugs more often than they do prescription drugs, according to the study. Among both male and female teens, there is a dangerous misconception that using prescribed medication to get high is safer than using illegal drugs. After all, it's really just "borrowing" medicine, right?

Opioids/ Painkillers

What are painkillers or opioids? Opioids are drugs that contain opium or are derived from and imitate opium. They are prescribed for pain relief and are only available by prescription. Most opioid or painkilling drugs are non-refillable and, when used properly under a medical doctor’s supervision, are safe and effective. Opioid drugs act by effectively changing the way a person experiences pain.

Morphine derivatives (or “narcotics”) come from opioids and are used to therapeutically treat pain, suppress coughing, alleviate diarrhea, and induce anesthesia. When using these narcotics, abusers experience a general sense of well-being by reduced tension, anxiety, and aggression.

Examples of Painkillers

Some of the most well-known painkillers are listed below with the names you might find on a prescription label. Note that although painkillers have different potencies and are taken in different ways, when they are abused, all pose a risk for addiction and other serious effects.

• Codeine: like morphine, this is found in opium, is weaker in action than morphine, and is used especially as a painkiller.

• Fentanyl (and fentanyl analogs): a man-made opioid painkiller similar to morphine that is administered as a skin patch or orally.

• Morphine: the powerful, active ingredient of opium is used as a painkiller and sedative.

• Opium: from the opium poppy, formerly used in medicine to soothe pain but is now often replaced by derivative alkaloids (as morphine or codeine) or man-made substitutes (opioids).

• Hydrocodone: often combined with acetaminophen for use as a painkiller. Vicodin (which is not available in Canada, but can be found in the USA) is an example.

• Oxycodone: a narcotic painkiller, for example Percocet and Percodan.

Are Teens Abusing Painkillers?

Painkillers are the prescription drugs most commonly abused by teens.

Painkillers are also the most abused type of prescription drugs by 16 to 17-year-olds, followed by stimulants, tranquilizers, and sedatives. Almost two out of five teens report having friends that abuse prescription painkillers and nearly three out of 10 report having friends that abuse prescription stimulants.

How Do Teens Take Painkillers?

There are several ways painkillers can be taken. Most teens report swallowing pills, but they can also be crushed and snorted for an intensified effect.

Signs and Symptoms

Short-term effects

Painkillers can cause drowsiness, inability to concentrate, apathy, lack of energy, constriction of the pupils, flushing of the face and neck, constipation, nausea, vomiting, and most significantly, respiratory depression.

Misuse of Prescription drugs and OTC medicine to get high has become a major source of concern both with Teens and Adults One teenager in five has admitted to taking prescription drugs to get high and 75 per cent of them say they stole them from home. Source - CAMH – Ontario Student Drug Use and Health Survey (2009 OSDUHS)

Long-term effects

If a teen abuses painkillers for a period of time, he can become addicted to the drug and experience withdrawal symptoms when he stops taking the drug. Associated with addiction is tolerance, which means more and more of the drug or a combination of drugs is needed to produce the same high or euphoric feeling, possibly, leading to overdose.

Potential Drug Interactions

Always consult your teens’ physician before giving them any medicines if they are already taking a prescribed painkiller or other medication, as it may be dangerous to use them together. Painkillers should not be used with alcohol, antihistamines, barbiturates, or benzodiazepines. Since these substances slow breathing, their combined effects could lead to life-threatening respiratory depression.

What Is a Painkiller Overdose?

Physical signs of painkiller overdose include pinpoint pupils, cold and clammy skin, confusion, convulsions, severe drowsiness, and slow or troubled breathing.

What Is Painkiller Withdrawal?

Due to the physical dependence produced by chronic use of opioid painkillers, teens who are prescribed opioid medications need to be monitored not just when they are appropriately taking the medicine, but also when they stop using the drug to reduce or avoid withdrawal symptoms. Symptoms of withdrawal can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes, and involuntary leg movements.

Street or Slang Terms for Painkillers

Oxies, OC, oxycotton, 80s, percs, vikes, and vikings are commonly used terms to refer to painkillers.

Fentanyl a Brief Description

Fentanyl is a powerful synthetic opiate analgesic similar to but more potent than morphine. It is typically used to treat patients with severe pain, or to manage pain after surgery. It is also sometimes used to treat people with chronic pain who are physically tolerant to opiates. It is a schedule II prescription drug.

Names

In its prescription form, fentanyl is known as Actiq, Duragesic, and Sublimaze. Street names for the drug include Apache, China girl, China white, dance fever, friend, goodfella, jackpot, murder 8, TNT, as well as Tango and Cash.

Effects

Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body’s opiate receptors, highly concentrated in areas of the brain that control pain and emotions. When opiate drugs bind to these receptors, they can drive up dopamine levels in the brain’s reward areas, producing a state of euphoria and relaxation. Medications called opiate receptor antagonists act by blocking the effects of opiate drugs. Naloxone is one such antagonist. Overdoses of fentanyl should be treated immediately with an opiate antagonist.

When prescribed by a physician, fentanyl is often administered via injection, transdermal patch, or in lozenge form. However, the type of fentanyl associated with recent overdoses was produced in clandestine laboratories and mixed with (or substituted for) heroin in a powder form.

Mixing fentanyl with street-sold heroin or cocaine markedly amplifies their potency and potential dangers. Effects include: euphoria, drowsiness/respiratory depression and arrest, nausea, confusion, constipation, sedation, unconsciousness, coma, tolerance, and addiction.

This article was from Partnership for a Drug Free Canada. Visit www.canadadrugfree.org for more information.

Organizations: Drug Free Canada, Swift Current and District Drug Task Force

Geographic location: Swift Current, Canada, USA

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