BodySense Blog

Prescription Drug Abuse

Angie had three finals in 1 day and wondered how she'd ever study for all of them - or even get through the exams themselves. So when her roommate offered some of her ADHD medicine because she said it would help Angie focus better, Angie jumped at the chance. After all, it was just this one time - and it was a prescription medication, so it must be safe. Unfortunately, it's not.

Some people experiment with prescription drugs because they think the drugs will help them have more fun, lose weight, fit in, and study more effectively. Prescription drugs can be easier to get than street drugs, and it may seem like they're safer: Family members or friends could have a prescription. But prescription drugs are also sometimes sold on the street like other illegal drugs.

Prescription painkillers and other medications help lots of people live more productive lives, freeing them from the symptoms of medical conditions like fibromyalgia or ADHD (attention deficit hyperactivity disorder). But that's only when those medications are prescribed for a particular individual to treat a specific condition. Taking prescription drugs in a way that hasn't been recommended by a doctor can be more dangerous than you might realize.

Prescription drugs are only safe for the individuals for whom they've actually been prescribed because a doctor has examined these people and knows that they won't have a bad reaction to the drugs. The doctor has also told them exactly how to take the medicine and about precautions, such as things to avoid while taking the drug (drinking alcohol, smoking, taking other medications, etc.).

Which Drugs Are Abused?

The most commonly used prescription drugs fall into three classes:

Opioids

• Examples: Oxycodone (OxyContin), hydrocodone (Vicodin), and meperidine (Demerol).
• Medical uses: Opioids are used to treat pain or relieve coughs or diarrhea.
• How they work: Opioids attach to opioid receptors in the central nervous system (the brain and the spinal cord), preventing the brain from receiving pain messages.

Central Nervous System (CNS) Depressants

• Examples: Pentobarbital sodium (Nembutal), diazepam (Valium), and alprazolam (Xanax).
• Medical uses: CNS depressants are used to treat anxiety, tension, panic attacks, and sleep disorders.
• How they work: CNS depressants slow down brain activity by increasing the activity of a neurotransmitter called GABA. The result is a drowsy or calming effect.

Stimulants

• Examples: Methylphenidate (Ritalin), amphetamine/dextroamphetamine (Adderall), and atomoxetine (Strattera).
• Medical uses: Stimulants can be used to treat narcolepsy, attention deficit hyperactivity disorder (ADHD), depression, obesity, and asthma.
• How they work: Stimulants increase brain activity, resulting in greater alertness, attention, and energy.

Over-the-Counter Drugs

Some people mistakenly think that prescription drugs are more powerful because you need a prescription for them. But it's possible to abuse or become addicted to over-the-counter (OTC) medications, too.

For example, dextromethorphan (DXM) is found in some OTC cough medicines. When someone takes the number of teaspoons or tablets that are recommended, everything is fine. But high doses can cause problems with the senses (especially vision and hearing) and can lead to confusion, stomach pain, numbness, and even hallucinations.

What Are the Dangers of Abusing Medications?

Like all drug abuse, using prescription drugs for the wrong reasons has serious risks for a person's health. Just a single dose of an opioid can lower a person's breathing rate and even kill when it's taken by the wrong person in the wrong circumstances. This risk is higher when opioids are taken with other substances like alcohol, antihistamines, and CNS depressants.

CNS depressants have risks, too. Reducing or stopping them can lead to seizures. Taking CNS depressants with other medications, such as prescription painkillers, some over-the-counter cold and allergy medications, or alcohol can slow a person's heartbeat and breathing - and even kill.

Abusing stimulants (like some ADHD drugs) may cause heart failure or seizures, both of which can kill. These risks are increased when stimulants are mixed with other medicines - even over-the-counter ones like certain cold medicines. Taking too much of a stimulant can lead a person to develop dangerously high body temperatures or an irregular heartbeat.

Taking several high doses over a short period of time may make a drug abuser aggressive or paranoid. Although stimulant abuse might not lead to physical dependence and withdrawal, the feelings these drugs give people may cause them to use the drugs more and more often so they become a habit that's hard to break.

The dangers of prescription drug abuse can be made even worse if people take drugs in a way they aren't supposed to. Ritalin may seem harmless because it's prescribed even for little kids with ADHD. But when a person snorts or injects Ritalin, it can be serious. There are also many variations of the same medication (the dose of medication and how long it stays in the body may vary). The person who doesn't have a prescription may not really know which one he or she has.

Probably the most common result of prescription drug abuse is addiction. People who abuse medications can become addicted just as easily as if they were taking street drugs. The reason many drugs have to be prescribed by a doctor is because some of them are quite addictive. That's why most doctors won't usually renew a prescription unless they see the patient - they want to examine the patient to make sure he or she isn't getting addicted.

How Do I Know if I'm Addicted?

There are many different signs that point to drug addiction. The most obvious is a need to have a particular drug or substance. Changes in mood, weight, or interests are other signs of drug addiction.

If you think you - or a friend - may be addicted to prescription drugs, talk to your doctor, campus health office, or counselor. They can help you get the help you need. It's especially important for someone who is going through withdrawal from a CNS depressant to speak with a doctor or seek medical treatment. Withdrawal can be dangerous when it's not monitored.

If a person has become addicted to prescription drugs, there are several kinds of treatment, depending on individual needs and the type of drug used. The two main categories of drug addiction treatment are behavioral and pharmacological.

Behavioral treatments teach people how to function without drugs - handling cravings, avoiding drugs and situations that could lead to drug use, and preventing and handling relapses. Pharmacological treatments involve giving a patient a special type of medication to help him or her overcome withdrawal symptoms and drug cravings.

Tips for Taking Prescription Medication

What if a doctor prescribed a medication for you and you're worried about becoming addicted? If you're taking the medicine the way your doctor told you to, you can relax: Doctors know how much medication to prescribe so that it's just enough for you. In the correct amount, the drug will relieve your symptoms without making you addicted.

If a doctor prescribes a pain medication, stimulant, or CNS depressant, follow the directions exactly. Here are some other things you can do to protect yourself:

• Keep all doctor's appointments. Your doctor will want you to visit often so he or she can monitor how well the medication is working for you and adjust the dose or change the medication as needed. Some medications must be stopped or changed after a while so that the person doesn't become addicted.
• Make a note of the effects the drug has on your body and emotions, especially in the first few days as your body gets used to it. Tell your doctor about these.
• Keep any information your pharmacist gives you about any drugs and activities you should steer clear of while taking your prescription. Reread it often to remind yourself of what you should avoid. If the information is too long or complicated, ask your pharmacist to give you the highlights.
• Don't increase or decrease the dose of your medication without checking with your doctor's office first - no matter how you're feeling.

Finally, don't use someone else's prescription. And don't allow a friend to use yours. Not only are you putting your friend at risk, but you could suffer, too: Pharmacists won't refill a prescription if a medication has been used up before it should be. And if you're found giving medication to someone else, it's considered a crime and you could find yourself in court.

KidsHealth

Family Meals Can Help Teen Girls Avoid Drugs, Alcohol

Eating meals together as a family can reduce a teen girl's risk of turning to alcohol or drugs, a new study suggests.

In families who ate at least five meals a week together, the teen girls were much less likely to drink alcohol, or smoke marijuana or cigarettes five years later, said study author Marla Eisenberg, an assistant professor of pediatrics at the University of Minnesota Medical School.

The same effect wasn't seen for boys in this study, although Eisenberg can't say why.

"One of the key findings we have here is for girls," she said. "We found girls who had regular family meals had half the odds of initiating cigarettes, alcohol or marijuana use in the five-year time period."

Eisenberg's team followed 806 Minnesota teens, about 55 percent of them girls and 45 percent of them boys. They first surveyed the children in school in 1998 to 1999 when they were about age 13, asking how often their family ate meals together and the kids' use of substances.

The researchers followed up with a second survey five years later.

At age 18, the girls who had regular meals with their family -- defined for the study as five or more a week -- had a much lower risk of substance abuse. And the meal didn't have to be dinner, Eisenberg said.

A previous analysis of the same study participants found a stronger association for girls than boys between family meals and a lower risk of eating disorders. Yet to come is an analysis of the effect family meals have on a teen's mental health.

The findings are published in the August issue of the Journal of Adolescent Health.

Other research by some of the same University of Minnesota researchers has revealed a link between regular family meals and a lower risk of high-risk behaviors, including violence, school problems and substance abuse in both boys and girls
.

While Eisenberg can't explain why regular family meals don't seem to keep boys away from alcohol and drugs, she said parents of boys can focus on other strategies, such as having brief, ongoing conversations about the dangers of substance abuse.

Health Day

7 Questions to Ask Your Doc If You Have a Major Decline in Sex Drive

1. Could it be caused by medications I'm taking? Loss of libido is a common side effect to some prescription medications.

2. I'm angry/stressed/tired/overwhelmed — could this be part of the problem? Emotions can wreak havoc with hormone levels and the endocrine system, and that can put a damper on your desire.

3. Am I overweight? High cholesterol and insulin resistance — two common medical conditions associated with being overweight — can affect sexual performance.

4. Could I be suffering from depression? Depressed people are rarely interested in sex.

5. Could I have a hormonal problem? Imbalances of testosterone in men and estrogen in women can lower libido.

6. I experience pain during sex — enough that I don't want to have sex much anymore. What's causing it? The problem could range from the relatively easy to correct (such as not enough foreplay) to a more severe underlying condition (such as an estrogen deficiency).

7. I haven't been able to achieve an orgasm in a while. What's happening to me? The problem could be related to medication you're taking, or it could be a harder-to-pinpoint psychological issue. Either way, your doctor will be able to help.

Revolution Health Group

Flu bugs growing resistance to drugs: studies

Seasonal flu viruses are developing the ability to evade influenza drugs globally, but how and why this is happening is not clear, experts told a conference on Monday.

Europe is the worst-affected by strains of influenza that resist the effects of antiviral drugs, but the resistance is growing globally, they told a meeting of the Infectious Diseases Society of America.

"A significant proportion of resistant viruses were observed in Europe this winter," Dr. Bruno Lina of Claude Bernard University in Lyons, France, told the meeting.

The resistance also varies by strain, with a quarter of H1N1 flu viruses resistant in Europe and about 11 percent of H1N1 in the United States, but far fewer cases of H3N2 and influenza B viruses.

Their findings show that flu viruses -- already known to mutate speedily -- may be even more unpredictable than anyone thought.

Experts fear drugs may become quickly useless to fight an unusually severe flu season or the emergence of a new strain of flu that may cause a pandemic. They have been stressing the need to develop new flu drugs and also quicker and better ways to make vaccines.

The World Health Organization and the U.S. Centers for Disease Control and Prevention have been collecting samples of the annual flu viruses to check them against the four available flu drugs: amantadine and rimantadine, and the newer drugs Tamiflu and Relenza.

The viruses changed rapidly over the past 2007-2008 flu season, Lina said. "We started with something like 10 percent in Europe," Lina said. By April of this year, 25 percent of the viruses tested were resistant to Tamiflu.

SUDDEN CHANGES

U.S. flu viruses developed a sudden ability to evade the effects of the older drugs amantadine and rimantadine during the 2005-2006 flu season, said Dr. Larisa Gubareva of the CDC. In 2006 the CDC said no one should use those drugs any more.

Doctors had hopes for two newer drugs -- Roche AG's Tamiflu, known generically as oseltamivir and licensed from Gilead Sciences, and GlaxoSmithKline's Relenza, known generically as zanamivir.

But already resistance is being seen to Tamiflu, a pill that can be taken to treat symptoms and also to prevent infection.

Lina's team tested more than 2,600 samples of flu viruses from patients in Europe and found baffling patterns of this resistance that appeared to have nothing to do with actual use of Tamiflu.

For instance in France, 54 percent of those tested in Paris carried the mutation that would give resistance to Tamiflu, compared to 29 percent in southeastern France. "Which makes absolutely no sense," Lina said.

Patients showed no difference in their symptoms if they were infected with resistant virus, he noted.

"It's difficult to understand. I have no idea why these viruses emerged," he said.

And in Europe, the H1N1 viruses were the most resistant.

Gubareva said tests across the United States, Canada and Mexico showed very quick development of drug resistance among H1N1 viruses. As of May 15 resistant viruses had been detected in 18 U.S. states out of 43 where virus samples from patients were tested, she said.

In Canada, resistant virus was found in nine of 13 provinces.

But only 6 percent of H3N2 and influenza B samples tested in North America had genetic mutations giving resistance to Tamiflu, she said.

Reuters

Talking to Your Child About Drugs

Just as you inoculate your children against illnesses like measles, you can help "immunize" them against drug use by giving them the facts before they're in a risky situation.

When kids don't feel comfortable talking to parents, they're likely to seek answers elsewhere, even if their sources are unreliable. Kids who aren't properly informed are at greater risk of engaging in unsafe behaviors and experimenting with drugs.

Preschool to Age 7

Before you get anxious about talking to young kids, take heart. You've probably already laid the groundwork for a discussion. For instance, whenever you give a fever medication or an antibiotic to your child, you have the opportunity to discuss the benefits and the appropriate and responsible use of those drugs. This is also a time when your child is likely to be very attentive to your behavior and any guidance that you provide.

Start taking advantage of "teachable moments" now. If you see a character on a billboard or on TV with a cigarette, talk to your child about smoking, nicotine addiction, and what smoking does to person's body. This can lead into a discussion about other drugs and how they can potentially cause harm.

Keep the tone of these discussions calm and use terms that your child can understand. Be specific about the effects of the drugs: how they make a person feel, the risk of overdose, and the other long-term damage they can cause. To give your kids these facts, you might have to do a little research.

Ages 8 to 12

As your kids grow older, you can begin conversations with them by asking them what they think about drugs. By asking the questions in a nonjudgmental, open-ended way, you're more likely to get an honest response.

Kids this age usually are still willing to talk openly to their parents about touchy subjects. Establishing a dialogue now helps keep the door open as kids get older and are less inclined to share their thoughts and feelings so openly.

Even if your question doesn't immediately result in a discussion, you'll get your kids thinking about the issue. If you show your kids that you're willing to discuss the topic and hear what they have to say, they might be more willing to come to you for help in the future.

News, such as steroid use in professional sports, can be springboards for casual conversations about current events. Use these discussions to provide your kids with information about the risks of drugs.

Ages 13 to 17

At this age, your kids are likely to know other kids who use or abuse alcohol or drugs. They're also likely to have friends and peers who drive. It's important to talk about the dangers of driving under the influence. Talk about the legal issues -- jail time and fines -- and the possibility that they or someone else might be killed or seriously injured.

Consider establishing a written or verbal contract on the rules about going out or using the car. You can promise to pick your kids up at any time (even 2:00 AM!) without asking questions if they call you when the person responsible for driving has been drinking or using drugs.

The contract also can detail other situations: For example, if you find out that someone drank or used drugs in your car while your son or daughter was behind the wheel, you may want to suspend driving privileges for 6 months. By discussing all of this with your kids from the start, you eliminate surprises and make your expectations clear.

Laying Good Groundwork

No parent, child, or family is immune to the effects of drugs. Some of the best kids can end up in trouble, even when they have made an effort to avoid it and even when they have been given the proper guidance from their parents.

However, certain groups of kids may be more likely to use drugs than others. Kids who have friends who use drugs are likely to try drugs themselves. Those feeling socially isolated for whatever reason may turn to drugs. So it's important to know your child's friends -- and their parents. Be involved in your children's lives. If your child's school runs an antidrug program, get involved. You might learn something! Pay attention to how your kids are feeling and let them know that you are available and willing to listen in a nonjudgmental way. Recognize when your kids are going through difficult times so that you can provide the support they need or seek additional care if it's needed.

A warm, open family environment -- where kids are encouraged to talk about their feelings, where their achievements are praised, and where their self-esteem is bolstered -- encourages kids to come forward with their questions and concerns. When censored in their own homes, kids go elsewhere to find support and answers to their most important questions.

KidsHealth