Prescription meds as deadly as street drugs

Apr 21st, 2014

Heidi Wicks

Prescription meds as deadly as street drugs

Just because some drugs are legal, it doesn’t mean they can’t be abused.

A goal of the Canadian Pharmacists Association (CPhA) is to educate the public on the importance of drug awareness, and the dangers of drug abuse – not only of illicit drugs, but also of prescription drugs.

According to Health Canada, the most vulnerable victim group is youth – whose curiosity and lack of knowledge can be detrimental to their health.

Students at Memorial’s School of Pharmacy are using their education to inform Newfoundland and Labrador’s youth, by offering a series of presentations on the dangers of drug abuse to a number of high schools during Pharmacist Awareness Month (PAM).

Vanessa Bennett, a second-year pharmacy student, presented to high school students during last year’s PAM events.

Ms. Bennett says that high school students are the most vulnerable demographic when it comes to potential drug abuse, and therefore, need to be very aware of its risks.

“High school is the time when many students become exposed to drugs, or have the opportunity to try them, whether it be at parties, at home, or even at school,” she said.

“It's important to educate youth before they are given the opportunity to misuse prescription drugs, as many people have the idea that just because a medication is prescribed by a physician it is safe and will have no negative consequences. These presentations teach the students that this is not always the case and explains some of the consequences of their misuse.

 During last year’s presentation, Ms. Bennett and co-presenter Kara O’Keefe (who is also involved in this year’s presentations) showed a disturbing video which portrayed a high school student who had died after attending a “pharm party” – a party where candy bowls of prescription pills are laid out as if they’re a bowl of potato chips.

Barbara Thomas (School of Pharmacy and Faculty of Medicine, Clinical Pharmacist, Eastern Health) teaches substance abuse to undergraduate pharmacy students.

Dr. Thomas believes that prescription drugs can be as lethal as illegal drugs if used incorrectly.

“The most common classes of prescription medications that are subject to abuse are the opioid analgesics such as oxycodone (Oxycontin, Percocet), the sedative hypnotics such as lorazepam (Ativan), diazepam (Valium), and the psychostimulants such as methylphenidate (Ritalin). Each of these medications can be lethal if taken in an excessive amount or if taken by someone whose system has not been introduced to the drug in smaller doses,” she said. “They could experience respiratory failure in a person who is drug naïve. That’s the worry with medications like methadone being out on the streets.”

Users can also be harmed by the method they choose to ingest the drug.

“For example, oxycodone controlled release is formulated to release the active ingredient continuously over several hours and because of this, is often prescribed to be given twice daily,” explained Dr. Thomas. “Abusers will often crush, snort, or inject this drug, which destroys the slow release properties of the formulation.”

Known as “dose dumping”, the user is exposed to rapid, very high concentrations of the drug that can be very dangerous, even lethal.

Over-use and abuse of these drugs can also cause psychiatric impairments such as mood and anxiety symptoms, paranoia, and psychosis, Dr. Thomas added.

“It can also cause havoc with organs outside of the brain system, which can have immediate and long term adverse consequences such as possibly-fatal respiratory issues, adverse effects to the heart including increased and irregular heartbeats, which could lead to a heart attack. Seizures can also occur, either due to acute intoxication or as a consequence of withdrawal.”

A recent warning released by the Office of the Chief Coroner in Ontario alerted physicians and pharmacists to lethal consequences from the recreational use of bupropion – an antidepressant also used as a smoking cessation therapy. The alert cited deaths associated with inhalation or injection of the drug.

Dr. Thomas feels that when it comes to public awareness, “we can’t take our foot off the gas.”

“I know that the school system in Newfoundland and Labrador is targeting our children at an early age through programs such as DARE, and are also reaching out to students at the junior high and high school level,” she said. “Despite this, we continue to have problems with substance abuse in our communities, and this tells me that we may need to step it up even more.”

Since education and awareness is so vital, Dr. Thomas is thrilled and proud that pharmacy students are taking the initiative to spread the word about the dangers of drug abuse.

“I think that there is a greater impact and the message is sometimes better received when it comes from a peer or from individuals who are closer to their own age – it’s often easier to connect in that regard. However, that shouldn’t stop the rest of us from delivering these messages as well.”