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RX & OTC Drugs

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Peter Cunningham

on 7 November 2013

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Transcript of RX & OTC Drugs

About 1 in 10 Americans ages 10 and over take antidepressants
14% of the young people taking an antidepressant became aggressive and even violent.

ED Visit
The number of benzodiazepine Emergency Department visits over-doubled between 2004 and 2011.
Antidepressants are prescribed for depression therapy, they are "presumed" to increase the concentration of one or more neurotransmitters which are norepinephrine, serotonin, and dopamine.
National Coalition Against Prescription Drug Abuse - ncapda.org
Drug-Free World - www.drugfreeworld.org
Prescription & Over the Counter Drugs
Psychotherapeutic drugs are drugs that are traditionally used within medicine to alter a person’s mood or state of mind. Drugs that fall into this category include prescription-like drugs such as pain relievers, stimulants and depressants.
CNS Depressants
Over The Counter
Drugs (OTC)

Risk Factors
Exposure to peers or a social environment where there's drug use.
Lack of knowledge about prescription drugs and their dangers.
Access to Rx medications
Improper disposal of medications.
Preventive Factors
Laws regulating sales (18+)
Proper disposal of medications.
Locking-up Rx medications, Locking Caps.
Over-site on the prescribing system (SB809).
Side-effects include:
poor coordination
slurred speech
blurred vision.
depressed breathing
depressed blood pressure
occur if used with other
drugs or alcohol - coma or death

Long-term use effects include:
tolerance and dependence
Acute benzodiazepine withdrawal syndrome generally lasts about two months.

Low dose dependence can last for 6-12 months, with the symptoms gradually improving.

Detoxification should be done in a medical facility.

Dangers of abrupt or over-rapid discontinuation can result in:
catatonia, delusions, convulsions, coma, suicide, and death
The amount of benzodiazepine admissions into treatment nearly tripled between 1998 and 2008.

The majority of the admissions were male, between the ages of 18 and 34, or non-Hispanic White.

of benzodiazepine admissions reported abuse of another substance in addition to abuse of benzodiazepines

percent reported primary abuse of another substance with secondary abuse of benzodiazepines
Stimulants are a class of drugs that elevate mood, increase feelings of well-being, and increase energy and alertness.
Slowed breathing
Same as short-term with dependence
diarrhea, nausea, and vomiting (Flu-like Symtoms)
muscle pain
Most commonly abused
Celexa, Effexor, Lexapro, Paxil, Prozac, and Zoloft.
Short term effects:
Irritability, nervousness, anxiety, agitation, tremors, hostility, irregular heartbeat, confused and incoherent thoughts, paranoia, hallucinations, psychosis, erectile dysfunction, loss of sex drive, and fatigue.

Long term effects:
Criminal behavior, memory problems, and symptomatic worsening that can lead to suicidal thoughts. Irregular heart rate, very high blood pressure and an increased risk of seizures can occur.

Suicidal thoughts, aggression, depression, crying spells, insomnia, dizziness, vomiting, headaches, and tremors.

Stimulants include:
Adderall, Concerta, Dexedrine, Metadate, Ritalin

Street name include:
The Smart Drug
Kibbles & Bits
Vitamin R

According to Inhalant Use across the Adolescent Years, a recent report from SAMHSA’s National Survey on Drug Use and Health (NSDUH), inhalants are used by young teens age 12 to 13 more than any other class of drugs.
Inhalants ordinary household products that are inhaled to get high.
There are three main categories solvents, gases, and nitrates.
Short term:
Increased heart rate, blood pressure, and metabolism
Reduced appetite

Long term:
Permanent damage to blood vessels
Irregular heart beat

Irritability, headaches, nausea, vomiting and mood swings
USFDA has identified about 17 fatal cases and 800 cases of side effects due to ephedrine consumption from 1993-1996. In spite of numerous ephedrine related deaths, the seriousness of the implications of consuming ephedrine products was not communicated to the people. It was only after the death of a baseball player in 2003, that the USFDA had revised the 1994 Dietary Supplements Act to include clauses on standardized dosage, content labels, and warnings on ephedrine containing products.
Sudafed, Claritin, Primatene Tablets
Every Day Products
Nail polish remover, variety of glues, spray paint, cooking spray, white out, aerosols like computer duster and air fresheners.
Dex, Robo, Robotriping, Skittles, Triple C, Tussin, DMX, Nightime
Short term effects: may cause confusion, dizziness, impaired vision, speech and physical coordination. Causes hallucinogen like experiences, causing loss of motor skills and impaired judgment.

Long term effects: this drug may also contain other ingredients like acetaminophen which can cause liver damage. If used for a long time insomnia and dysphoria can be developed. This drug is usually combined with alcohol and other drugs that can lead to overdose and death. If dosage is high enough it can suppress the central nervous system and cause death.

Withdrawals: depending on usage tolerance and dependence can be developed. If usage is in high dosage it can create toxic psychosis.


Diazepam (Valium)
Alprazolam (Xanax)
Lorazepam (Ativan)
Clonazepam (Klonopin)
Chlordiazepoxide (Librium)

Nemutal (phenobarbital)
Amytal Sodium
Codeine, Vicodin, hydrocodone, MS Contin (morphine), Oxycontin, Percoset (oxycodone),Dilaudid (hydromorphone),Duragesic (fentanyl)
Street Names-Oxy 80′s, hillbilly heroin, or percs,vikes, viko, or norco
General Rx Stats
Pharmaceuticals were much more common than illicit drugs in suicide attempts:

Pain relievers were found to be involved in 38% of drug-related suicide attempts. Narcotic pain relievers and acetaminophen products were involved in about 13% .

Benzodiazepines (anti-anxiety drugs) were found to be involved in 29.3% of drug-related suicide attempts. Alprazolam (e.g., Xanax) and clonazepam (e.g., Klonopin®) each accounted for about a third (11.1% and 9.5%, respectively).

Antidepressants appeared in 19.6% of visits. About half (9.8%) of those visits involved an SSRI antidepressant such as citalopram (e.g., Celexa®), sertraline (e.g., Zoloft®), or fluoxetine (e.g., Prozac). Trazodone (e.g., Desyrel®), a SARI antidepressant, was involved in about a quarter (4.8%).
Substances that slow normal brain activity by inhibiting function of the Central Nervous System (CNS).

Treatment for:
anxiety or agitation
seizure disorder
alleviate muscle pain
induce sleep
relieve withdrawal symptoms of alcohol dependence
Among persons aged 12 or older who misused or abused prescription pain relievers:
• 55% received from a friend or relative for free.*
• 11.4% purchased from a friend or relative.
• 4.8% took from a friend or relative without asking.
• 17.3% received from a doctor’s prescription.
• 4.4% received from a dealer or stranger.
• 0.4% ordered on the Internet.
*Among those receiving drugs from a friend or family for free, 79.3% of friends or relatives received drugs from a doctor’s prescription.
Generally referred to as painkillers, these drugs contain opium or opium-like substances and are used to relieve pain. It is a class of drugs that includes hydrocodone, methadone, oxycodone, and oxymorphone

Nationwide, 20.7% of students had taken prescription drugs without a doctor’s prescription one or more times during their life.
Nationwide, 2.9% of students had used heroin one or more times during their life.

Short term effects: very fast effects similar to alcohol but intoxication lasts very little. It has similar effects to anesthesia slowing down the body. Slurred speech, dizziness, confusion, lack of coordination, nausea and vomiting. Also can cause hallucinations and delusions.
Long term effects: weight loss, muscle weakness, irritability and depression. Due to the “high” disappearing rapidly people use products repeatedly and can cause loss of consciousness or death.inhalants go through the lungs and into the bloodstream, and are quickly distributed to the brain and other organs in the body. Long time exposure to inhalants can lead to brain or nerve damage that produces results similar to that of multiple sclerosis.
DXM is a synthetically produced substance that is chemically related to codeine, though it is not an opiate.
DMX is cough suppressant ingredient found in cough and cold medications
Poison Control-DMX
Year Teenagers All Other Age Groups
2000 1,623 900
2001 2,276 1,107
2002 2,881 1,139
2003 3,271 1,111
Pseudoephedrine is a decongestant found in medications used for the relief of nasal and various allergy conditions and cold symptoms.

Use/Abuse: It is widely abused for its stimulant effects. People abuse it for losing weight and athletes use it to enhance performance. Also students use it to help them study. It is most dangerous because it used to make methamphetamine.
Trade Names
Short term effects: excited speech, decreased appetite, and increased physical activity levels. Hyperactive behavior that causes, anxiety, tension, tremor, weakness, dizziness, vertigo, headache, confusion, delirium, hallucination, sweating, nausea, and vomiting.

Long term effects: Pseudoephedrine affects the central nervous system and can cause many cardiovascular problems like arrhythmia, high blood pressure, and strokes. It can also cause death.

Withdrawals: Some withdrawal symptoms may be less severe than others, but all will be unpleasant to the user; such as, headache, nausea, vomiting, irritability, uncontrollable shaking, irregular heartbeat, paranoia, and depression.

CNS Depressants
from Long-Term Benzodiazepine Use
Benzodiazepine Treatment Admissions

2005 non-medical use of stimulants taken in a lifetime:

Ages 12-17 about 3%

Ages 18-25 about 11%

Ages 26-older about 8%
One in four teens (24 percent) reports having misused or abused a stimulant at least once in their lifetime (up from 18 percent in 2008 to 24 percent in 2012), which translates to about 5 million teens. That is a 33 percent increase over a five-year period.

One in four teens (26 percent) believes that stimulant drugs can be used as a study aid.

More than a quarter of teens (27 percent) mistakenly believe that misusing and abusing stimulants is safer than using street drugs.
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