Prescription Drugs: A Bitter Pill in Indiana

Each year millions of people use prescription medications safely to help treat and cure

illnesses as well as prevent further disease complications. While most prescriptions are

used as directed, there are a growing number of cases of misuse of prescription drugs.

According to the Indiana Attorney General prescription drug abuse is a growing epidemic.

As a result of this lesson, you will learn:

What you should know about prescription drug abuse.

Common prescription drugs involved in overdoses.

Tips to prevent accidental prescription drug overdoses.

Signs and symptoms of a prescription drug overdose.

Actions to take if you suspect a drug overdose.

Safe disposal of prescription drugs.

Activity:

Let’s talk about prescription drug abuse. What do you think it is?

Ask members to share their thoughts.

What is Prescription Drug Abuse?

According to the National Institute on Drug Abuse, prescription drug abuse is the use of a

medication without a prescription, in a way other than as prescribed, or for the experience

or feelings elicited. According to several national surveys, prescription medications, such as

those used to treat pain, attention deficit disorders, and anxiety, are being abused at a rate

second only to marijuana among illicit drug users. The consequences of this abuse have

been steadily worsening, reflected in increased treatment admissions, emergency room

visits, and overdose deaths.

QUIZ: TRUE OR FALSE Read the statements and ask club members to respond whether the statement is true or false. What Do YOU Think Is this Prescription Drug Abuse? 1. Mixing prescription drugs with over-the-counter medications without telling your doctor.

2. Taking someone else’s medicine.

3. Mixing your medication with alcohol.

4. Taking more medicine than the doctor prescribed.

5. Taking medicine too frequently.

6. Not taking your medicine and instead saving it to sell.

All statements are True! Distribute Purdue publication: “Use As Directed: Preventing Prescription Drug Overdoses”.

• Share the information with your members from the Common Prescription Drugs Chart on page one of the handout. The chart helps to explain types of drugs, what they are used for and why someone might take them.

• Have members take turns reading out loud the tips on page two to learn how to prevent accidental prescription overdose.

• Distribute the word search, “Symptoms of a Prescription Drug Overdose”. After members complete the puzzle, review the symptoms.

Distribute handout on Safe Drug Disposal:

Review proper disposal practices with club members.

• Check the Bitter Pill IN website through Indiana Prescription Drug Abuse Prevention Task Force for Drug Take-Back locations in your community: (http://www.in.gov/bitterpill/safe_storage.html)

• or call your county Extension Educator for Health and Human Sciences to find out about prescription drug disposal in your local community.

Resources for more information:

Check with your Extension Educator for Health and Human Sciences for Poison Help Line Magnets Poison Help Line: 1-800-222-1222

Bitter Pill Indiana: Indiana Prescription Drug Abuse Facts:

http://www.in.gov/bitterpill/files/Rx_Drug_Awareness_Rack_Card_2014.pdf 2

Handouts for Membership: “Use As Directed: Preventing Prescription Drug Overdoses” - HHS-790-W “How to Dispose of Medicines Properly” - http://water.epa.gov/scitech/swguidance/ppcp/upload/ppcpflyer.pdf Symptoms of a Prescription Drug Overdose Word Search and Answer Key

Lesson developed by:

Susan Plassmeier Vanderburgh County County Extension Director Extension Educator - Health and Human Sciences 13301 Darmstadt Road Evansville, IN 47725-9593 812.435.5287 splassme@purdue.edu

Jan Dougan Dubois County County Extension Director Extension Educator - Health and Human Sciences 1482 Executive Blvd., Suite A Jasper, IN 47546-9300 812.482.1782 jmdougan@purdue.edu

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HHS-790-WHealth and Human Sciences

Each year millions of people use prescription medications safely to help treat and cure illnesses as well as prevent further disease complications. While most prescriptions are used as directed, there are a growing number of cases of misuse of prescription drugs.Prescription drug overdose is the cause of 114 deaths daily in the United States. Approximately 82 percent of these deaths are accidental. In addition 6,748 patients present to the emergency department every day for the misuse of prescription drugs.*In 2011, deaths due to prescription drug overdoses exceeded those caused by car accidents and continue to increase today. Indiana has the 17th highest drug overdose mortality rate in the United States.*

Use As Directed: Preventing Prescription Drug Overdoses

* Source: Centers for Disease Control and Prevention

By Claire McClain, Purdue University College of Pharmacy

Common Prescription Drugs Involved in OverdosesThe prescription drugs in the chart below contribute to more deaths than street drugs such as cocaine and heroin. The majority of the deaths from use of prescription drugs happen by accident.

Type Used to Treat Examples of Prescriptions[generic name (trade name)]

Opioids• pain relief • oxycodone (Roxicodone®, Oxycontin®)

• methadone (Dolophine®, Amidone®)• morphine (Avinza®)

Benzodiazepines

• anxiety• panic attacks• insomnia• depression

• alprazolam (Xanax®)• diazepam (Valium®)• lorazepam (Ativan®)

Amphetamine-like substances

• attention-deficit hyperactivity disorder

• narcolepsy

• amphetamine/dextroamphetamine (Adderall®)• methylphenidate (Ritalin®)

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Tips to Prevent Accidental Prescription Drug OverdosesThere are risks of harm if prescription medications are not used as prescribed by the doctor. This applies to medications we use ourselves and those we give to our loved ones. Use the following tips to help prevent accidental overdoses of prescription medications.

• Always read the label on the prescription bottle. Never take more medicine than the doctor has directed.

• Talk to your doctor or pharmacist before mixing medications. Some medications can have harmful interactions with other medications or foods. This can include over-the-counter medications such as aspirin, acetaminophen (Tylenol®), or medications for heartburn.

• If you are using a liquid medication, use the measuring tool provided by the pharmacy. Do not use silverware or dosing devices intended for other medications.

• Know a child’s weight when giving over-the-counter medications along with prescription medications. Call a medical professional if you have any questions about how much to give to a child.

• Store all medications in a safe place away from children and pets.

• If your pain does not go away with medication, contact your physician right away. Do not take more medication than stated on the directions.

• Use medication boxes to organize daily medications. This will help prevent taking more than the prescribed amount of medication.

• Do not mix alcohol with prescription pain pills, anxiety medications, acetaminophen (Tylenol®), or medications for attention-deficit disorder.

• Do not share prescription medications with anyone. Only take medication that is prescribed to you by your doctor.

Signs and Symptoms of a Prescription Drug OverdoseIt is important to know the signs and symptoms that someone has taken too much medication and who to call for help.Symptoms can vary depending on the prescription drug an individual has used. Some prescription drugs can slow down our body, while others can speed it up. The most common signs and symptoms of prescription drug overdose include:

• abnormal pupil size (significant constriction or dilation)

• difficulty breathing• unconsciousness• hallucinations• excessive drowsiness• nausea/vomiting• excessive sweating• seizures• confusion• unsteadiness

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Purdue University is an Affirmative Action institution. This material may be available in alternative formats.

Jan. 2015

Order or download materials from Purdue Extension • The Education Store

www.edustore.purdue.edu1-888-EXT-INFO • www.extension.purdue.edu

If You Suspect a Drug Overdose . . .

• Call 911 immediately if you suspect that an individual has overdosed on drugs.

• If the individual does not have a pulse, and you are trained to perform basic life support, start CPR.

• Try to determine what medication the individual has ingested.

• Give any prescription medication bottles to the emergency responders.

• If you believe you have accidentally taken too much of your medication, call 911 for help.

Poison Help Line: 1-800-222-1222 Available 24 hours a day,

7 days a week

Free and confidential service for any questions

Serves all of the United States and many territories

Provides translation services in 161 languages

More people abuse prescription drugs than cocaine, heroin, hallucinogens,

and inhalants combined. Source: Indiana Bitter Pill website, bitterpill.in.gov

Sources1. Home and Recreational Safety web page. Centers

for Disease Control and Prevention. Available at: www.cdc.gov/homeandrecreationalsafety/overdose/facts.html. Accessed 21 November 2014.

2. For Consumers web page. U.S. Food and Drug Administration. Available at: www.fda.gov/forconsumers/consumerupdates/ucm253338.htm. Accessed 22 August 2014.

3. Bitter Pill website. Indiana Prescription Drug Abuse Prevention Task Force. Office of the Indiana Attorney General. Available at: www.in.gov/bitterpill/index.html. Accessed 22 August 2014.

4. Poison Help web page. U.S. Department of Health and Human Services. Available at: www.poisonhelp.hrsa.gov/poison-centers/index.html. Accessed 21 November 2014.

This publication was reviewed by Rosanne Griggs, clinical associate professor, Purdue University School of Nursing, and Steven Abel, professor of pharmacy practice, Purdue University College of Pharmacy.

2ND CHOICE: HOUSEHOLD DISPOSAL STEPS*

* Drug Disposal Guidelines, Office of National Drug Control Policy, October 2009

DON’T: Flush expired or unwanted prescription and over-the-counter drugs down the toilet or drain unless the label or accompanying patient information specifically instructs you to do so.

DO: Return unwanted or expired prescription and over-the-counter drugs to a drug take-back program or follow the steps for household dis-posal below.

5. The sealed container with the drug mixture, and the empty drug containers, can now be placed in the trash.

1. Take your prescription drugs out of their original containers.

3. Put the mixture into a disposable container with a lid, such as an empty margarine

tub, or into a sealable bag.

2. Mix drugs with an undesirable substance, such as cat litter or used coffee grounds.

4. Conceal or remove any personal information, including Rx number, on the empty

containers by covering it with permanent marker or duct tape, or by scratching it off.

Drug Take-Back Event

1ST CHOICE: DRUG TAKE-BACK EVENTS

To dispose of prescription and over-the-counter drugs, call your city or

county government’s household trash and recycling service and ask if a

drug take-back program is available in your community. Some counties

hold household hazardous waste collection days, where prescription

and over-the-counter drugs are accepted at a central location for proper

disposal.

How to Dispose of Medicines Properly

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How Proper Disposal of Medicines Protects You and

the Earth:

For more information, go to www.epa.gov/ppcp/

Or call the Safe Drinking Water Hotline at 800-426-4791

Office of Water EPA 816-F-11-003 April 2011

How Improper Disposal of Medicines May End Up

in Our Drinking Water Sources

Prevents poisoning of children and pets

Deters misuse by teenagers and adults

Avoids health problems from accidentally taking the wrong medicine, too much of the same medicine, or a medicine that is too old to work well

Keeps medicines from entering streams and rivers when poured down the drain or flushed down the toilet

In homes that use septic tanks, prescription and over-the-counter drugs flushed down the toilet can leach

into the ground and seep into ground water.

In cities and towns where residences are connected to wastewater treatment plants, prescription and

over-the-counter drugs poured down the sink or flushed down the toilet can pass through the treatment

system and enter rivers and lakes. They may flow downstream to serve as sources for community drink-

ing water supplies. Water treatment plants are generally not equipped to routinely remove medicines.

Symptoms of a Prescription Drug Overdose

D M S C M J K H H A N Y K H T S I V H U M I T S S E I Z U R E S A F S S N M Y B E R F G E Y N G F D X L Y Z Z E K R K A C Z H F U N N O C S L L C C G N M K J B C I T T I I I X E U P J S Z T S M A H N M T G W T C D D C P I Z Z A R U M A Z O L F R I I A U I A W V U A C O O C E L R O Y M Y Y N N L Z E E L V X I I O S K M T O Z Q D A W B T O T A R T N C N U N A V C P R T B U A B Y I S X Y U S F A U L Y D U I M A K M Y K B M N Z P N U N B P Q I O E S B F N A C N R P U A O S Y U U U N D R O W S I N E S S E V N C I E H P S P S H C T P Y T J D C X A A N O E M I M L M V W E D A L N D W I R T U N M T L L K B W U K E J X Q F F O D M H Q B V S H Q C Y L U Q G X N M X O D J I I J Q I D L Z K K C A L D V H L V T T R S N U Z X O F D O W V Y N A A F A T R F T T G E S W E A T I N G H Q U Y C N K P W C D E

Find these words in the puzzle:

ABNORMAL PUPIL SIZE

CONFUSION

DIFFICULTY BREATHING

DROWSINESS

HALLUCINATIONS

NAUSEA

SEIZURES

SWEATING

UNCONSCIOUSNESS

UNSTEADINESS

VOMITING

Source: Created using online Puzzlemaker.

Symptoms of a Prescription Drug Overdose

D M S C M J K H H A N Y K H T S I V H U M I T S S E I Z U R E S A F S S N M Y B E R F G E Y N G F D X L Y Z Z E K R K A C Z H F U N N O C S L L C C G N M K J B C I T T I I I X E U P J S Z T S M A H N M T G W T C D D C P I Z Z A R U M A Z O L F R I I A U I A W V U A C O O C E L R O Y M Y Y N N L Z E E L V X I I O S K M T O Z Q D A W B T O T A R T N C N U N A V C P R T B U A B Y I S X Y U S F A U L Y D U I M A K M Y K B M N Z P N U N B P Q I O E S B F N A C N R P U A O S Y U U U N D R O W S I N E S S E V N C I E H P S P S H C T P Y T J D C X A A N O E M I M L M V W E D A L N D W I R T U N M T L L K B W U K E J X Q F F O D M H Q B V S H Q C Y L U Q G X N M X O D J I I J Q I D L Z K K C A L D V H L V T T R S N U Z X O F D O W V Y N A A F A T R F T T G E S W E A T I N G H Q U Y C N K P W C D E

Find these words in the puzzle:

ABNORMAL PUPIL SIZE

CONFUSION

DIFFICULTY BREATHING

DROWSINESS

HALLUCINATIONS

NAUSEA

SEIZURES

SWEATING

UNCONSCIOUSNESS

UNSTEADINESS

VOMITING

Source: Created using online Puzzlemaker.