Prescription for Danger

by Kevin T. Collopy, BA, FP-C, CCEMT-P, NREMT-P, WEMT and Greg Friese, MS, NREMT-P
Created:

Prescription drug abuse is rampant among today’s adolescents; here’s what you need to know about this epidemic


REFERENCES

1. National Institute on Drug Abuse, Prescription Drug Abuse Chart. www.nida.nih.gov/DrugPages/PrescripDrugsChart.html.

2. Association of State and Territorial Health Officials. Prescription Drug Overdose: State Health Agencies Respond, Arlington, VA.

3. Hertz JA., Knight JR. Prescription drug misuse: A growing national problem. Adolescent Medicine Clinics 17(3):751, October 2006.

4. National Institute on Drug Abuse for Teens, Prescription Drug Abuse. http://teens.drugabuse.gov/facts/facts_rx1.php.

5. Office of National Drug Control Policy Executive, Office of the President. Teens and Prescription Drugs, http://www.theantidrug.com/pdfs/TEENS_AND_PRESCRIPTION_DRUGS.pdf.

6. Meehan WJ. Opioid abuse. http://emedicine.medscape.com/article/287790-overview.

7. Mantooth Robin. Benzodiazepine toxicity. http://emedicine.medscape.com/article/813255-overview.

8. National Institute on Drug Abuse for Teens. Stimulants. http://teens.drugabuse.gov/facts/facts_stim1.php.

9. Mayo Clinic. Prescription Drug Abuse Symptoms. http://www.mayoclinic.com/health/prescription-drug-abuse/DS01079/DSECTION=symptoms.

10. Larson MF. Amphetamine-related psychiatric disorders. http://emedicine.medscape.com/article/289973-overview.

11. Handly N. Amphetamine toxicity, http://emedicine.medscape.com/article/812518-overview.

12. Casa DJ, Armstrong LE, Ganio MS, Yeargin SW. Exertional heat stroke in competitive athletes. Competitive Sports and Pain Management, 4(6): 309-317, 2005.

Table 1: Percentage of High School Students Misusing Prescription Drugs by Type, 20053
Drug 8th Grade 10th Grade 12th Grade
*N/R=not reported
Oxycontin 1.8 3.2 5.5
Hydrocodone 2.6 5.9 9.5
Amphetamines 5 8 9
Tranquilizers 2.8 4.8 6.8
Sedatives N/R N/R 7.2

 

Table 2: Signs and Symptoms of Abuse of Different Prescription Drugs3,10,11
DRUG PHYSICAL EFFECT OF MISUSE (SUBACUTE) TOXIC EFFECT (ACUTE) WITHDRAWAL (NONACUTE) LABORATORY TESTING
Opioids Euphoria, sedation, constipation, ulcers, respiratory depression Depression, miosis, pulmonary edema, hypotension, respiratory arrest Restlessness, insomnia, tremors, twitching, lacrimation, skin flushing, diaphoresis, nausea, vomiting, tachycardia, hypertension, fever Can be detected for several days after last use
Stimulants and Amphetamines Euphoria, self-confidence, excitement, agitation, impaired judgment, increased concentration and alertness, psychosis, delirium, mania, anxiety, paranoia, confusion, hallucinations, weight loss, hypertension, insomnia, tachycardia or bradycardia, dilated pupils, chills, nausea/vomiting, chest pain, cardiac dysrhythmias Restlessness, insomnia, tremors, seizure, coma, mood irritability, diaphoresis, risk for intracranial hemorrhage, palpitations, dry mouth, chest pain, hyperthermia, diastolic hypertension, hypertensive crisis, dysrhythmia including ventricular tachycardia, diarrhea, painful rashes Mood swings, depression, suicidal ideations, increased appetite, drug craving, exhaustion, increased sleeping, vivid dreams Detected in urine three hours to three days following ingestion
Tranquilizers Drowsiness, ataxia, dizziness, memory impairment, psychomotor changes, paradoxical reaction of agitation Often occurs with co-consumption of alcohol; sedation, dysarthria, nystagmus, blurred vision, paresthesia Insomnia, hypersensitivity to light and sound, irritability, twitching, confusion, delirium, seizures, tachycardia Can be detected in urine several weeks following ingestion
Sedatives Slurred speech, unsteady gait, impaired judgment and agitation, disinhibited behaviors, drowsiness, dizziness, confusion, blurred vision, amnesia Nystagmus, ataxia, confusion, emotional lability, decreased corneal reflexes, unresponsiveness or coma, respiratory depression, poor temperature regulation Restlessness, tremors, hyperactive reflexes, insomnia, anxiety, hallucinations, delirium, cramps, seizures, nausea, vomiting Detected in both urine and serum testing

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