8144DV
ISBN-13 978-1-55548-862-8
PRESCRIPTION DRUGS UPDATE
DVD Version
PrescriPtion Drugs uPDate
Credits
Human relations meDia PrescriPtion Drugs uPDate
Copyright 2011Human Relations Media Inc
Executive Producer
Anson W Schloat
Producer
John OrsquoNeill
Consultants
Scott DuvaTrumbull Police Department
Tom JannetteCT Narcotic Enforcement Officers Association
Allison FultonHousatonic Valley Coalition Against Substance Abuse
Teacherrsquos Resource Book
Celine Provini
PrescriPtion Drugs uPDate
table of Contents
Human relations meDia PrescriPtion Drugs uPDate
DVD Menu iIntroduction 1Learning Objectives 2Program Summary 3PrePost Test Answer Key 4Note to the Teacher 5
Student Activities 1 PrePost Test 7 2 Empty Promises 9 3 Class Debates 12 4 Research Project 13 5 Think Again 15 6 Media Blitz 16 7 The Lives behind the Statistics 17 8 Drug Abuse Fortune Teller 18 9 Donrsquot Be a Lab Rat 19 10 The Slippery Slope 20 11 Dear Answer Guy 22 12 Polypharmacy in the News 23
Fact Sheets 1 Prescription Drugs FAQs 24 2 Stimulants 26 3 Opioid Painkillers 27 4 CNS Depressants 28 5 The Stages of Addiction 29 6 Tolerance Withdrawal and Relapse 30 7 Dangers of Polypharmacy 31 8 Internet Pharmacies 32 9 Legal Consequences of Prescription Drug Abuse 33 10 Taking Medications Safely 34 11 What Can I Do 35 12 Signs of Overdose 36 13 Helpful Resources 37 14 Bibliography 39Other Programs from Human Relations Media 40
i
PrescriPtion Drugs uPDate
dVd Menu
Human relations meDia PrescriPtion Drugs uPDate
MAIN MENU
d Playd Play with Spanish Subtitles
This option allows you to view the program with Spanish subtitles Subtitles are enableddisabled by selecting a button on the DVD player remote or by using the remote to select subtitles from the menu button
d Chapter Selection
From here you can access many different paths of the DVD beginning with the introduction and ending with the credits
1 Introduction
2 Prescription Drug Abuse
3 Opiates Depressants Stimulants
4 Dealing with Addiction
5 Emotional Effects
6 Conclusion
d Teacherrsquos Resource BookA printable file of the accompanying Teacherrsquos Resource Book is available on the DVD Load the DVD onto a computer that has a DVD-ROM and Adobe Acrobat Reader
For PC users From the ldquoStartrdquo menu click on ldquoMy Computerrdquo then right click on your DVD disk drive and select ldquoExplorerdquo Double click on the PDF document to open the Teacherrsquos Resource Book
For Mac users In ldquoFinderrdquo click on the DVD under ldquoDevicesrdquo Then click on the PDF document to open the Teacherrsquos Resource Book
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
introduCtion
1
Concerned adults might worry about teens getting mixed up with drugs like alcohol tobacco or marijuana but they may not realize that another type of drug poses an even greater danger to young peoplemdashnamely prescription drugs In fact the average teen is more likely to abuse these substances than any illegal drug Prescription drugs are legal and easy to obtain When misused they are also potentially deadly Many teens are unaware of the threat posed by these drugs mistakenly assuming that any product that comes from a pharmacy canrsquot be too dangerous They couldnrsquot be more wrong Prescription drug abuse means taking a medication that was prescribed for someone else or taking a medication for reasons other than the purpose the drug was intended for or intentionally taking a higher dose than recommended Far from being a ldquosaferdquo high prescription drugs can cause a number of adverse reactions such as vomiting rapid heart rate high blood pressure depressed breathing overdose and even death In the past 10 years prescription drugs have been responsible for a soaring number of accidental deaths In fact in 2010 the US Centers for Disease Control reported that fatalities from prescription drug overdoses had become the second leading cause of accidental death in the countrymdashsecond only to car crashes Prescription drugs can also be highly addictive Young addicts may throw away their money relationships futures and even their lives in pursuit of getting high One category of frequently abused medication is opioid painkillers such as Vicodinreg or OxyContinreg Another type is depressants like Valiumreg and Xanaxreg These are commonly used to treat anxiety and sleep disorders A third type is stimulants such as Ritalinreg or Adderallreg which are commonly prescribed for attention deficit-hyperactivity disorder All three classes of medication can have serious side effects including overdose and death The dangers multiply when abusers combine different types of drugs to get high sharply increasing the risk of complications According to the 2009 National Youth Risk Behavior Survey prescription drug abuse is on the rise One in five teens reported using a prescription drug without doctorrsquos orders One reason for the increase is the mistaken belief that legal medication poses no threat even when taken to get high Another even more worrisome reason is the ease of obtaining these drugs The Partnership for a Drug-Free America study found that three in five teens say that prescription pain medications are easy to get from their parentsrsquo medicine cabinets and half of teens surveyed said they could get prescription drugs immediately anywhere Prescription Drug Update teaches teens exactly what is at stake if they abuse legal medications Medical and legal experts explain the health risks involved with drug abuse Viewers also hear from a group of young recovering prescription drug addicts These teens describe how their drug abuse started out as fun but quickly progressed into addiction overdose struggles with rehab centers and serious damage to their relationships with family and friends Through their powerful stories and the hard-hitting truth about the medical risks young people will come away armed with the facts they need to resist the trap of prescription drug abuse
PrescriPtion Drugs uPDate
learning objeCtiVes
PrescriPtion Drugs uPDate Human relations meDia2
After viewing the video Prescription Drugs Update and participating in the activities included in this Teacherrsquos Resource Book your students will be able to
d understand the difference between responsible and irresponsible use of prescription drugs
d distinguish among the three major classes of commonly abused medications opioid painkillers central nervous system depressants and stimulant drugs
d describe side effects and dangers of these medications
d explain why using prescription stimulants as ldquoperformance enhancersrdquo is misguided and dangerous
d understand how addiction develops in stages and how tolerance withdrawal and relapse relate to addiction
d discuss the risks of obtaining medications from illegal rogue Internet pharmacies
d explain the dangers of polypharmacy including additive and synergistic drug effects
d understand that sharing prescription drugs with others is hazardous as well as illegal
d spot the warning signs of someone elsersquos prescription and OTC drug abuse
d relate to real stories of youth like themselves who have experienced serious consequences as a result of abusing prescription drugs
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
3
The program opens with a montage of advertisements for prescription drugs A chorus of voices share some commonly held public perceptions of these medications ldquoThey seem clean and safehellipThey come by way of an authority that we generally trusthellipItrsquos in every magazine itrsquos on television every single dayhellipHow can they possibly hurt yourdquo On-camera expertsmdashincluding a narcotics enforcement representative a police officer and a prevention professionalmdashtell viewers that prescription medications should be taken only under the supervision of a doctor When individuals take pills not prescribed specifically for them they run the risk of an allergic reaction or worsemdashaddiction possible overdose and death Further possessing medications that are ldquocontrolled substancesrdquo without a valid prescription is illegal The police officer notes that when misused prescription drugs are no safer than illicit or illegal street drugs Several teens discuss how they fell into the addiction trap with prescription drugs Some began using medications for legitimate medical reasons others intentionally misused them in order to get high The young people agree that they underestimated the addictive dangers of these substances Expert commentators note some of the unpleasant consequences of misusing prescription drugs Side effects and toxic events can include choking rash vomiting racing heart and depressed breathing Withdrawal symptoms can include bone and body aches and cold sweats Next a graphic identifies the three major classes of commonly abused prescription medications opioid pain relievers central nervous system depressants used to treat anxiety and insomnia and stimulants used to treat attention deficit hyperactivity disorder and narcolepsy The narrator explains the dangers of taking high doses of these medications For opioids and central nervous system depressants dangers include severe respiratory depression For stimulants dangers include high blood pressure heart rate and body temperature The experts and teens move on to the dangers of mixing prescription medications In combination certain types of drugs can react to each other causing a buildup of substances that becomes too much for the body to process Abusers can end up in the hospital overdose on the drugs and even die One of the young people describes it this way ldquoI had friends pass out in front of me I had this one my best friend Hersquos alive but he was clinically dead for like five minutesrdquo The experts then point out the similarity between some prescription medications and illegal street drugs ldquoPrescription painkillers are just as addictive as heroinrdquo says one of the teens ldquoAnything you can get in the street you can get in the pharmacyrdquo says another youth panelist The prevention expert agrees ldquoIf you become addicted to painkillers and all of a sudden you canrsquot get them anymore or theyrsquore too costly you may seek out other alternatives that are street drugsrdquo
PrograM suMMary
PrescriPtion Drugs uPDate Human relations meDia
PrescriPtion Drugs uPDate
4
The teens then discuss the devastating consequences of their addictions Says one ldquoI ended up robbing people Irsquove taken peoplersquos money and left them in the city in the back of a bar at two orsquoclock in the morningrdquo The teens describe entering rehab multiple times only to relapse and begin abusing the drug again The experts describe the pain and difficulty of withdrawal symptoms ldquoYoursquore sick for days Itrsquos vomiting fever chills body aches bone aches and the list goes onrdquo Drug use also had a profound impact on many of the teensrsquo families One young woman lost both her mother and stepfather to overdoses ldquoPrescription drugs tore my family apart I got custody of my two sisters at 19rdquo Another notes that his drug abuse caused him to lose his familyrsquos trust ldquoEvery time yoursquore at dinner or something like that yoursquoll look up and everybody will just be looking at you to see if yoursquore highrdquo Another adds ldquoIt definitely changed the way my parents feel about me I came home and I canrsquot live here nowrdquo A third teen explains ldquoTherersquos no more asking to use the carhellipbecause nobody trusts you And you canrsquot really earn that backrdquo For many of the teens prescription drug addiction also caused them to be expelled from high school or college ldquoTherersquos no way Irsquom going to be able to go to collegerdquo says one young man ldquoAnd I canrsquot even join the service or anything You know recruiters laugh at me when I walk in Theyrsquore like lsquoDude no way manmdashyoursquove got narcotics chargesrsquordquo When asked what message they hope other teens learn from viewing this program one young person says ldquoIf your goal is to disappoint your family and to go rob and steal and everythingmdashbecause thatrsquos what itrsquos going to lead tomdashthenhellipgo ahead [and abuse prescription drugs] But if thatrsquos not what you want in life donrsquot even pick it uprdquo The prevention expert adds ldquoThe message to teens is if yoursquore not [misusing prescription drugs] and you havenrsquot used them yet please do not use them If you know somebody who is try to help him or her learn other coping skills Seek the counsel or resources that you need to get off themrdquo The program closes with a montage of celebrities who have died from drug overdoses The narcotic enforcement representative urges young people to make better choices than these adults who despite their great fame made serious and ultimately fatal mistakes in their lives
PrePost Test Answer Key
1 b2 c3 a4 b5 d6 d7 d8 a9 c
10 d
PrograM suMMary Continued
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
5
General Note
Discussing prescription drug abuse with your students can be a difficult balancing act The aim of this Teacherrsquos Resource Book is to expand upon the content introduced in the video by offering a range of prevention education materials and to encourage your students to resist peer pressure and experimentation
However there is the risk that some students might be tempted to use the information provided here as a ldquoroad maprdquo steering them toward experimentation rather than as a STOP sign warning them to steer clear
As much as you need to alert your students to the risks and dangers of these medicines you must also avoid inadvertently giving teens the kind of information that may lead them to experiment with pharmaceuticals This difficulty is magnified by the fact that these legal drugs are readily available to many young people Young people often must look no further than their home medicine cabinet
Note on Specific Content
Every class is different in terms of maturity and critical thinking skills Therefore every teacher should carefully assess his or her classrsquos maturity level before participating in the activities included in this Teacherrsquos Resource Book Teachers are encouraged to read each activity and fact sheet thoroughly and use only those that are appropriate for their students
Many of the fact sheets provided will allow you to explore the dangers of prescription drugs without revealing specific details about how these medicines are abused However the age and maturity of your students should be considered when determining which sheets are appropriate for your class
The following pages reveal some details about how medications may be abused or require Internet research that could reveal these details (specific website suggestions are always provided to avoid this possibility allowing ldquosurfingrdquo beyond these sites is not recommended) These pages should therefore be carefully evaluated before classroom use
Activity 2 Empty PromisesActivity 10 The Slippery SlopeActivity 12 Polypharmacy in the NewsFact Sheet 2 StimulantsFact Sheet 3 Opioid PainkillersFact Sheet 4 CNS DepressantsFact Sheet 7 Dangers of PolypharmacyFact Sheet 8 Internet Pharmacies
note to the teaCher
PrescriPtion Drugs uPDate Human relations meDia
This page has been left blank intentionally
PrescriPtion Drugs uPDate
6
STUDENT ACTIVITIES
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
7
PrePost test
activity 1a
1 Which of the following types of medications are not among the most commonly abused prescription drugs
a) opioid pain medications b) antidepressants c) anti-anxiety medications d) medications for attention deficit hyperactivity disorder
2 Being addicted to which type of prescription drug increases a personrsquos risk of abusing heroin
a) anti-anxiety medications b) medications for attention deficit hyperactivity disorder c) opioid pain medications d) antidepressants
3 If someone addicted to prescription drugs is vomiting and has a fever chills and body aches the person is probably experiencing ____________
a) withdrawal b) an allergic reaction c) a stomach virus d) a placebo effect
4 Drugs like Ritalinreg and Adderallreg ___________ a personrsquos heart rate while drugs like Valiumreg and Xanaxreg ___________ a personrsquos heart rate
a) do not affect do affect b) speed up slow down c) decrease increase d) do affect do not affect
5 Depressants are often prescribed to treat _____________
a) hyperactivity b) depression c) insomnia d) anxiety
This activity is continued on the next page
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
PrescriPtion Drugs uPDate
Credits
Human relations meDia PrescriPtion Drugs uPDate
Copyright 2011Human Relations Media Inc
Executive Producer
Anson W Schloat
Producer
John OrsquoNeill
Consultants
Scott DuvaTrumbull Police Department
Tom JannetteCT Narcotic Enforcement Officers Association
Allison FultonHousatonic Valley Coalition Against Substance Abuse
Teacherrsquos Resource Book
Celine Provini
PrescriPtion Drugs uPDate
table of Contents
Human relations meDia PrescriPtion Drugs uPDate
DVD Menu iIntroduction 1Learning Objectives 2Program Summary 3PrePost Test Answer Key 4Note to the Teacher 5
Student Activities 1 PrePost Test 7 2 Empty Promises 9 3 Class Debates 12 4 Research Project 13 5 Think Again 15 6 Media Blitz 16 7 The Lives behind the Statistics 17 8 Drug Abuse Fortune Teller 18 9 Donrsquot Be a Lab Rat 19 10 The Slippery Slope 20 11 Dear Answer Guy 22 12 Polypharmacy in the News 23
Fact Sheets 1 Prescription Drugs FAQs 24 2 Stimulants 26 3 Opioid Painkillers 27 4 CNS Depressants 28 5 The Stages of Addiction 29 6 Tolerance Withdrawal and Relapse 30 7 Dangers of Polypharmacy 31 8 Internet Pharmacies 32 9 Legal Consequences of Prescription Drug Abuse 33 10 Taking Medications Safely 34 11 What Can I Do 35 12 Signs of Overdose 36 13 Helpful Resources 37 14 Bibliography 39Other Programs from Human Relations Media 40
i
PrescriPtion Drugs uPDate
dVd Menu
Human relations meDia PrescriPtion Drugs uPDate
MAIN MENU
d Playd Play with Spanish Subtitles
This option allows you to view the program with Spanish subtitles Subtitles are enableddisabled by selecting a button on the DVD player remote or by using the remote to select subtitles from the menu button
d Chapter Selection
From here you can access many different paths of the DVD beginning with the introduction and ending with the credits
1 Introduction
2 Prescription Drug Abuse
3 Opiates Depressants Stimulants
4 Dealing with Addiction
5 Emotional Effects
6 Conclusion
d Teacherrsquos Resource BookA printable file of the accompanying Teacherrsquos Resource Book is available on the DVD Load the DVD onto a computer that has a DVD-ROM and Adobe Acrobat Reader
For PC users From the ldquoStartrdquo menu click on ldquoMy Computerrdquo then right click on your DVD disk drive and select ldquoExplorerdquo Double click on the PDF document to open the Teacherrsquos Resource Book
For Mac users In ldquoFinderrdquo click on the DVD under ldquoDevicesrdquo Then click on the PDF document to open the Teacherrsquos Resource Book
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
introduCtion
1
Concerned adults might worry about teens getting mixed up with drugs like alcohol tobacco or marijuana but they may not realize that another type of drug poses an even greater danger to young peoplemdashnamely prescription drugs In fact the average teen is more likely to abuse these substances than any illegal drug Prescription drugs are legal and easy to obtain When misused they are also potentially deadly Many teens are unaware of the threat posed by these drugs mistakenly assuming that any product that comes from a pharmacy canrsquot be too dangerous They couldnrsquot be more wrong Prescription drug abuse means taking a medication that was prescribed for someone else or taking a medication for reasons other than the purpose the drug was intended for or intentionally taking a higher dose than recommended Far from being a ldquosaferdquo high prescription drugs can cause a number of adverse reactions such as vomiting rapid heart rate high blood pressure depressed breathing overdose and even death In the past 10 years prescription drugs have been responsible for a soaring number of accidental deaths In fact in 2010 the US Centers for Disease Control reported that fatalities from prescription drug overdoses had become the second leading cause of accidental death in the countrymdashsecond only to car crashes Prescription drugs can also be highly addictive Young addicts may throw away their money relationships futures and even their lives in pursuit of getting high One category of frequently abused medication is opioid painkillers such as Vicodinreg or OxyContinreg Another type is depressants like Valiumreg and Xanaxreg These are commonly used to treat anxiety and sleep disorders A third type is stimulants such as Ritalinreg or Adderallreg which are commonly prescribed for attention deficit-hyperactivity disorder All three classes of medication can have serious side effects including overdose and death The dangers multiply when abusers combine different types of drugs to get high sharply increasing the risk of complications According to the 2009 National Youth Risk Behavior Survey prescription drug abuse is on the rise One in five teens reported using a prescription drug without doctorrsquos orders One reason for the increase is the mistaken belief that legal medication poses no threat even when taken to get high Another even more worrisome reason is the ease of obtaining these drugs The Partnership for a Drug-Free America study found that three in five teens say that prescription pain medications are easy to get from their parentsrsquo medicine cabinets and half of teens surveyed said they could get prescription drugs immediately anywhere Prescription Drug Update teaches teens exactly what is at stake if they abuse legal medications Medical and legal experts explain the health risks involved with drug abuse Viewers also hear from a group of young recovering prescription drug addicts These teens describe how their drug abuse started out as fun but quickly progressed into addiction overdose struggles with rehab centers and serious damage to their relationships with family and friends Through their powerful stories and the hard-hitting truth about the medical risks young people will come away armed with the facts they need to resist the trap of prescription drug abuse
PrescriPtion Drugs uPDate
learning objeCtiVes
PrescriPtion Drugs uPDate Human relations meDia2
After viewing the video Prescription Drugs Update and participating in the activities included in this Teacherrsquos Resource Book your students will be able to
d understand the difference between responsible and irresponsible use of prescription drugs
d distinguish among the three major classes of commonly abused medications opioid painkillers central nervous system depressants and stimulant drugs
d describe side effects and dangers of these medications
d explain why using prescription stimulants as ldquoperformance enhancersrdquo is misguided and dangerous
d understand how addiction develops in stages and how tolerance withdrawal and relapse relate to addiction
d discuss the risks of obtaining medications from illegal rogue Internet pharmacies
d explain the dangers of polypharmacy including additive and synergistic drug effects
d understand that sharing prescription drugs with others is hazardous as well as illegal
d spot the warning signs of someone elsersquos prescription and OTC drug abuse
d relate to real stories of youth like themselves who have experienced serious consequences as a result of abusing prescription drugs
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
3
The program opens with a montage of advertisements for prescription drugs A chorus of voices share some commonly held public perceptions of these medications ldquoThey seem clean and safehellipThey come by way of an authority that we generally trusthellipItrsquos in every magazine itrsquos on television every single dayhellipHow can they possibly hurt yourdquo On-camera expertsmdashincluding a narcotics enforcement representative a police officer and a prevention professionalmdashtell viewers that prescription medications should be taken only under the supervision of a doctor When individuals take pills not prescribed specifically for them they run the risk of an allergic reaction or worsemdashaddiction possible overdose and death Further possessing medications that are ldquocontrolled substancesrdquo without a valid prescription is illegal The police officer notes that when misused prescription drugs are no safer than illicit or illegal street drugs Several teens discuss how they fell into the addiction trap with prescription drugs Some began using medications for legitimate medical reasons others intentionally misused them in order to get high The young people agree that they underestimated the addictive dangers of these substances Expert commentators note some of the unpleasant consequences of misusing prescription drugs Side effects and toxic events can include choking rash vomiting racing heart and depressed breathing Withdrawal symptoms can include bone and body aches and cold sweats Next a graphic identifies the three major classes of commonly abused prescription medications opioid pain relievers central nervous system depressants used to treat anxiety and insomnia and stimulants used to treat attention deficit hyperactivity disorder and narcolepsy The narrator explains the dangers of taking high doses of these medications For opioids and central nervous system depressants dangers include severe respiratory depression For stimulants dangers include high blood pressure heart rate and body temperature The experts and teens move on to the dangers of mixing prescription medications In combination certain types of drugs can react to each other causing a buildup of substances that becomes too much for the body to process Abusers can end up in the hospital overdose on the drugs and even die One of the young people describes it this way ldquoI had friends pass out in front of me I had this one my best friend Hersquos alive but he was clinically dead for like five minutesrdquo The experts then point out the similarity between some prescription medications and illegal street drugs ldquoPrescription painkillers are just as addictive as heroinrdquo says one of the teens ldquoAnything you can get in the street you can get in the pharmacyrdquo says another youth panelist The prevention expert agrees ldquoIf you become addicted to painkillers and all of a sudden you canrsquot get them anymore or theyrsquore too costly you may seek out other alternatives that are street drugsrdquo
PrograM suMMary
PrescriPtion Drugs uPDate Human relations meDia
PrescriPtion Drugs uPDate
4
The teens then discuss the devastating consequences of their addictions Says one ldquoI ended up robbing people Irsquove taken peoplersquos money and left them in the city in the back of a bar at two orsquoclock in the morningrdquo The teens describe entering rehab multiple times only to relapse and begin abusing the drug again The experts describe the pain and difficulty of withdrawal symptoms ldquoYoursquore sick for days Itrsquos vomiting fever chills body aches bone aches and the list goes onrdquo Drug use also had a profound impact on many of the teensrsquo families One young woman lost both her mother and stepfather to overdoses ldquoPrescription drugs tore my family apart I got custody of my two sisters at 19rdquo Another notes that his drug abuse caused him to lose his familyrsquos trust ldquoEvery time yoursquore at dinner or something like that yoursquoll look up and everybody will just be looking at you to see if yoursquore highrdquo Another adds ldquoIt definitely changed the way my parents feel about me I came home and I canrsquot live here nowrdquo A third teen explains ldquoTherersquos no more asking to use the carhellipbecause nobody trusts you And you canrsquot really earn that backrdquo For many of the teens prescription drug addiction also caused them to be expelled from high school or college ldquoTherersquos no way Irsquom going to be able to go to collegerdquo says one young man ldquoAnd I canrsquot even join the service or anything You know recruiters laugh at me when I walk in Theyrsquore like lsquoDude no way manmdashyoursquove got narcotics chargesrsquordquo When asked what message they hope other teens learn from viewing this program one young person says ldquoIf your goal is to disappoint your family and to go rob and steal and everythingmdashbecause thatrsquos what itrsquos going to lead tomdashthenhellipgo ahead [and abuse prescription drugs] But if thatrsquos not what you want in life donrsquot even pick it uprdquo The prevention expert adds ldquoThe message to teens is if yoursquore not [misusing prescription drugs] and you havenrsquot used them yet please do not use them If you know somebody who is try to help him or her learn other coping skills Seek the counsel or resources that you need to get off themrdquo The program closes with a montage of celebrities who have died from drug overdoses The narcotic enforcement representative urges young people to make better choices than these adults who despite their great fame made serious and ultimately fatal mistakes in their lives
PrePost Test Answer Key
1 b2 c3 a4 b5 d6 d7 d8 a9 c
10 d
PrograM suMMary Continued
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
5
General Note
Discussing prescription drug abuse with your students can be a difficult balancing act The aim of this Teacherrsquos Resource Book is to expand upon the content introduced in the video by offering a range of prevention education materials and to encourage your students to resist peer pressure and experimentation
However there is the risk that some students might be tempted to use the information provided here as a ldquoroad maprdquo steering them toward experimentation rather than as a STOP sign warning them to steer clear
As much as you need to alert your students to the risks and dangers of these medicines you must also avoid inadvertently giving teens the kind of information that may lead them to experiment with pharmaceuticals This difficulty is magnified by the fact that these legal drugs are readily available to many young people Young people often must look no further than their home medicine cabinet
Note on Specific Content
Every class is different in terms of maturity and critical thinking skills Therefore every teacher should carefully assess his or her classrsquos maturity level before participating in the activities included in this Teacherrsquos Resource Book Teachers are encouraged to read each activity and fact sheet thoroughly and use only those that are appropriate for their students
Many of the fact sheets provided will allow you to explore the dangers of prescription drugs without revealing specific details about how these medicines are abused However the age and maturity of your students should be considered when determining which sheets are appropriate for your class
The following pages reveal some details about how medications may be abused or require Internet research that could reveal these details (specific website suggestions are always provided to avoid this possibility allowing ldquosurfingrdquo beyond these sites is not recommended) These pages should therefore be carefully evaluated before classroom use
Activity 2 Empty PromisesActivity 10 The Slippery SlopeActivity 12 Polypharmacy in the NewsFact Sheet 2 StimulantsFact Sheet 3 Opioid PainkillersFact Sheet 4 CNS DepressantsFact Sheet 7 Dangers of PolypharmacyFact Sheet 8 Internet Pharmacies
note to the teaCher
PrescriPtion Drugs uPDate Human relations meDia
This page has been left blank intentionally
PrescriPtion Drugs uPDate
6
STUDENT ACTIVITIES
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
7
PrePost test
activity 1a
1 Which of the following types of medications are not among the most commonly abused prescription drugs
a) opioid pain medications b) antidepressants c) anti-anxiety medications d) medications for attention deficit hyperactivity disorder
2 Being addicted to which type of prescription drug increases a personrsquos risk of abusing heroin
a) anti-anxiety medications b) medications for attention deficit hyperactivity disorder c) opioid pain medications d) antidepressants
3 If someone addicted to prescription drugs is vomiting and has a fever chills and body aches the person is probably experiencing ____________
a) withdrawal b) an allergic reaction c) a stomach virus d) a placebo effect
4 Drugs like Ritalinreg and Adderallreg ___________ a personrsquos heart rate while drugs like Valiumreg and Xanaxreg ___________ a personrsquos heart rate
a) do not affect do affect b) speed up slow down c) decrease increase d) do affect do not affect
5 Depressants are often prescribed to treat _____________
a) hyperactivity b) depression c) insomnia d) anxiety
This activity is continued on the next page
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
PrescriPtion Drugs uPDate
table of Contents
Human relations meDia PrescriPtion Drugs uPDate
DVD Menu iIntroduction 1Learning Objectives 2Program Summary 3PrePost Test Answer Key 4Note to the Teacher 5
Student Activities 1 PrePost Test 7 2 Empty Promises 9 3 Class Debates 12 4 Research Project 13 5 Think Again 15 6 Media Blitz 16 7 The Lives behind the Statistics 17 8 Drug Abuse Fortune Teller 18 9 Donrsquot Be a Lab Rat 19 10 The Slippery Slope 20 11 Dear Answer Guy 22 12 Polypharmacy in the News 23
Fact Sheets 1 Prescription Drugs FAQs 24 2 Stimulants 26 3 Opioid Painkillers 27 4 CNS Depressants 28 5 The Stages of Addiction 29 6 Tolerance Withdrawal and Relapse 30 7 Dangers of Polypharmacy 31 8 Internet Pharmacies 32 9 Legal Consequences of Prescription Drug Abuse 33 10 Taking Medications Safely 34 11 What Can I Do 35 12 Signs of Overdose 36 13 Helpful Resources 37 14 Bibliography 39Other Programs from Human Relations Media 40
i
PrescriPtion Drugs uPDate
dVd Menu
Human relations meDia PrescriPtion Drugs uPDate
MAIN MENU
d Playd Play with Spanish Subtitles
This option allows you to view the program with Spanish subtitles Subtitles are enableddisabled by selecting a button on the DVD player remote or by using the remote to select subtitles from the menu button
d Chapter Selection
From here you can access many different paths of the DVD beginning with the introduction and ending with the credits
1 Introduction
2 Prescription Drug Abuse
3 Opiates Depressants Stimulants
4 Dealing with Addiction
5 Emotional Effects
6 Conclusion
d Teacherrsquos Resource BookA printable file of the accompanying Teacherrsquos Resource Book is available on the DVD Load the DVD onto a computer that has a DVD-ROM and Adobe Acrobat Reader
For PC users From the ldquoStartrdquo menu click on ldquoMy Computerrdquo then right click on your DVD disk drive and select ldquoExplorerdquo Double click on the PDF document to open the Teacherrsquos Resource Book
For Mac users In ldquoFinderrdquo click on the DVD under ldquoDevicesrdquo Then click on the PDF document to open the Teacherrsquos Resource Book
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
introduCtion
1
Concerned adults might worry about teens getting mixed up with drugs like alcohol tobacco or marijuana but they may not realize that another type of drug poses an even greater danger to young peoplemdashnamely prescription drugs In fact the average teen is more likely to abuse these substances than any illegal drug Prescription drugs are legal and easy to obtain When misused they are also potentially deadly Many teens are unaware of the threat posed by these drugs mistakenly assuming that any product that comes from a pharmacy canrsquot be too dangerous They couldnrsquot be more wrong Prescription drug abuse means taking a medication that was prescribed for someone else or taking a medication for reasons other than the purpose the drug was intended for or intentionally taking a higher dose than recommended Far from being a ldquosaferdquo high prescription drugs can cause a number of adverse reactions such as vomiting rapid heart rate high blood pressure depressed breathing overdose and even death In the past 10 years prescription drugs have been responsible for a soaring number of accidental deaths In fact in 2010 the US Centers for Disease Control reported that fatalities from prescription drug overdoses had become the second leading cause of accidental death in the countrymdashsecond only to car crashes Prescription drugs can also be highly addictive Young addicts may throw away their money relationships futures and even their lives in pursuit of getting high One category of frequently abused medication is opioid painkillers such as Vicodinreg or OxyContinreg Another type is depressants like Valiumreg and Xanaxreg These are commonly used to treat anxiety and sleep disorders A third type is stimulants such as Ritalinreg or Adderallreg which are commonly prescribed for attention deficit-hyperactivity disorder All three classes of medication can have serious side effects including overdose and death The dangers multiply when abusers combine different types of drugs to get high sharply increasing the risk of complications According to the 2009 National Youth Risk Behavior Survey prescription drug abuse is on the rise One in five teens reported using a prescription drug without doctorrsquos orders One reason for the increase is the mistaken belief that legal medication poses no threat even when taken to get high Another even more worrisome reason is the ease of obtaining these drugs The Partnership for a Drug-Free America study found that three in five teens say that prescription pain medications are easy to get from their parentsrsquo medicine cabinets and half of teens surveyed said they could get prescription drugs immediately anywhere Prescription Drug Update teaches teens exactly what is at stake if they abuse legal medications Medical and legal experts explain the health risks involved with drug abuse Viewers also hear from a group of young recovering prescription drug addicts These teens describe how their drug abuse started out as fun but quickly progressed into addiction overdose struggles with rehab centers and serious damage to their relationships with family and friends Through their powerful stories and the hard-hitting truth about the medical risks young people will come away armed with the facts they need to resist the trap of prescription drug abuse
PrescriPtion Drugs uPDate
learning objeCtiVes
PrescriPtion Drugs uPDate Human relations meDia2
After viewing the video Prescription Drugs Update and participating in the activities included in this Teacherrsquos Resource Book your students will be able to
d understand the difference between responsible and irresponsible use of prescription drugs
d distinguish among the three major classes of commonly abused medications opioid painkillers central nervous system depressants and stimulant drugs
d describe side effects and dangers of these medications
d explain why using prescription stimulants as ldquoperformance enhancersrdquo is misguided and dangerous
d understand how addiction develops in stages and how tolerance withdrawal and relapse relate to addiction
d discuss the risks of obtaining medications from illegal rogue Internet pharmacies
d explain the dangers of polypharmacy including additive and synergistic drug effects
d understand that sharing prescription drugs with others is hazardous as well as illegal
d spot the warning signs of someone elsersquos prescription and OTC drug abuse
d relate to real stories of youth like themselves who have experienced serious consequences as a result of abusing prescription drugs
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
3
The program opens with a montage of advertisements for prescription drugs A chorus of voices share some commonly held public perceptions of these medications ldquoThey seem clean and safehellipThey come by way of an authority that we generally trusthellipItrsquos in every magazine itrsquos on television every single dayhellipHow can they possibly hurt yourdquo On-camera expertsmdashincluding a narcotics enforcement representative a police officer and a prevention professionalmdashtell viewers that prescription medications should be taken only under the supervision of a doctor When individuals take pills not prescribed specifically for them they run the risk of an allergic reaction or worsemdashaddiction possible overdose and death Further possessing medications that are ldquocontrolled substancesrdquo without a valid prescription is illegal The police officer notes that when misused prescription drugs are no safer than illicit or illegal street drugs Several teens discuss how they fell into the addiction trap with prescription drugs Some began using medications for legitimate medical reasons others intentionally misused them in order to get high The young people agree that they underestimated the addictive dangers of these substances Expert commentators note some of the unpleasant consequences of misusing prescription drugs Side effects and toxic events can include choking rash vomiting racing heart and depressed breathing Withdrawal symptoms can include bone and body aches and cold sweats Next a graphic identifies the three major classes of commonly abused prescription medications opioid pain relievers central nervous system depressants used to treat anxiety and insomnia and stimulants used to treat attention deficit hyperactivity disorder and narcolepsy The narrator explains the dangers of taking high doses of these medications For opioids and central nervous system depressants dangers include severe respiratory depression For stimulants dangers include high blood pressure heart rate and body temperature The experts and teens move on to the dangers of mixing prescription medications In combination certain types of drugs can react to each other causing a buildup of substances that becomes too much for the body to process Abusers can end up in the hospital overdose on the drugs and even die One of the young people describes it this way ldquoI had friends pass out in front of me I had this one my best friend Hersquos alive but he was clinically dead for like five minutesrdquo The experts then point out the similarity between some prescription medications and illegal street drugs ldquoPrescription painkillers are just as addictive as heroinrdquo says one of the teens ldquoAnything you can get in the street you can get in the pharmacyrdquo says another youth panelist The prevention expert agrees ldquoIf you become addicted to painkillers and all of a sudden you canrsquot get them anymore or theyrsquore too costly you may seek out other alternatives that are street drugsrdquo
PrograM suMMary
PrescriPtion Drugs uPDate Human relations meDia
PrescriPtion Drugs uPDate
4
The teens then discuss the devastating consequences of their addictions Says one ldquoI ended up robbing people Irsquove taken peoplersquos money and left them in the city in the back of a bar at two orsquoclock in the morningrdquo The teens describe entering rehab multiple times only to relapse and begin abusing the drug again The experts describe the pain and difficulty of withdrawal symptoms ldquoYoursquore sick for days Itrsquos vomiting fever chills body aches bone aches and the list goes onrdquo Drug use also had a profound impact on many of the teensrsquo families One young woman lost both her mother and stepfather to overdoses ldquoPrescription drugs tore my family apart I got custody of my two sisters at 19rdquo Another notes that his drug abuse caused him to lose his familyrsquos trust ldquoEvery time yoursquore at dinner or something like that yoursquoll look up and everybody will just be looking at you to see if yoursquore highrdquo Another adds ldquoIt definitely changed the way my parents feel about me I came home and I canrsquot live here nowrdquo A third teen explains ldquoTherersquos no more asking to use the carhellipbecause nobody trusts you And you canrsquot really earn that backrdquo For many of the teens prescription drug addiction also caused them to be expelled from high school or college ldquoTherersquos no way Irsquom going to be able to go to collegerdquo says one young man ldquoAnd I canrsquot even join the service or anything You know recruiters laugh at me when I walk in Theyrsquore like lsquoDude no way manmdashyoursquove got narcotics chargesrsquordquo When asked what message they hope other teens learn from viewing this program one young person says ldquoIf your goal is to disappoint your family and to go rob and steal and everythingmdashbecause thatrsquos what itrsquos going to lead tomdashthenhellipgo ahead [and abuse prescription drugs] But if thatrsquos not what you want in life donrsquot even pick it uprdquo The prevention expert adds ldquoThe message to teens is if yoursquore not [misusing prescription drugs] and you havenrsquot used them yet please do not use them If you know somebody who is try to help him or her learn other coping skills Seek the counsel or resources that you need to get off themrdquo The program closes with a montage of celebrities who have died from drug overdoses The narcotic enforcement representative urges young people to make better choices than these adults who despite their great fame made serious and ultimately fatal mistakes in their lives
PrePost Test Answer Key
1 b2 c3 a4 b5 d6 d7 d8 a9 c
10 d
PrograM suMMary Continued
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
5
General Note
Discussing prescription drug abuse with your students can be a difficult balancing act The aim of this Teacherrsquos Resource Book is to expand upon the content introduced in the video by offering a range of prevention education materials and to encourage your students to resist peer pressure and experimentation
However there is the risk that some students might be tempted to use the information provided here as a ldquoroad maprdquo steering them toward experimentation rather than as a STOP sign warning them to steer clear
As much as you need to alert your students to the risks and dangers of these medicines you must also avoid inadvertently giving teens the kind of information that may lead them to experiment with pharmaceuticals This difficulty is magnified by the fact that these legal drugs are readily available to many young people Young people often must look no further than their home medicine cabinet
Note on Specific Content
Every class is different in terms of maturity and critical thinking skills Therefore every teacher should carefully assess his or her classrsquos maturity level before participating in the activities included in this Teacherrsquos Resource Book Teachers are encouraged to read each activity and fact sheet thoroughly and use only those that are appropriate for their students
Many of the fact sheets provided will allow you to explore the dangers of prescription drugs without revealing specific details about how these medicines are abused However the age and maturity of your students should be considered when determining which sheets are appropriate for your class
The following pages reveal some details about how medications may be abused or require Internet research that could reveal these details (specific website suggestions are always provided to avoid this possibility allowing ldquosurfingrdquo beyond these sites is not recommended) These pages should therefore be carefully evaluated before classroom use
Activity 2 Empty PromisesActivity 10 The Slippery SlopeActivity 12 Polypharmacy in the NewsFact Sheet 2 StimulantsFact Sheet 3 Opioid PainkillersFact Sheet 4 CNS DepressantsFact Sheet 7 Dangers of PolypharmacyFact Sheet 8 Internet Pharmacies
note to the teaCher
PrescriPtion Drugs uPDate Human relations meDia
This page has been left blank intentionally
PrescriPtion Drugs uPDate
6
STUDENT ACTIVITIES
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
7
PrePost test
activity 1a
1 Which of the following types of medications are not among the most commonly abused prescription drugs
a) opioid pain medications b) antidepressants c) anti-anxiety medications d) medications for attention deficit hyperactivity disorder
2 Being addicted to which type of prescription drug increases a personrsquos risk of abusing heroin
a) anti-anxiety medications b) medications for attention deficit hyperactivity disorder c) opioid pain medications d) antidepressants
3 If someone addicted to prescription drugs is vomiting and has a fever chills and body aches the person is probably experiencing ____________
a) withdrawal b) an allergic reaction c) a stomach virus d) a placebo effect
4 Drugs like Ritalinreg and Adderallreg ___________ a personrsquos heart rate while drugs like Valiumreg and Xanaxreg ___________ a personrsquos heart rate
a) do not affect do affect b) speed up slow down c) decrease increase d) do affect do not affect
5 Depressants are often prescribed to treat _____________
a) hyperactivity b) depression c) insomnia d) anxiety
This activity is continued on the next page
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
i
PrescriPtion Drugs uPDate
dVd Menu
Human relations meDia PrescriPtion Drugs uPDate
MAIN MENU
d Playd Play with Spanish Subtitles
This option allows you to view the program with Spanish subtitles Subtitles are enableddisabled by selecting a button on the DVD player remote or by using the remote to select subtitles from the menu button
d Chapter Selection
From here you can access many different paths of the DVD beginning with the introduction and ending with the credits
1 Introduction
2 Prescription Drug Abuse
3 Opiates Depressants Stimulants
4 Dealing with Addiction
5 Emotional Effects
6 Conclusion
d Teacherrsquos Resource BookA printable file of the accompanying Teacherrsquos Resource Book is available on the DVD Load the DVD onto a computer that has a DVD-ROM and Adobe Acrobat Reader
For PC users From the ldquoStartrdquo menu click on ldquoMy Computerrdquo then right click on your DVD disk drive and select ldquoExplorerdquo Double click on the PDF document to open the Teacherrsquos Resource Book
For Mac users In ldquoFinderrdquo click on the DVD under ldquoDevicesrdquo Then click on the PDF document to open the Teacherrsquos Resource Book
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
introduCtion
1
Concerned adults might worry about teens getting mixed up with drugs like alcohol tobacco or marijuana but they may not realize that another type of drug poses an even greater danger to young peoplemdashnamely prescription drugs In fact the average teen is more likely to abuse these substances than any illegal drug Prescription drugs are legal and easy to obtain When misused they are also potentially deadly Many teens are unaware of the threat posed by these drugs mistakenly assuming that any product that comes from a pharmacy canrsquot be too dangerous They couldnrsquot be more wrong Prescription drug abuse means taking a medication that was prescribed for someone else or taking a medication for reasons other than the purpose the drug was intended for or intentionally taking a higher dose than recommended Far from being a ldquosaferdquo high prescription drugs can cause a number of adverse reactions such as vomiting rapid heart rate high blood pressure depressed breathing overdose and even death In the past 10 years prescription drugs have been responsible for a soaring number of accidental deaths In fact in 2010 the US Centers for Disease Control reported that fatalities from prescription drug overdoses had become the second leading cause of accidental death in the countrymdashsecond only to car crashes Prescription drugs can also be highly addictive Young addicts may throw away their money relationships futures and even their lives in pursuit of getting high One category of frequently abused medication is opioid painkillers such as Vicodinreg or OxyContinreg Another type is depressants like Valiumreg and Xanaxreg These are commonly used to treat anxiety and sleep disorders A third type is stimulants such as Ritalinreg or Adderallreg which are commonly prescribed for attention deficit-hyperactivity disorder All three classes of medication can have serious side effects including overdose and death The dangers multiply when abusers combine different types of drugs to get high sharply increasing the risk of complications According to the 2009 National Youth Risk Behavior Survey prescription drug abuse is on the rise One in five teens reported using a prescription drug without doctorrsquos orders One reason for the increase is the mistaken belief that legal medication poses no threat even when taken to get high Another even more worrisome reason is the ease of obtaining these drugs The Partnership for a Drug-Free America study found that three in five teens say that prescription pain medications are easy to get from their parentsrsquo medicine cabinets and half of teens surveyed said they could get prescription drugs immediately anywhere Prescription Drug Update teaches teens exactly what is at stake if they abuse legal medications Medical and legal experts explain the health risks involved with drug abuse Viewers also hear from a group of young recovering prescription drug addicts These teens describe how their drug abuse started out as fun but quickly progressed into addiction overdose struggles with rehab centers and serious damage to their relationships with family and friends Through their powerful stories and the hard-hitting truth about the medical risks young people will come away armed with the facts they need to resist the trap of prescription drug abuse
PrescriPtion Drugs uPDate
learning objeCtiVes
PrescriPtion Drugs uPDate Human relations meDia2
After viewing the video Prescription Drugs Update and participating in the activities included in this Teacherrsquos Resource Book your students will be able to
d understand the difference between responsible and irresponsible use of prescription drugs
d distinguish among the three major classes of commonly abused medications opioid painkillers central nervous system depressants and stimulant drugs
d describe side effects and dangers of these medications
d explain why using prescription stimulants as ldquoperformance enhancersrdquo is misguided and dangerous
d understand how addiction develops in stages and how tolerance withdrawal and relapse relate to addiction
d discuss the risks of obtaining medications from illegal rogue Internet pharmacies
d explain the dangers of polypharmacy including additive and synergistic drug effects
d understand that sharing prescription drugs with others is hazardous as well as illegal
d spot the warning signs of someone elsersquos prescription and OTC drug abuse
d relate to real stories of youth like themselves who have experienced serious consequences as a result of abusing prescription drugs
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
3
The program opens with a montage of advertisements for prescription drugs A chorus of voices share some commonly held public perceptions of these medications ldquoThey seem clean and safehellipThey come by way of an authority that we generally trusthellipItrsquos in every magazine itrsquos on television every single dayhellipHow can they possibly hurt yourdquo On-camera expertsmdashincluding a narcotics enforcement representative a police officer and a prevention professionalmdashtell viewers that prescription medications should be taken only under the supervision of a doctor When individuals take pills not prescribed specifically for them they run the risk of an allergic reaction or worsemdashaddiction possible overdose and death Further possessing medications that are ldquocontrolled substancesrdquo without a valid prescription is illegal The police officer notes that when misused prescription drugs are no safer than illicit or illegal street drugs Several teens discuss how they fell into the addiction trap with prescription drugs Some began using medications for legitimate medical reasons others intentionally misused them in order to get high The young people agree that they underestimated the addictive dangers of these substances Expert commentators note some of the unpleasant consequences of misusing prescription drugs Side effects and toxic events can include choking rash vomiting racing heart and depressed breathing Withdrawal symptoms can include bone and body aches and cold sweats Next a graphic identifies the three major classes of commonly abused prescription medications opioid pain relievers central nervous system depressants used to treat anxiety and insomnia and stimulants used to treat attention deficit hyperactivity disorder and narcolepsy The narrator explains the dangers of taking high doses of these medications For opioids and central nervous system depressants dangers include severe respiratory depression For stimulants dangers include high blood pressure heart rate and body temperature The experts and teens move on to the dangers of mixing prescription medications In combination certain types of drugs can react to each other causing a buildup of substances that becomes too much for the body to process Abusers can end up in the hospital overdose on the drugs and even die One of the young people describes it this way ldquoI had friends pass out in front of me I had this one my best friend Hersquos alive but he was clinically dead for like five minutesrdquo The experts then point out the similarity between some prescription medications and illegal street drugs ldquoPrescription painkillers are just as addictive as heroinrdquo says one of the teens ldquoAnything you can get in the street you can get in the pharmacyrdquo says another youth panelist The prevention expert agrees ldquoIf you become addicted to painkillers and all of a sudden you canrsquot get them anymore or theyrsquore too costly you may seek out other alternatives that are street drugsrdquo
PrograM suMMary
PrescriPtion Drugs uPDate Human relations meDia
PrescriPtion Drugs uPDate
4
The teens then discuss the devastating consequences of their addictions Says one ldquoI ended up robbing people Irsquove taken peoplersquos money and left them in the city in the back of a bar at two orsquoclock in the morningrdquo The teens describe entering rehab multiple times only to relapse and begin abusing the drug again The experts describe the pain and difficulty of withdrawal symptoms ldquoYoursquore sick for days Itrsquos vomiting fever chills body aches bone aches and the list goes onrdquo Drug use also had a profound impact on many of the teensrsquo families One young woman lost both her mother and stepfather to overdoses ldquoPrescription drugs tore my family apart I got custody of my two sisters at 19rdquo Another notes that his drug abuse caused him to lose his familyrsquos trust ldquoEvery time yoursquore at dinner or something like that yoursquoll look up and everybody will just be looking at you to see if yoursquore highrdquo Another adds ldquoIt definitely changed the way my parents feel about me I came home and I canrsquot live here nowrdquo A third teen explains ldquoTherersquos no more asking to use the carhellipbecause nobody trusts you And you canrsquot really earn that backrdquo For many of the teens prescription drug addiction also caused them to be expelled from high school or college ldquoTherersquos no way Irsquom going to be able to go to collegerdquo says one young man ldquoAnd I canrsquot even join the service or anything You know recruiters laugh at me when I walk in Theyrsquore like lsquoDude no way manmdashyoursquove got narcotics chargesrsquordquo When asked what message they hope other teens learn from viewing this program one young person says ldquoIf your goal is to disappoint your family and to go rob and steal and everythingmdashbecause thatrsquos what itrsquos going to lead tomdashthenhellipgo ahead [and abuse prescription drugs] But if thatrsquos not what you want in life donrsquot even pick it uprdquo The prevention expert adds ldquoThe message to teens is if yoursquore not [misusing prescription drugs] and you havenrsquot used them yet please do not use them If you know somebody who is try to help him or her learn other coping skills Seek the counsel or resources that you need to get off themrdquo The program closes with a montage of celebrities who have died from drug overdoses The narcotic enforcement representative urges young people to make better choices than these adults who despite their great fame made serious and ultimately fatal mistakes in their lives
PrePost Test Answer Key
1 b2 c3 a4 b5 d6 d7 d8 a9 c
10 d
PrograM suMMary Continued
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
5
General Note
Discussing prescription drug abuse with your students can be a difficult balancing act The aim of this Teacherrsquos Resource Book is to expand upon the content introduced in the video by offering a range of prevention education materials and to encourage your students to resist peer pressure and experimentation
However there is the risk that some students might be tempted to use the information provided here as a ldquoroad maprdquo steering them toward experimentation rather than as a STOP sign warning them to steer clear
As much as you need to alert your students to the risks and dangers of these medicines you must also avoid inadvertently giving teens the kind of information that may lead them to experiment with pharmaceuticals This difficulty is magnified by the fact that these legal drugs are readily available to many young people Young people often must look no further than their home medicine cabinet
Note on Specific Content
Every class is different in terms of maturity and critical thinking skills Therefore every teacher should carefully assess his or her classrsquos maturity level before participating in the activities included in this Teacherrsquos Resource Book Teachers are encouraged to read each activity and fact sheet thoroughly and use only those that are appropriate for their students
Many of the fact sheets provided will allow you to explore the dangers of prescription drugs without revealing specific details about how these medicines are abused However the age and maturity of your students should be considered when determining which sheets are appropriate for your class
The following pages reveal some details about how medications may be abused or require Internet research that could reveal these details (specific website suggestions are always provided to avoid this possibility allowing ldquosurfingrdquo beyond these sites is not recommended) These pages should therefore be carefully evaluated before classroom use
Activity 2 Empty PromisesActivity 10 The Slippery SlopeActivity 12 Polypharmacy in the NewsFact Sheet 2 StimulantsFact Sheet 3 Opioid PainkillersFact Sheet 4 CNS DepressantsFact Sheet 7 Dangers of PolypharmacyFact Sheet 8 Internet Pharmacies
note to the teaCher
PrescriPtion Drugs uPDate Human relations meDia
This page has been left blank intentionally
PrescriPtion Drugs uPDate
6
STUDENT ACTIVITIES
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
7
PrePost test
activity 1a
1 Which of the following types of medications are not among the most commonly abused prescription drugs
a) opioid pain medications b) antidepressants c) anti-anxiety medications d) medications for attention deficit hyperactivity disorder
2 Being addicted to which type of prescription drug increases a personrsquos risk of abusing heroin
a) anti-anxiety medications b) medications for attention deficit hyperactivity disorder c) opioid pain medications d) antidepressants
3 If someone addicted to prescription drugs is vomiting and has a fever chills and body aches the person is probably experiencing ____________
a) withdrawal b) an allergic reaction c) a stomach virus d) a placebo effect
4 Drugs like Ritalinreg and Adderallreg ___________ a personrsquos heart rate while drugs like Valiumreg and Xanaxreg ___________ a personrsquos heart rate
a) do not affect do affect b) speed up slow down c) decrease increase d) do affect do not affect
5 Depressants are often prescribed to treat _____________
a) hyperactivity b) depression c) insomnia d) anxiety
This activity is continued on the next page
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
introduCtion
1
Concerned adults might worry about teens getting mixed up with drugs like alcohol tobacco or marijuana but they may not realize that another type of drug poses an even greater danger to young peoplemdashnamely prescription drugs In fact the average teen is more likely to abuse these substances than any illegal drug Prescription drugs are legal and easy to obtain When misused they are also potentially deadly Many teens are unaware of the threat posed by these drugs mistakenly assuming that any product that comes from a pharmacy canrsquot be too dangerous They couldnrsquot be more wrong Prescription drug abuse means taking a medication that was prescribed for someone else or taking a medication for reasons other than the purpose the drug was intended for or intentionally taking a higher dose than recommended Far from being a ldquosaferdquo high prescription drugs can cause a number of adverse reactions such as vomiting rapid heart rate high blood pressure depressed breathing overdose and even death In the past 10 years prescription drugs have been responsible for a soaring number of accidental deaths In fact in 2010 the US Centers for Disease Control reported that fatalities from prescription drug overdoses had become the second leading cause of accidental death in the countrymdashsecond only to car crashes Prescription drugs can also be highly addictive Young addicts may throw away their money relationships futures and even their lives in pursuit of getting high One category of frequently abused medication is opioid painkillers such as Vicodinreg or OxyContinreg Another type is depressants like Valiumreg and Xanaxreg These are commonly used to treat anxiety and sleep disorders A third type is stimulants such as Ritalinreg or Adderallreg which are commonly prescribed for attention deficit-hyperactivity disorder All three classes of medication can have serious side effects including overdose and death The dangers multiply when abusers combine different types of drugs to get high sharply increasing the risk of complications According to the 2009 National Youth Risk Behavior Survey prescription drug abuse is on the rise One in five teens reported using a prescription drug without doctorrsquos orders One reason for the increase is the mistaken belief that legal medication poses no threat even when taken to get high Another even more worrisome reason is the ease of obtaining these drugs The Partnership for a Drug-Free America study found that three in five teens say that prescription pain medications are easy to get from their parentsrsquo medicine cabinets and half of teens surveyed said they could get prescription drugs immediately anywhere Prescription Drug Update teaches teens exactly what is at stake if they abuse legal medications Medical and legal experts explain the health risks involved with drug abuse Viewers also hear from a group of young recovering prescription drug addicts These teens describe how their drug abuse started out as fun but quickly progressed into addiction overdose struggles with rehab centers and serious damage to their relationships with family and friends Through their powerful stories and the hard-hitting truth about the medical risks young people will come away armed with the facts they need to resist the trap of prescription drug abuse
PrescriPtion Drugs uPDate
learning objeCtiVes
PrescriPtion Drugs uPDate Human relations meDia2
After viewing the video Prescription Drugs Update and participating in the activities included in this Teacherrsquos Resource Book your students will be able to
d understand the difference between responsible and irresponsible use of prescription drugs
d distinguish among the three major classes of commonly abused medications opioid painkillers central nervous system depressants and stimulant drugs
d describe side effects and dangers of these medications
d explain why using prescription stimulants as ldquoperformance enhancersrdquo is misguided and dangerous
d understand how addiction develops in stages and how tolerance withdrawal and relapse relate to addiction
d discuss the risks of obtaining medications from illegal rogue Internet pharmacies
d explain the dangers of polypharmacy including additive and synergistic drug effects
d understand that sharing prescription drugs with others is hazardous as well as illegal
d spot the warning signs of someone elsersquos prescription and OTC drug abuse
d relate to real stories of youth like themselves who have experienced serious consequences as a result of abusing prescription drugs
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
3
The program opens with a montage of advertisements for prescription drugs A chorus of voices share some commonly held public perceptions of these medications ldquoThey seem clean and safehellipThey come by way of an authority that we generally trusthellipItrsquos in every magazine itrsquos on television every single dayhellipHow can they possibly hurt yourdquo On-camera expertsmdashincluding a narcotics enforcement representative a police officer and a prevention professionalmdashtell viewers that prescription medications should be taken only under the supervision of a doctor When individuals take pills not prescribed specifically for them they run the risk of an allergic reaction or worsemdashaddiction possible overdose and death Further possessing medications that are ldquocontrolled substancesrdquo without a valid prescription is illegal The police officer notes that when misused prescription drugs are no safer than illicit or illegal street drugs Several teens discuss how they fell into the addiction trap with prescription drugs Some began using medications for legitimate medical reasons others intentionally misused them in order to get high The young people agree that they underestimated the addictive dangers of these substances Expert commentators note some of the unpleasant consequences of misusing prescription drugs Side effects and toxic events can include choking rash vomiting racing heart and depressed breathing Withdrawal symptoms can include bone and body aches and cold sweats Next a graphic identifies the three major classes of commonly abused prescription medications opioid pain relievers central nervous system depressants used to treat anxiety and insomnia and stimulants used to treat attention deficit hyperactivity disorder and narcolepsy The narrator explains the dangers of taking high doses of these medications For opioids and central nervous system depressants dangers include severe respiratory depression For stimulants dangers include high blood pressure heart rate and body temperature The experts and teens move on to the dangers of mixing prescription medications In combination certain types of drugs can react to each other causing a buildup of substances that becomes too much for the body to process Abusers can end up in the hospital overdose on the drugs and even die One of the young people describes it this way ldquoI had friends pass out in front of me I had this one my best friend Hersquos alive but he was clinically dead for like five minutesrdquo The experts then point out the similarity between some prescription medications and illegal street drugs ldquoPrescription painkillers are just as addictive as heroinrdquo says one of the teens ldquoAnything you can get in the street you can get in the pharmacyrdquo says another youth panelist The prevention expert agrees ldquoIf you become addicted to painkillers and all of a sudden you canrsquot get them anymore or theyrsquore too costly you may seek out other alternatives that are street drugsrdquo
PrograM suMMary
PrescriPtion Drugs uPDate Human relations meDia
PrescriPtion Drugs uPDate
4
The teens then discuss the devastating consequences of their addictions Says one ldquoI ended up robbing people Irsquove taken peoplersquos money and left them in the city in the back of a bar at two orsquoclock in the morningrdquo The teens describe entering rehab multiple times only to relapse and begin abusing the drug again The experts describe the pain and difficulty of withdrawal symptoms ldquoYoursquore sick for days Itrsquos vomiting fever chills body aches bone aches and the list goes onrdquo Drug use also had a profound impact on many of the teensrsquo families One young woman lost both her mother and stepfather to overdoses ldquoPrescription drugs tore my family apart I got custody of my two sisters at 19rdquo Another notes that his drug abuse caused him to lose his familyrsquos trust ldquoEvery time yoursquore at dinner or something like that yoursquoll look up and everybody will just be looking at you to see if yoursquore highrdquo Another adds ldquoIt definitely changed the way my parents feel about me I came home and I canrsquot live here nowrdquo A third teen explains ldquoTherersquos no more asking to use the carhellipbecause nobody trusts you And you canrsquot really earn that backrdquo For many of the teens prescription drug addiction also caused them to be expelled from high school or college ldquoTherersquos no way Irsquom going to be able to go to collegerdquo says one young man ldquoAnd I canrsquot even join the service or anything You know recruiters laugh at me when I walk in Theyrsquore like lsquoDude no way manmdashyoursquove got narcotics chargesrsquordquo When asked what message they hope other teens learn from viewing this program one young person says ldquoIf your goal is to disappoint your family and to go rob and steal and everythingmdashbecause thatrsquos what itrsquos going to lead tomdashthenhellipgo ahead [and abuse prescription drugs] But if thatrsquos not what you want in life donrsquot even pick it uprdquo The prevention expert adds ldquoThe message to teens is if yoursquore not [misusing prescription drugs] and you havenrsquot used them yet please do not use them If you know somebody who is try to help him or her learn other coping skills Seek the counsel or resources that you need to get off themrdquo The program closes with a montage of celebrities who have died from drug overdoses The narcotic enforcement representative urges young people to make better choices than these adults who despite their great fame made serious and ultimately fatal mistakes in their lives
PrePost Test Answer Key
1 b2 c3 a4 b5 d6 d7 d8 a9 c
10 d
PrograM suMMary Continued
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
5
General Note
Discussing prescription drug abuse with your students can be a difficult balancing act The aim of this Teacherrsquos Resource Book is to expand upon the content introduced in the video by offering a range of prevention education materials and to encourage your students to resist peer pressure and experimentation
However there is the risk that some students might be tempted to use the information provided here as a ldquoroad maprdquo steering them toward experimentation rather than as a STOP sign warning them to steer clear
As much as you need to alert your students to the risks and dangers of these medicines you must also avoid inadvertently giving teens the kind of information that may lead them to experiment with pharmaceuticals This difficulty is magnified by the fact that these legal drugs are readily available to many young people Young people often must look no further than their home medicine cabinet
Note on Specific Content
Every class is different in terms of maturity and critical thinking skills Therefore every teacher should carefully assess his or her classrsquos maturity level before participating in the activities included in this Teacherrsquos Resource Book Teachers are encouraged to read each activity and fact sheet thoroughly and use only those that are appropriate for their students
Many of the fact sheets provided will allow you to explore the dangers of prescription drugs without revealing specific details about how these medicines are abused However the age and maturity of your students should be considered when determining which sheets are appropriate for your class
The following pages reveal some details about how medications may be abused or require Internet research that could reveal these details (specific website suggestions are always provided to avoid this possibility allowing ldquosurfingrdquo beyond these sites is not recommended) These pages should therefore be carefully evaluated before classroom use
Activity 2 Empty PromisesActivity 10 The Slippery SlopeActivity 12 Polypharmacy in the NewsFact Sheet 2 StimulantsFact Sheet 3 Opioid PainkillersFact Sheet 4 CNS DepressantsFact Sheet 7 Dangers of PolypharmacyFact Sheet 8 Internet Pharmacies
note to the teaCher
PrescriPtion Drugs uPDate Human relations meDia
This page has been left blank intentionally
PrescriPtion Drugs uPDate
6
STUDENT ACTIVITIES
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
7
PrePost test
activity 1a
1 Which of the following types of medications are not among the most commonly abused prescription drugs
a) opioid pain medications b) antidepressants c) anti-anxiety medications d) medications for attention deficit hyperactivity disorder
2 Being addicted to which type of prescription drug increases a personrsquos risk of abusing heroin
a) anti-anxiety medications b) medications for attention deficit hyperactivity disorder c) opioid pain medications d) antidepressants
3 If someone addicted to prescription drugs is vomiting and has a fever chills and body aches the person is probably experiencing ____________
a) withdrawal b) an allergic reaction c) a stomach virus d) a placebo effect
4 Drugs like Ritalinreg and Adderallreg ___________ a personrsquos heart rate while drugs like Valiumreg and Xanaxreg ___________ a personrsquos heart rate
a) do not affect do affect b) speed up slow down c) decrease increase d) do affect do not affect
5 Depressants are often prescribed to treat _____________
a) hyperactivity b) depression c) insomnia d) anxiety
This activity is continued on the next page
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
PrescriPtion Drugs uPDate
learning objeCtiVes
PrescriPtion Drugs uPDate Human relations meDia2
After viewing the video Prescription Drugs Update and participating in the activities included in this Teacherrsquos Resource Book your students will be able to
d understand the difference between responsible and irresponsible use of prescription drugs
d distinguish among the three major classes of commonly abused medications opioid painkillers central nervous system depressants and stimulant drugs
d describe side effects and dangers of these medications
d explain why using prescription stimulants as ldquoperformance enhancersrdquo is misguided and dangerous
d understand how addiction develops in stages and how tolerance withdrawal and relapse relate to addiction
d discuss the risks of obtaining medications from illegal rogue Internet pharmacies
d explain the dangers of polypharmacy including additive and synergistic drug effects
d understand that sharing prescription drugs with others is hazardous as well as illegal
d spot the warning signs of someone elsersquos prescription and OTC drug abuse
d relate to real stories of youth like themselves who have experienced serious consequences as a result of abusing prescription drugs
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
3
The program opens with a montage of advertisements for prescription drugs A chorus of voices share some commonly held public perceptions of these medications ldquoThey seem clean and safehellipThey come by way of an authority that we generally trusthellipItrsquos in every magazine itrsquos on television every single dayhellipHow can they possibly hurt yourdquo On-camera expertsmdashincluding a narcotics enforcement representative a police officer and a prevention professionalmdashtell viewers that prescription medications should be taken only under the supervision of a doctor When individuals take pills not prescribed specifically for them they run the risk of an allergic reaction or worsemdashaddiction possible overdose and death Further possessing medications that are ldquocontrolled substancesrdquo without a valid prescription is illegal The police officer notes that when misused prescription drugs are no safer than illicit or illegal street drugs Several teens discuss how they fell into the addiction trap with prescription drugs Some began using medications for legitimate medical reasons others intentionally misused them in order to get high The young people agree that they underestimated the addictive dangers of these substances Expert commentators note some of the unpleasant consequences of misusing prescription drugs Side effects and toxic events can include choking rash vomiting racing heart and depressed breathing Withdrawal symptoms can include bone and body aches and cold sweats Next a graphic identifies the three major classes of commonly abused prescription medications opioid pain relievers central nervous system depressants used to treat anxiety and insomnia and stimulants used to treat attention deficit hyperactivity disorder and narcolepsy The narrator explains the dangers of taking high doses of these medications For opioids and central nervous system depressants dangers include severe respiratory depression For stimulants dangers include high blood pressure heart rate and body temperature The experts and teens move on to the dangers of mixing prescription medications In combination certain types of drugs can react to each other causing a buildup of substances that becomes too much for the body to process Abusers can end up in the hospital overdose on the drugs and even die One of the young people describes it this way ldquoI had friends pass out in front of me I had this one my best friend Hersquos alive but he was clinically dead for like five minutesrdquo The experts then point out the similarity between some prescription medications and illegal street drugs ldquoPrescription painkillers are just as addictive as heroinrdquo says one of the teens ldquoAnything you can get in the street you can get in the pharmacyrdquo says another youth panelist The prevention expert agrees ldquoIf you become addicted to painkillers and all of a sudden you canrsquot get them anymore or theyrsquore too costly you may seek out other alternatives that are street drugsrdquo
PrograM suMMary
PrescriPtion Drugs uPDate Human relations meDia
PrescriPtion Drugs uPDate
4
The teens then discuss the devastating consequences of their addictions Says one ldquoI ended up robbing people Irsquove taken peoplersquos money and left them in the city in the back of a bar at two orsquoclock in the morningrdquo The teens describe entering rehab multiple times only to relapse and begin abusing the drug again The experts describe the pain and difficulty of withdrawal symptoms ldquoYoursquore sick for days Itrsquos vomiting fever chills body aches bone aches and the list goes onrdquo Drug use also had a profound impact on many of the teensrsquo families One young woman lost both her mother and stepfather to overdoses ldquoPrescription drugs tore my family apart I got custody of my two sisters at 19rdquo Another notes that his drug abuse caused him to lose his familyrsquos trust ldquoEvery time yoursquore at dinner or something like that yoursquoll look up and everybody will just be looking at you to see if yoursquore highrdquo Another adds ldquoIt definitely changed the way my parents feel about me I came home and I canrsquot live here nowrdquo A third teen explains ldquoTherersquos no more asking to use the carhellipbecause nobody trusts you And you canrsquot really earn that backrdquo For many of the teens prescription drug addiction also caused them to be expelled from high school or college ldquoTherersquos no way Irsquom going to be able to go to collegerdquo says one young man ldquoAnd I canrsquot even join the service or anything You know recruiters laugh at me when I walk in Theyrsquore like lsquoDude no way manmdashyoursquove got narcotics chargesrsquordquo When asked what message they hope other teens learn from viewing this program one young person says ldquoIf your goal is to disappoint your family and to go rob and steal and everythingmdashbecause thatrsquos what itrsquos going to lead tomdashthenhellipgo ahead [and abuse prescription drugs] But if thatrsquos not what you want in life donrsquot even pick it uprdquo The prevention expert adds ldquoThe message to teens is if yoursquore not [misusing prescription drugs] and you havenrsquot used them yet please do not use them If you know somebody who is try to help him or her learn other coping skills Seek the counsel or resources that you need to get off themrdquo The program closes with a montage of celebrities who have died from drug overdoses The narcotic enforcement representative urges young people to make better choices than these adults who despite their great fame made serious and ultimately fatal mistakes in their lives
PrePost Test Answer Key
1 b2 c3 a4 b5 d6 d7 d8 a9 c
10 d
PrograM suMMary Continued
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
5
General Note
Discussing prescription drug abuse with your students can be a difficult balancing act The aim of this Teacherrsquos Resource Book is to expand upon the content introduced in the video by offering a range of prevention education materials and to encourage your students to resist peer pressure and experimentation
However there is the risk that some students might be tempted to use the information provided here as a ldquoroad maprdquo steering them toward experimentation rather than as a STOP sign warning them to steer clear
As much as you need to alert your students to the risks and dangers of these medicines you must also avoid inadvertently giving teens the kind of information that may lead them to experiment with pharmaceuticals This difficulty is magnified by the fact that these legal drugs are readily available to many young people Young people often must look no further than their home medicine cabinet
Note on Specific Content
Every class is different in terms of maturity and critical thinking skills Therefore every teacher should carefully assess his or her classrsquos maturity level before participating in the activities included in this Teacherrsquos Resource Book Teachers are encouraged to read each activity and fact sheet thoroughly and use only those that are appropriate for their students
Many of the fact sheets provided will allow you to explore the dangers of prescription drugs without revealing specific details about how these medicines are abused However the age and maturity of your students should be considered when determining which sheets are appropriate for your class
The following pages reveal some details about how medications may be abused or require Internet research that could reveal these details (specific website suggestions are always provided to avoid this possibility allowing ldquosurfingrdquo beyond these sites is not recommended) These pages should therefore be carefully evaluated before classroom use
Activity 2 Empty PromisesActivity 10 The Slippery SlopeActivity 12 Polypharmacy in the NewsFact Sheet 2 StimulantsFact Sheet 3 Opioid PainkillersFact Sheet 4 CNS DepressantsFact Sheet 7 Dangers of PolypharmacyFact Sheet 8 Internet Pharmacies
note to the teaCher
PrescriPtion Drugs uPDate Human relations meDia
This page has been left blank intentionally
PrescriPtion Drugs uPDate
6
STUDENT ACTIVITIES
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
7
PrePost test
activity 1a
1 Which of the following types of medications are not among the most commonly abused prescription drugs
a) opioid pain medications b) antidepressants c) anti-anxiety medications d) medications for attention deficit hyperactivity disorder
2 Being addicted to which type of prescription drug increases a personrsquos risk of abusing heroin
a) anti-anxiety medications b) medications for attention deficit hyperactivity disorder c) opioid pain medications d) antidepressants
3 If someone addicted to prescription drugs is vomiting and has a fever chills and body aches the person is probably experiencing ____________
a) withdrawal b) an allergic reaction c) a stomach virus d) a placebo effect
4 Drugs like Ritalinreg and Adderallreg ___________ a personrsquos heart rate while drugs like Valiumreg and Xanaxreg ___________ a personrsquos heart rate
a) do not affect do affect b) speed up slow down c) decrease increase d) do affect do not affect
5 Depressants are often prescribed to treat _____________
a) hyperactivity b) depression c) insomnia d) anxiety
This activity is continued on the next page
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
3
The program opens with a montage of advertisements for prescription drugs A chorus of voices share some commonly held public perceptions of these medications ldquoThey seem clean and safehellipThey come by way of an authority that we generally trusthellipItrsquos in every magazine itrsquos on television every single dayhellipHow can they possibly hurt yourdquo On-camera expertsmdashincluding a narcotics enforcement representative a police officer and a prevention professionalmdashtell viewers that prescription medications should be taken only under the supervision of a doctor When individuals take pills not prescribed specifically for them they run the risk of an allergic reaction or worsemdashaddiction possible overdose and death Further possessing medications that are ldquocontrolled substancesrdquo without a valid prescription is illegal The police officer notes that when misused prescription drugs are no safer than illicit or illegal street drugs Several teens discuss how they fell into the addiction trap with prescription drugs Some began using medications for legitimate medical reasons others intentionally misused them in order to get high The young people agree that they underestimated the addictive dangers of these substances Expert commentators note some of the unpleasant consequences of misusing prescription drugs Side effects and toxic events can include choking rash vomiting racing heart and depressed breathing Withdrawal symptoms can include bone and body aches and cold sweats Next a graphic identifies the three major classes of commonly abused prescription medications opioid pain relievers central nervous system depressants used to treat anxiety and insomnia and stimulants used to treat attention deficit hyperactivity disorder and narcolepsy The narrator explains the dangers of taking high doses of these medications For opioids and central nervous system depressants dangers include severe respiratory depression For stimulants dangers include high blood pressure heart rate and body temperature The experts and teens move on to the dangers of mixing prescription medications In combination certain types of drugs can react to each other causing a buildup of substances that becomes too much for the body to process Abusers can end up in the hospital overdose on the drugs and even die One of the young people describes it this way ldquoI had friends pass out in front of me I had this one my best friend Hersquos alive but he was clinically dead for like five minutesrdquo The experts then point out the similarity between some prescription medications and illegal street drugs ldquoPrescription painkillers are just as addictive as heroinrdquo says one of the teens ldquoAnything you can get in the street you can get in the pharmacyrdquo says another youth panelist The prevention expert agrees ldquoIf you become addicted to painkillers and all of a sudden you canrsquot get them anymore or theyrsquore too costly you may seek out other alternatives that are street drugsrdquo
PrograM suMMary
PrescriPtion Drugs uPDate Human relations meDia
PrescriPtion Drugs uPDate
4
The teens then discuss the devastating consequences of their addictions Says one ldquoI ended up robbing people Irsquove taken peoplersquos money and left them in the city in the back of a bar at two orsquoclock in the morningrdquo The teens describe entering rehab multiple times only to relapse and begin abusing the drug again The experts describe the pain and difficulty of withdrawal symptoms ldquoYoursquore sick for days Itrsquos vomiting fever chills body aches bone aches and the list goes onrdquo Drug use also had a profound impact on many of the teensrsquo families One young woman lost both her mother and stepfather to overdoses ldquoPrescription drugs tore my family apart I got custody of my two sisters at 19rdquo Another notes that his drug abuse caused him to lose his familyrsquos trust ldquoEvery time yoursquore at dinner or something like that yoursquoll look up and everybody will just be looking at you to see if yoursquore highrdquo Another adds ldquoIt definitely changed the way my parents feel about me I came home and I canrsquot live here nowrdquo A third teen explains ldquoTherersquos no more asking to use the carhellipbecause nobody trusts you And you canrsquot really earn that backrdquo For many of the teens prescription drug addiction also caused them to be expelled from high school or college ldquoTherersquos no way Irsquom going to be able to go to collegerdquo says one young man ldquoAnd I canrsquot even join the service or anything You know recruiters laugh at me when I walk in Theyrsquore like lsquoDude no way manmdashyoursquove got narcotics chargesrsquordquo When asked what message they hope other teens learn from viewing this program one young person says ldquoIf your goal is to disappoint your family and to go rob and steal and everythingmdashbecause thatrsquos what itrsquos going to lead tomdashthenhellipgo ahead [and abuse prescription drugs] But if thatrsquos not what you want in life donrsquot even pick it uprdquo The prevention expert adds ldquoThe message to teens is if yoursquore not [misusing prescription drugs] and you havenrsquot used them yet please do not use them If you know somebody who is try to help him or her learn other coping skills Seek the counsel or resources that you need to get off themrdquo The program closes with a montage of celebrities who have died from drug overdoses The narcotic enforcement representative urges young people to make better choices than these adults who despite their great fame made serious and ultimately fatal mistakes in their lives
PrePost Test Answer Key
1 b2 c3 a4 b5 d6 d7 d8 a9 c
10 d
PrograM suMMary Continued
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
5
General Note
Discussing prescription drug abuse with your students can be a difficult balancing act The aim of this Teacherrsquos Resource Book is to expand upon the content introduced in the video by offering a range of prevention education materials and to encourage your students to resist peer pressure and experimentation
However there is the risk that some students might be tempted to use the information provided here as a ldquoroad maprdquo steering them toward experimentation rather than as a STOP sign warning them to steer clear
As much as you need to alert your students to the risks and dangers of these medicines you must also avoid inadvertently giving teens the kind of information that may lead them to experiment with pharmaceuticals This difficulty is magnified by the fact that these legal drugs are readily available to many young people Young people often must look no further than their home medicine cabinet
Note on Specific Content
Every class is different in terms of maturity and critical thinking skills Therefore every teacher should carefully assess his or her classrsquos maturity level before participating in the activities included in this Teacherrsquos Resource Book Teachers are encouraged to read each activity and fact sheet thoroughly and use only those that are appropriate for their students
Many of the fact sheets provided will allow you to explore the dangers of prescription drugs without revealing specific details about how these medicines are abused However the age and maturity of your students should be considered when determining which sheets are appropriate for your class
The following pages reveal some details about how medications may be abused or require Internet research that could reveal these details (specific website suggestions are always provided to avoid this possibility allowing ldquosurfingrdquo beyond these sites is not recommended) These pages should therefore be carefully evaluated before classroom use
Activity 2 Empty PromisesActivity 10 The Slippery SlopeActivity 12 Polypharmacy in the NewsFact Sheet 2 StimulantsFact Sheet 3 Opioid PainkillersFact Sheet 4 CNS DepressantsFact Sheet 7 Dangers of PolypharmacyFact Sheet 8 Internet Pharmacies
note to the teaCher
PrescriPtion Drugs uPDate Human relations meDia
This page has been left blank intentionally
PrescriPtion Drugs uPDate
6
STUDENT ACTIVITIES
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
7
PrePost test
activity 1a
1 Which of the following types of medications are not among the most commonly abused prescription drugs
a) opioid pain medications b) antidepressants c) anti-anxiety medications d) medications for attention deficit hyperactivity disorder
2 Being addicted to which type of prescription drug increases a personrsquos risk of abusing heroin
a) anti-anxiety medications b) medications for attention deficit hyperactivity disorder c) opioid pain medications d) antidepressants
3 If someone addicted to prescription drugs is vomiting and has a fever chills and body aches the person is probably experiencing ____________
a) withdrawal b) an allergic reaction c) a stomach virus d) a placebo effect
4 Drugs like Ritalinreg and Adderallreg ___________ a personrsquos heart rate while drugs like Valiumreg and Xanaxreg ___________ a personrsquos heart rate
a) do not affect do affect b) speed up slow down c) decrease increase d) do affect do not affect
5 Depressants are often prescribed to treat _____________
a) hyperactivity b) depression c) insomnia d) anxiety
This activity is continued on the next page
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
PrescriPtion Drugs uPDate Human relations meDia
PrescriPtion Drugs uPDate
4
The teens then discuss the devastating consequences of their addictions Says one ldquoI ended up robbing people Irsquove taken peoplersquos money and left them in the city in the back of a bar at two orsquoclock in the morningrdquo The teens describe entering rehab multiple times only to relapse and begin abusing the drug again The experts describe the pain and difficulty of withdrawal symptoms ldquoYoursquore sick for days Itrsquos vomiting fever chills body aches bone aches and the list goes onrdquo Drug use also had a profound impact on many of the teensrsquo families One young woman lost both her mother and stepfather to overdoses ldquoPrescription drugs tore my family apart I got custody of my two sisters at 19rdquo Another notes that his drug abuse caused him to lose his familyrsquos trust ldquoEvery time yoursquore at dinner or something like that yoursquoll look up and everybody will just be looking at you to see if yoursquore highrdquo Another adds ldquoIt definitely changed the way my parents feel about me I came home and I canrsquot live here nowrdquo A third teen explains ldquoTherersquos no more asking to use the carhellipbecause nobody trusts you And you canrsquot really earn that backrdquo For many of the teens prescription drug addiction also caused them to be expelled from high school or college ldquoTherersquos no way Irsquom going to be able to go to collegerdquo says one young man ldquoAnd I canrsquot even join the service or anything You know recruiters laugh at me when I walk in Theyrsquore like lsquoDude no way manmdashyoursquove got narcotics chargesrsquordquo When asked what message they hope other teens learn from viewing this program one young person says ldquoIf your goal is to disappoint your family and to go rob and steal and everythingmdashbecause thatrsquos what itrsquos going to lead tomdashthenhellipgo ahead [and abuse prescription drugs] But if thatrsquos not what you want in life donrsquot even pick it uprdquo The prevention expert adds ldquoThe message to teens is if yoursquore not [misusing prescription drugs] and you havenrsquot used them yet please do not use them If you know somebody who is try to help him or her learn other coping skills Seek the counsel or resources that you need to get off themrdquo The program closes with a montage of celebrities who have died from drug overdoses The narcotic enforcement representative urges young people to make better choices than these adults who despite their great fame made serious and ultimately fatal mistakes in their lives
PrePost Test Answer Key
1 b2 c3 a4 b5 d6 d7 d8 a9 c
10 d
PrograM suMMary Continued
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
5
General Note
Discussing prescription drug abuse with your students can be a difficult balancing act The aim of this Teacherrsquos Resource Book is to expand upon the content introduced in the video by offering a range of prevention education materials and to encourage your students to resist peer pressure and experimentation
However there is the risk that some students might be tempted to use the information provided here as a ldquoroad maprdquo steering them toward experimentation rather than as a STOP sign warning them to steer clear
As much as you need to alert your students to the risks and dangers of these medicines you must also avoid inadvertently giving teens the kind of information that may lead them to experiment with pharmaceuticals This difficulty is magnified by the fact that these legal drugs are readily available to many young people Young people often must look no further than their home medicine cabinet
Note on Specific Content
Every class is different in terms of maturity and critical thinking skills Therefore every teacher should carefully assess his or her classrsquos maturity level before participating in the activities included in this Teacherrsquos Resource Book Teachers are encouraged to read each activity and fact sheet thoroughly and use only those that are appropriate for their students
Many of the fact sheets provided will allow you to explore the dangers of prescription drugs without revealing specific details about how these medicines are abused However the age and maturity of your students should be considered when determining which sheets are appropriate for your class
The following pages reveal some details about how medications may be abused or require Internet research that could reveal these details (specific website suggestions are always provided to avoid this possibility allowing ldquosurfingrdquo beyond these sites is not recommended) These pages should therefore be carefully evaluated before classroom use
Activity 2 Empty PromisesActivity 10 The Slippery SlopeActivity 12 Polypharmacy in the NewsFact Sheet 2 StimulantsFact Sheet 3 Opioid PainkillersFact Sheet 4 CNS DepressantsFact Sheet 7 Dangers of PolypharmacyFact Sheet 8 Internet Pharmacies
note to the teaCher
PrescriPtion Drugs uPDate Human relations meDia
This page has been left blank intentionally
PrescriPtion Drugs uPDate
6
STUDENT ACTIVITIES
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
7
PrePost test
activity 1a
1 Which of the following types of medications are not among the most commonly abused prescription drugs
a) opioid pain medications b) antidepressants c) anti-anxiety medications d) medications for attention deficit hyperactivity disorder
2 Being addicted to which type of prescription drug increases a personrsquos risk of abusing heroin
a) anti-anxiety medications b) medications for attention deficit hyperactivity disorder c) opioid pain medications d) antidepressants
3 If someone addicted to prescription drugs is vomiting and has a fever chills and body aches the person is probably experiencing ____________
a) withdrawal b) an allergic reaction c) a stomach virus d) a placebo effect
4 Drugs like Ritalinreg and Adderallreg ___________ a personrsquos heart rate while drugs like Valiumreg and Xanaxreg ___________ a personrsquos heart rate
a) do not affect do affect b) speed up slow down c) decrease increase d) do affect do not affect
5 Depressants are often prescribed to treat _____________
a) hyperactivity b) depression c) insomnia d) anxiety
This activity is continued on the next page
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
PrescriPtion Drugs uPDate
5
General Note
Discussing prescription drug abuse with your students can be a difficult balancing act The aim of this Teacherrsquos Resource Book is to expand upon the content introduced in the video by offering a range of prevention education materials and to encourage your students to resist peer pressure and experimentation
However there is the risk that some students might be tempted to use the information provided here as a ldquoroad maprdquo steering them toward experimentation rather than as a STOP sign warning them to steer clear
As much as you need to alert your students to the risks and dangers of these medicines you must also avoid inadvertently giving teens the kind of information that may lead them to experiment with pharmaceuticals This difficulty is magnified by the fact that these legal drugs are readily available to many young people Young people often must look no further than their home medicine cabinet
Note on Specific Content
Every class is different in terms of maturity and critical thinking skills Therefore every teacher should carefully assess his or her classrsquos maturity level before participating in the activities included in this Teacherrsquos Resource Book Teachers are encouraged to read each activity and fact sheet thoroughly and use only those that are appropriate for their students
Many of the fact sheets provided will allow you to explore the dangers of prescription drugs without revealing specific details about how these medicines are abused However the age and maturity of your students should be considered when determining which sheets are appropriate for your class
The following pages reveal some details about how medications may be abused or require Internet research that could reveal these details (specific website suggestions are always provided to avoid this possibility allowing ldquosurfingrdquo beyond these sites is not recommended) These pages should therefore be carefully evaluated before classroom use
Activity 2 Empty PromisesActivity 10 The Slippery SlopeActivity 12 Polypharmacy in the NewsFact Sheet 2 StimulantsFact Sheet 3 Opioid PainkillersFact Sheet 4 CNS DepressantsFact Sheet 7 Dangers of PolypharmacyFact Sheet 8 Internet Pharmacies
note to the teaCher
PrescriPtion Drugs uPDate Human relations meDia
This page has been left blank intentionally
PrescriPtion Drugs uPDate
6
STUDENT ACTIVITIES
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
7
PrePost test
activity 1a
1 Which of the following types of medications are not among the most commonly abused prescription drugs
a) opioid pain medications b) antidepressants c) anti-anxiety medications d) medications for attention deficit hyperactivity disorder
2 Being addicted to which type of prescription drug increases a personrsquos risk of abusing heroin
a) anti-anxiety medications b) medications for attention deficit hyperactivity disorder c) opioid pain medications d) antidepressants
3 If someone addicted to prescription drugs is vomiting and has a fever chills and body aches the person is probably experiencing ____________
a) withdrawal b) an allergic reaction c) a stomach virus d) a placebo effect
4 Drugs like Ritalinreg and Adderallreg ___________ a personrsquos heart rate while drugs like Valiumreg and Xanaxreg ___________ a personrsquos heart rate
a) do not affect do affect b) speed up slow down c) decrease increase d) do affect do not affect
5 Depressants are often prescribed to treat _____________
a) hyperactivity b) depression c) insomnia d) anxiety
This activity is continued on the next page
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
PrescriPtion Drugs uPDate Human relations meDia
This page has been left blank intentionally
PrescriPtion Drugs uPDate
6
STUDENT ACTIVITIES
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
7
PrePost test
activity 1a
1 Which of the following types of medications are not among the most commonly abused prescription drugs
a) opioid pain medications b) antidepressants c) anti-anxiety medications d) medications for attention deficit hyperactivity disorder
2 Being addicted to which type of prescription drug increases a personrsquos risk of abusing heroin
a) anti-anxiety medications b) medications for attention deficit hyperactivity disorder c) opioid pain medications d) antidepressants
3 If someone addicted to prescription drugs is vomiting and has a fever chills and body aches the person is probably experiencing ____________
a) withdrawal b) an allergic reaction c) a stomach virus d) a placebo effect
4 Drugs like Ritalinreg and Adderallreg ___________ a personrsquos heart rate while drugs like Valiumreg and Xanaxreg ___________ a personrsquos heart rate
a) do not affect do affect b) speed up slow down c) decrease increase d) do affect do not affect
5 Depressants are often prescribed to treat _____________
a) hyperactivity b) depression c) insomnia d) anxiety
This activity is continued on the next page
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
STUDENT ACTIVITIES
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
7
PrePost test
activity 1a
1 Which of the following types of medications are not among the most commonly abused prescription drugs
a) opioid pain medications b) antidepressants c) anti-anxiety medications d) medications for attention deficit hyperactivity disorder
2 Being addicted to which type of prescription drug increases a personrsquos risk of abusing heroin
a) anti-anxiety medications b) medications for attention deficit hyperactivity disorder c) opioid pain medications d) antidepressants
3 If someone addicted to prescription drugs is vomiting and has a fever chills and body aches the person is probably experiencing ____________
a) withdrawal b) an allergic reaction c) a stomach virus d) a placebo effect
4 Drugs like Ritalinreg and Adderallreg ___________ a personrsquos heart rate while drugs like Valiumreg and Xanaxreg ___________ a personrsquos heart rate
a) do not affect do affect b) speed up slow down c) decrease increase d) do affect do not affect
5 Depressants are often prescribed to treat _____________
a) hyperactivity b) depression c) insomnia d) anxiety
This activity is continued on the next page
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
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Everything You Need to Know about Tobacco in 22 Minutes video and print
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DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
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Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
7
PrePost test
activity 1a
1 Which of the following types of medications are not among the most commonly abused prescription drugs
a) opioid pain medications b) antidepressants c) anti-anxiety medications d) medications for attention deficit hyperactivity disorder
2 Being addicted to which type of prescription drug increases a personrsquos risk of abusing heroin
a) anti-anxiety medications b) medications for attention deficit hyperactivity disorder c) opioid pain medications d) antidepressants
3 If someone addicted to prescription drugs is vomiting and has a fever chills and body aches the person is probably experiencing ____________
a) withdrawal b) an allergic reaction c) a stomach virus d) a placebo effect
4 Drugs like Ritalinreg and Adderallreg ___________ a personrsquos heart rate while drugs like Valiumreg and Xanaxreg ___________ a personrsquos heart rate
a) do not affect do affect b) speed up slow down c) decrease increase d) do affect do not affect
5 Depressants are often prescribed to treat _____________
a) hyperactivity b) depression c) insomnia d) anxiety
This activity is continued on the next page
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
PrePost test
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
8
activity 1b
6 Some teens might believe that prescription drugs are safer than illegal drugs because
a) they are prescribed by a doctor b) they can be found in many households c) they are advertised on TV and in magazines d) All of the above
7 Mixing prescription medications with each other andor with alcohol can lead to
______________
a) hospitalization b) overdose c) death d) Any of the above
8 Prescription medications used to treat attention deficit hyperactivity disorder are chemically most similar to what street drug
a) cocaine b) ecstasy c) heroin d) LSD
9 Overdosing on which type of prescription drug can cause an elevated body temperature rapid heart rate and possibly even cardiac arrest
a) depressants b) hallucinogens c) stimulants d) opioid painkillers
10 Vicodinreg and OxyContinreg are prescription drugs used to treat ______________
a) narcolepsy b) allergies c) withdrawal symptoms d) pain
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
9
Some young people misuse prescription stimulants such as Ritalinreg and Adderallreg because they believe the drugs will help them study longer and do better on tests If you knew someone who was considering non-medical use of one of these medications would you be able to convince the person to think twice For this activity first read up on the subject and then try out your own persuasive abilities
PART ONE Read the interviews below and then continue to Part Two
This activity is continued on the next page
eMPty ProMises
activity 2a
Interview with a medical expert
Q Is it true that prescription stimulants such as Ritalinreg and Adderallreg can help you study and do better on tests even if you donrsquot have ADHD
A These medications increase your ability to stay tuned in when school is boring but they wonrsquot make you any smarter For the most part lack of attention isnrsquot what keeps a student from learning
When people with ADHD take these medications it doesnrsquot increase their abilities or give them any advantage over classmates It simply allows them to experience classroom instruction in the way that a typical student would
Q Irsquove heard that stimulant medications are pretty safe Is there really any harm in taking them as a study aid
A Large amounts of Ritalinreg Adderallreg or similar drugs will leave a person jittery and actually make concentration more difficult Even if these drugs cause you to stay up all night it doesnrsquot mean that you will learn more Forming memories is actually a chemical processmdashif you donrsquot give your brain time to rest and consolidate what yoursquove learned the material is not likely to be retained
Overdosing can cause symptoms like shaking seizures and hallucinations Those with ADHD who take these medications can experience side effects such as insomnia heart palpitations stomachaches and headaches
Interview with a college administrator
Q If a student takes prescription stimulants to gain a ldquocompetitive edgerdquo over other students is that considered cheating much like an athlete who takes steroids
A I think the real question is ldquoWhat can we do to improve our academic culture so that students do not feel they need prescription stimulants to help them coperdquo
Students may be surprised to learn that it is not usually the ldquooverachieving brainiacsrdquo who resort to stimulants It is the average-performing student who perhaps has not managed his or her time effectively and is now desperately trying to catch up
Misusing stimulants may give a false sense of confidence to students who tend to feel a bit inferior to other students
So is that the same as cheating
I believe that these medications can cheat students out of a sense of genuine accomplishment Frankly as a way to get ahead academically prescription drugs just donrsquot ldquomake the graderdquo
What works bestmdashand has always worked bestmdashfor succeeding in school is pretty old-fashioned hard work wise use of study time and getting extra help when itrsquos needed If a student is having trouble keeping up there are people who can help whether itrsquos a teacher a tutor or a counselor who can help students get a handle on their social lives make healthy choices and manage their time better
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
10
PART TWO Make a list of five reasons why misusing prescription stimulants in the hopes of doing better in school might end up doing a student more harm than good
1
2
3
4
5
Make a list of five healthy non-chemical strategies for coping with academic stress
1
2
3
4
5
This activity is continued on the next page
eMPty ProMises
activity 2b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
11
PART THREE In groups of three create a role-play skit Each group has five minutes to plan their roles and another five minutes to act out their skit The rest of your class will observe the performance and discuss it afterwards
In each group one student will portray a student who is considering abusing stimulant drugs to do better in school The other two students will play the roles of concerned classmates who try to convince their friend to change hisher mind
Use the space below to brainstorm ideas with your group Compare what each of you wrote for Part Two of this activity and create persuasive arguments to convince your friend not to experiment with prescription stimulants Be sure to give your friend a few concrete suggestions for better healthier ways to deal with school stresses
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PART FOUR After you and your classmates have finished your role plays discuss what could have been done differently and identify anything that could have been improved so that the arguments against prescription stimulants would be more persuasive
eMPty ProMises activity 2c
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
12
PART ONE Divide the class into two equal groups One group must argue yes and the other group must argue no Each side must support its position with facts and valid arguments Choose one of the following debate topics
If a student takes prescription medications to gain a ldquocompetitive edgerdquo over other students should that be considered cheating much like an athlete who takes steroids Why or why not
The United States is one of only two nations that allow drug companies to advertise directly to consumers Many people believe that frequent exposure to ads for pharmaceutical products leads consumers to assume that using prescription drugs is a normal part of life Should television radio and print media ads for drugs be disallowed in the United States Why or why not
Is teaching kids about the dangers of prescription drug abuse the same as setting out a road map for students who may be curious about these substances Why or why not
If a doctor writes out a prescription for a patient and the patient then becomes addicted to the medicine because he or she is taking it in higher-than-recommended doses should the doctor be held legally responsible Why or why not
PART TWO If none of these topics stimulate class debate create your own topic in the space below
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
activity 3
Class debates
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
13
Investigate one of the following topics and write a short paper summarizing your research Be sure to use legitimate sources including the library and valid Internet websites Use a Resource Tracker to keep track of your sources If your topic is a drug be sure to research its effects usage and any advisories regarding it from the Food and Drug Administration
Non-medical Use of Prescription Drugs When abused prescription medications can be just as dangerous as illicit drugs Why are they so dangerous Research two different prescription drugs that might be abused What are their side effects How many people are abusing these drugs each year What statistics exist about addiction or death as a result of misuse
Stimulants Depressants and Opioids What does it mean when a drug is a stimulant What does it mean when a drug is a depressant What does it mean when a drug is an opioid What are some examples of stimulants depressants and opioids What are some of the proper medical uses of these drugs Are any of these drugs addictive Which of these drugs has the highest potential for abuse
Hooked to the WebThe Internet has been called a ldquopharmaceutical candy store stocked with addictive drugsrdquo by the National Center on Addiction and Substance Abuse (CASA) at Columbia University Investigate the issue What action has the Drug Enforcement Administration (DEA) taken to reduce the practice of Internet pharmacies filling orders without sufficient medical consultation What laws are being implemented by the federal government to crack down on Internet drugstores that sell prescription drugs without requiring a doctorrsquos prescription
Drug InteractionsWhat happens when two different types of drugs are taken at the same time What are some examples of drugs that could produce harmful effects when taken in conjunction with one another Investigate the term ldquopolypharmacyrdquo and explain the dangers of mixing medications
Ryan Haight Online Pharmacy Consumer Protection ActIn September 2008 Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act to address the problem of online prescription drug abuse and trafficking Explain why the bill was proposed and what the bill covers including key respects in which it will amend the Controlled Substances Act (CSA) What impact do you think the passage of this bill will have on the larger issue of prescription drug abuse
This activity is continued on the next page
activity 4a
researCh ProjeCt
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________resourCe traCker
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
Title of book or article
Author(s)
Published bywebsite address
Copyright date
Subject covered
Quote(s)
Notes
14
activity 4b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
15
How would you respond if you heard a friend making any of the statements below For each one write down an assertive answer that includes facts about the dangers of abusing prescription drugs
1 Vicky got addicted because she used this stuff every day But this is differentmdashIrsquom only using it once in a while when I need to cram for a test
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2 Come on be serious They canrsquot put me in jail for using this Itrsquos the same stuff that they advertise on television
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3 My mom took these pills after she got her wisdom teeth pulled I doubt theyrsquore too strongmdashshe drove my little sister to nursery school every day
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4 I donrsquot see the big dealmdashitrsquos not like I bought these pills from some drug dealer in a shady alley someplace
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5 You canrsquot get arrested for driving under the influence if you have a legal prescription for the drug
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6 My grandfather took one of these pills every single day for a year and he didnrsquot get addicted so why should I worry
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
think again
activity 5
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
16
For this activity imagine that you work at an advertising agency that has been hired to produce a 60-second radio public service announcement (PSA) in order to help prevent teens from abusing prescription drugs The PSA will be aimed at youth ages 12 to 20
Working in teams of four to five classmates create a simple memorable and persuasive message based on the information you learned from the video and the fact sheets below
Prescription Drugs FAQs (fact sheet 1)Stimulants (fact sheet 2)Opioid Painkillers (fact sheet 3)CNS Depressants (fact sheet 4)
Once all of your classmates have created their own PSAs hold a schoolwide competition to see which PSA is the most effective Teachers and students from other classes can be the judges
Key points to remember when creating a PSA
d Because you only have a very short time to reach your audience your language should be simple and vivid Take your time and make every word count Hone your message until itrsquos crystal clear
d Practice reading the PSA aloud in a slow clear voice in order to get the timing right
d Ideally your ad should have a memorable ldquohookrdquomdasha phrase that grabs viewersrsquo attention For example well-known taglines created by the Ad Council include ldquoFriends donrsquot let friends drive drunkrdquo and ldquoYou could learn a lot from a dummyrdquo
d You want your listeners to be inspired to do something as a result of having heard your PSAmdashtry to urge them to take a specific action such as calling a number or visiting a website to get more information spread the word to educate someone else or engage in a specific behavior
d Describe the specific negative consequences (social psychological economic andor legal) that might result from abusing prescription drugs but avoid using exaggerated fear tactics that are likely to be ignored
d Your PSA doesnrsquot have to be negativemdashyou can also mention the positive results of avoiding prescription drug abuse (such as doing better in school having more spending money or being better able to achieve your life goals)
Adapted from ldquoPreparing Public Service Announcementsrdquo contributed by Chris Hampton and edited by Phil Rabinowitz and Kate Nagy Available at the Community Tool Box lthttpctbkueduendefaultaspxgt Atkin C (2004) ldquoMedia Intervention Impact Evidence and Promising Strategiesrdquo In Bonnie RJ and OrsquoConnell ME Eds Reducing Underage Drinking A Collective Responsibility lthttpwwwnapedu catalog10729htmlgt
Media blitz activity 6
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
17
According to the Partnership for a Drug-Free America todayrsquos teens are more likely to abuse prescription drugs than illegal drugs Why Because they mistakenly believe that prescription drugs are safer than street drugs Wrong When misused prescription drugs are just as dangerous as any illegal drug
Furthermore the Centers for Disease Control indicate that prescription drugs are largely to blame for a huge increase in accidental drug overdose deaths (from about 20000 to about 32000 per year) in the past decade
Read the accounts below to get a more personal idea of what these statistics mean These are real accounts of two deaths that ocurred as a result of prescription drug abuse
the liVes behind the statistiCs
activity 7
In February 2010 Eddie C was found dead by his parents after overdosing on prescription medicines He had taken 15 Xanaxreg pills In his system traces of alcohol and antihistamines were also found Eddie began abusing prescription drugs in high school He did manage to get clean twice but subsequently relapsed When he died Eddie was 22 years old engaged to be married and a father to two small children
Mark Brsquos parents had no idea that their 18-year-old son was hooked on prescription drugs He began taking prescription painkillers in his junior year of high school to relieve chronic back pain after a lacrosse injury His parents never noticed any signs of drug abuse Mark was two weeks away from completing his first year of college when in August 2010 he died of an overdose The toxicology report found oxycodone and acetaminophen in his system
As you can see prescription drug abuse can be lethal Although people often donrsquot think of prescription drugs as having the same stigma as illegal drugs the consequences of their abuse can be just as deadly Youth is no guarantee of health either both Eddie and Mark began abusing drugs while they were in high school
Using the information that yoursquove learned from the video and fact sheets compose a letter to a teen maybe someone like Eddie or Mark In your letter provide information that could help the person make a wise decision about abusing prescription drugsmdashand perhaps save a life Write your letter on the back of this page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
18
Get interactive the old school way with the paper fortune teller Itrsquos a fun (and safe) way to discover the effects of prescription drug abuse Just choose an activity select a prescription drug and voila See the possible outcome for yourself All you have to do is cut and fold this paper fortune teller template Then consult the predictor to discover possible side effects of prescription drug abuse All of these side effects can happen when you abuse or misuse prescription drugs Although not all of the side effects will happen to everyone taking prescription drugs without a prescription or ignoring your doctorrsquos instructions is dangerous You never know what yoursquore getting into
Source National Institute on Drug Abuse lthttpteensdrugabusegovpeerxpdfPEERx_Toolkit_FortuneTellerpdfgt
drug abuse fortune teller
activity 8
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
19
From 1995 to 2002 pharmaceutical manufacturers were the nationrsquos most profitable industry You probably have noticed an increase in the amount of pharmaceutical ads on TV and in magazines over the last decade Here is your chance to reflect on what that means for usmdashas consumers as patients and as healthy individuals
On the back of this page answer the questions below
1 Venture a guessmdashhow many prescriptions do you think the average person living in your state has in their medicine cabinet at home Is it more than five More than ten After you make your guess consult the Internet to find out the correct answer
TIP Search under ldquoretail Rx drugs per capitardquo Or try this link which is updated yearly lthttpwwwstatehealthfactsorgcomparemaptablejspind=267ampcat=5gt
2 In your opinion is pharmaceutical advertising effective
3 How might the widespread frequency of pharmaceutical ads on TV affect doctors
4 How might it affect consumers
5 Has our culture changed in terms of its willingness to seek out prescription drugs How
6 Do you think patients are dissatisfied if doctors do not write them prescriptions Explain
7 Do you think there is a connection between the number of prescriptions in our homes and the number of ads we see for pharmaceutical products Explain
8 What should patients do in order to be smart consumers
donrsquot be a lab rat activity 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
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25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
20
Addiction to any drugmdashlegal or illegalmdashcan be thought of as a ldquoslippery sloperdquo involving a progressive loss of control over onersquos actions Read the following stories and imagine that the main characters are your good friends You need to urge your friends to get off the ldquoslippery sloperdquo that leads to addiction before itrsquos too late What can you say to your friends
Read The Stages of Addiction (fact sheet 5) to learn more about the stages individuals go through in developing an addiction
Think about and discuss the following questions with your classmates
d What questions would you ask your friend to get a better sense of the situation from hisher perspective
d What are some ldquored flagsrdquo in your friendrsquos feelings or behavior that might indicate where he or she is on the ldquoslippery sloperdquo
d Are there points in either story where you feel your friend could have made a different choice that would have worked out better
d What recommendations or advice would you give to your friend How would you approach this with Amy as opposed to Malcolm
d What type(s) of help might you suggest that your friend seek or access How would you approach this with Amy as opposed to Malcolm
1Amy has become overwhelmed with her Advanced Placement schoolwork and many competing demands including swim and dance team volunteering at a local preschool program working a waitressing job on weekends and submitting college applications Her grades have been slipping a little lately as her parents have pointed out One of her older brotherrsquos friends offered her a few stimulant pills that she could try for free After that first time Amy has gone back to her brotherrsquos friend every week for the past two months to buy more pills Now of course hersquos charging her for the medication and Amy finds herself spending all her tip money from waitressing Amy stays up all night at least three times a week in order to do her schoolwork Her grades have not improved but at least shersquos finding the
This activity is continued on the next page
the sliPPery sloPe activity 10a
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
21
time to get things done The ability to stay up for long stretches is totally worth the ldquojitteryrdquo feeling and racing heartbeat she experiences Her parents friends and teachers have noticed that shersquos crankier than usual Recently she got in trouble with her boss for arguing with a customer at the restaurant Amy believes that taking the medication is her own business and that nobody has the right to tell her what to do
2Malcolm began taking a prescription opioid pain medication after he tore a ligament playing football After several weeks he noticed something strangemdashhis urge to take the pills was growing even though his injury was healing He figured it was no big deal since after all he was still experiencing some discomfort and on top of it he was depressed about having missed the entire season Taking a few extra doses here and there seemed to help his state of mind At a follow-up appointment his doctor recommended an over-the-counter pain reliever and would not write a new prescription for the opioid pain medication Malcolm began to feel increasingly nervousmdashand even feverish nauseous and achymdashafter a few days without the medication Today Malcolm found someone at school who had a few similar pills that he was willing to sell to Malcolm Taking them made him feel better both mentally and physically Now he is worried about what will happen in the days ahead if his classmate runs out of pills
the sliPPery sloPe activity10b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
22
Answer Guyrsquos advice column is the most popular section of your schoolrsquos student website Every week students email their questions to Answer Guy You are one of the editors in charge of answering these letters Itrsquos important that your responses include good factual advice Use what you learned in the video and from the fact sheets to answer this weekrsquos letters Write your replies on the back of this page
Dear Answer Guy
Irsquom starting to fall behind in my classesmdashthere just doesnrsquot seem to be enough time to get everything done After school I have to attend student government meetings or go to work at the movie theater so by the time I get home at night Irsquom too tired to study Last week I complained to my friend and he said he could help He gave me some pills he said would give me energy They did make me feel awake and sharp itrsquos true But later on after they wore off I was even more exhausted than before Now Irsquom having second thoughts about taking them again Even though they worked so well I donrsquot really know what they are My friend got them from his doctor and he says theyrsquore not a big deal What should I do
Confused
Dear Answer Guy
My mom has a prescription for Valiumreg I know it makes her really calm and relaxed Irsquove been really stressed out latelymdashmy boyfriend dumped me the SATs are coming up and homework has been difficult The other day I almost took some Valium because I needed to relax so badly My mom got it from a doctor so it canrsquot hurt me right
Frazzled
dear answer guy activity 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
23
Have you ever heard a person say ldquoOne plus one equals threerdquo to illustrate how facts may be misleading or surprising When it comes to using prescription drugs itrsquos an equation that is not only true but can be a matter of life or death
On January 22 2008 actor Heath Ledger died suddenly at the age of 28 The medical examiner determined that the cause of death was an accidental drug overdose of several prescription medications According to authorities none of the drugs in his systemmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess All the drugs had been legitimately prescribed for him
Although Ledger apparently did not take an excessive dose of his medications the combination turned out to be deadly In his case one plus one did indeed equal more than two The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Combining prescription medications is known as ldquopolypharmacyrdquo Before you continue read Dangers of Polypharmacy (fact sheet 7) to learn more about polypharmacy additive effects and synergistic effects
A partial list of celebrities who have had a problem with prescription drugs is offered below These individuals have gone to rehab or died as a result of prescription drugs (They may also have used illegal substances)
Choose one of these namesmdashor come up with a noteworthy name of your ownmdashand research the case In a brief paragraph explain what medications were involved and whether polypharmacy was an issue for the person If possible find out whether the medications that were used had a synergistic effect or an additive effectmdashor both
PolyPharMaCy in the news
activity 12
Paula Abdul
DJ AM
Chevy Chase
Robert Downey Jr
Eminem
Judy Garland
Corey Haim
Jimi Hendrix
Whitney Houston
Michael Jackson
Rush Limbaugh
George Michael
Marilyn Monroe
Brittany Murphy
Kelly Osbourne
Dana Plato
Chris Penn
Elvis Presley
Winona Ryder
Anna Nicole Smith
Daniel Wayne Smith
Hunter S Thompson
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
FACT SHEETS
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
24
PresCriPtion drugs faQs Fact sHeet 1a
What are prescription drugsAny medicine that is available only with a written prescription from a doctor is a prescription drug Prescription drugs are regulated by the Food and Drug Administrationrsquos Center for Drug Evaluation and Research (CDER) Before any new prescription drug is approved for sale in the United States its manufacturer must prove that the new drug is safe and effective for human use when it is used correctly according to the prescribing doctorrsquos instructions
What is prescription drug abuseThere is a reason that prescription drugs are intended to be taken under the direction of a doctor because if theyrsquore used improperly they can be dangerous or even fatal Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed Abuse can include taking a friendrsquos or relativersquos prescription to treat pain get high to help with studying or any other reason If the prescription was not written for YOU donrsquot use it Itrsquos illegal and dangerous
What kinds of prescription drugs are abusedThe three classes of prescription drugs that are most commonly abused are
1 Opioids which are most often prescribed to treat pain
2 Central nervous system (CNS) depressants which are used to treat anxiety and sleep disorders
3 Stimulants which are prescribed to treat the sleep disorder narcolepsy and attention deficit hyperactivity disorder (ADHD)
How many teens abuse prescription drugsIn 2008 19 million youth (or 77 percent of youth) ages 12 to 17 abused prescription drugs with 16 million (65 percent) abusing a prescription pain medication That makes painkillers one of the most commonly abused drugs by teens after tobacco alcohol and marijuana In fact on average 2000 teenagers ages 12 to 17 per day used a prescription drug without a doctorrsquos guidance for the first time Opioids (such as the pain relievers OxyContinreg and Vicodinreg) central nervous system depressants and stimulants are the most commonly abused prescription drugs
This fact sheet is continued on the next page
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
25
Whatrsquos the truth about prescription drugsSome teens think that abusing prescription drugs is safer than abusing illicit drugs such as heroin Not true Prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended Never make a decision based on misinformationmdash you could risk losing your life
Consider these facts
d Every day in the United States an average of 2000 teenagers use prescription drugs without a doctorrsquos guidance for the first time
d Painkillers are one of the most commonly abused drugs by teens after tobacco alcohol and marijuana
d Abusing prescription drugs is illegalmdashand that includes sharing prescriptions with friends
d Opioids (such as OxyContinreg or Percocetreg) CNS depressants (such as Valiumreg or Xanaxreg) and stimulants (such as Adderallreg or Ritalinreg) are the most commonly abused prescription drugs
d Taking just one large dose of an opioid (such as OxyContinreg or Percocetreg) could cause severe breathing complications or death
d If combined with any medication or substance that causes drowsiness CNS depressants (such as Valiumreg or Xanaxreg) can slow both the heart and respiration which can lead to death
d From 1999 to 2005 accidental poisoning deaths from prescription drug overdoses increased by 86 percent
d Overdosing on prescription pain medications accounted for 95 percent of all accidental poisoning deaths in 2007
d Taking high doses of a stimulant (such as Adderallreg or Ritalinreg) can cause an irregular heartbeat dangerously high body temperatures and the potential for heart failure or seizures
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-facts2gt
PresCriPtion drugs faQs Fact sHeet 1b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
26
Stimulants are prescribed for medical conditions including attention deficit hyperactivity disorder (ADHD) narcolepsy (a disorder causing a person to fall asleep unexpectedly) and depression Medications include dextroamphetamine (Dexedrinereg and Adderallreg) and methylphenidate (Ritalinreg and Concertareg)
How do they workStimulants increase alertness and attention by increasing brain activity elevating blood pressure and increasing breathing and heart rate People with ADHD experience increased focus because the medication ldquowakes uprdquo the brain function that helps screen out distractions in the environment
What are their side effects and dangersLarge doses of stimulants can lead to hostile or paranoid behavior high body temperature heart problems and seizures Even individuals taking the proper dose for medical reasons may experience lack of appetite have trouble falling asleep andor feel ldquocrankyrdquo as the medication is wearing off for the day
Are there any polypharmacy warningsPrescription stimulants should not be combined with over-the-counter decongestants diet drugs some antidepressants asthma medication or other prescription stimulants
What about addictionIndividuals may become addicted to stimulants Withdrawal symptoms associated with stopping use include depression tiredness and problems sleeping
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
stiMulants
Fact sHeet 2
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
27
Opioids are commonly prescribed to relieve pain They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain Studies have shown that if taken exactly as prescribed by a medical professional opioids can manage pain safely and effectively The problem occurs when they are abused
Opioids are commonly prescribed for effective pain relief Medications include morphine (eg Kadianreg) codeine hydrocodone (eg Vicodinreg) oxycodone (eg OxyContinreg Percocetreg) and related drugs
How do they workOpioids attach to proteins called opioid receptors found in the brain spinal cord and digestive tract in order to block the perception of pain
What are their side effects and dangersSide effects of opioids include drowsiness nausea constipation and depressed breathing Taking a large single dose of an opioid could stop breathing and lead to death These medications are safe to use with other substances only under a physicianrsquos supervision In general they should not be used with alcohol or other medications such as antihistamines barbiturates or benzodiazepines Because all of these substances cause a slower rate of breathing their combined effects could lead to life-threatening respiratory complications Repeated abuse of opioids can lead to addiction
Are there any polypharmacy warningsOpioids should not be used with other substances that depress the central nervous system such as alcohol antihistamines (eg Benadrylreg) barbiturates (eg Nembutalreg) and benzodiazepines (eg Xanaxreg)
What about addictionLong-term use of opioids can lead to physical dependence and addiction Withdrawal symptoms include restlessness muscle and bone pain trouble sleeping diarrhea vomiting cold flashes with goose bumps and uncontrollable leg movements Prescription opioids are chemically similar to heroin Therefore addiction to opioids increases the odds that a person will try heroin
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
oPioid Painkillers
Fact sHeet 3
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
28
Central nervous system (CNS) depressants help to calm anxiety and allow individuals to fall asleep Commonly prescribed drugs include barbiturates such as Mebaralreg and Nembutalreg and benzodiazepines such as Valiumreg and Xanaxreg
How do they workCNS depressants also referred to as sedatives and tranquilizers slow functioning and decrease activity within the central nervous system which includes the brain and spinal cord
What are their side effects and dangersIndividuals taking CNS depressants may feel sleepy and uncoordinated so that tasks like driving may not be safe In high doses they also can cause dizziness confusion and memory problems
Are there any polypharmacy warningsCNS depressants should not be combined with any other medication or substance that causes CNS depression including prescription pain medicines some over-the-counter cold and allergy medications and alcohol Combining CNS depressants can slow heart rate and breathing to levels low enough to cause death
What about addictionIf a person uses these drugs for a long period of time his or her body will develop a tolerance and larger doses will be necessary to achieve the same effects Continued use can lead to physical dependence and withdrawal symptoms can result when use is stopped When in withdrawal from CNS depressants the brain can experience severe ldquoreboundrdquo in terms of activity level potentially leading to seizures and other serious consequences
Source National Institute on Drug Abuse National Institutes of Health US Department of Health and Human Services lthttpteensdrugabusegovpeerxthe-factsopioidsfaq gt
Cns dePressants
Fact sHeet 4
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
29
People donrsquot simply wake up one day addicted to drugs The addiction process occurs in stages over a span of time At each point a drug user can reach out for help to interrupt the process Imagine addiction as someone riding a bike down a slippery slope the farther a person gets down the slope the faster the bike will be going and the harder it will be to stop Trying to return back to the top of the slope will be even more difficult Thatrsquos why itrsquos crucial to seek help for addiction as soon as possible when it is easier to change behavior Full-fledged addiction is a brain disease An individual in the late stages of addiction will have little control over his or her behavior and the addiction may ultimately prove fatal
There are many forms of treatment for addiction Not all forms work for everyone Treatment has the best chance of success for a young person if it involves his or her family and focuses on all aspects of life social school legal and medical Medication can be helpful for addiction to certain substances such as opioids The stages of addiction include
Stage Typical behaviors
Use
d Experimentationd Using only at parties ldquonow and thenrdquod Few consequences experienced from used Feeling of control over used Sometimes use starts because the person is trying to solve a problem such as a painful injury or stress at school
Misuse
d Using regularly (eg at every party)d Hanging out with peers who use becomes most common form of entertainmentd Person begins breaking curfew and sneaking aroundlying to hide used Grades or work begin to slip
Abuse
d Larger doses of drug are needed to achieve same pleasurable feelingd Getting (or stealing) money and finding a ldquodealerrdquo take up a lot of energyd Using the drug no longer feels like a choiced Harmful consequences of usemdashillness accidents legal problems negative reactions from othersmdashdo not make the person stop using d Attempts to stop use are unsuccessfuld Person may deny being an addict
Dependence
d Using dailyaloned Complete loss of control over used Use dominates every waking momentd Withdrawal symptoms occurd Very large doses needed risk of overdose
the stages of addiCtion
Fact sHeet 5
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate30
Addiction is a medical condition It is a recurring brain disorder that leaves individuals unable to control their use of drugs Some teens might begin to experiment with drugs because their friends do or because the feeling they get from the drug feels good others might turn to drugs in an effort to relieve depression stress or pain
Young people are more likely than adults to take risks and experiment with substances because the areas of the brain that control impulses are not fully mature in teenagers (the brain doesnrsquot stop developing until about age 25) Youth also tend to be influenced by the risk-taking behavior of their peers But experimentation can quickly progress into more damaging use until the drug takes over the personrsquos life Herersquos how it works
ToleranceUsing drugs does make a person feel goodmdashbut the more he or she uses the more that pleasurable effect is diminished Repeated use causes actual changes in the brain A userrsquos brain stops producing the natural chemicals that cause happiness and good feelings This means that the person needs larger and larger doses of the drug to feel the same high Eventually the abuser needs the drug just to feel normal The need for ever-larger amounts of a drug is called tolerance
WithdrawalAs a person develops a tolerance and continues to use more and more of a drug his or her usual needs and desires become secondary to the goal of using the drug The userrsquos body becomes physically dependent on the drug to function At this point the person is no longer just using the drug for pleasure If a person tries to reduce or stop use he or she might experience severe symptomsmdashincluding nausea sweating diarrhea and muscle and bone painmdashas the body struggles to adjust to the absence of the drug These symptoms are called withdrawal Someone who is going through treatment for addiction must be supervised by a doctor because withdrawal symptoms can be life-threatening
RelapseMost people who receive treatment for addiction will return to using the drug at least once This return to use is called relapse Relapse is common because an addicted personrsquos brain has been damaged by the drug use and requires time to heal
Tolerance withdrawal and relapse are medical conditions that make it extremely hard for someone to recover from addiction Often it takes many years and multiple trips through treatment before a person successfully stops use He or she must be careful for the rest of hisher life to avoid situations that could tempt drug use
Name __________________________________toleranCe withdrawal and relaPse
Fact sHeet 6
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate31
ldquoPolypharmacyrdquo is defined as combining prescription medications People may do this on purpose because they believe that certain combinations of medications (or even combinations of unknown prescription drugs) can help them party relax or seem ldquocoolrdquo to others Others may combine medications carelessly or by accident (ie taking a newly prescribed drug without telling their doctor about other medications theyrsquore already using or forgetting to read medication labels that instruct them to avoid taking certain other drugs at the same time)
Just as taking too much of a single medication can be fatal polypharmacy can be very dangerous The death of actor Heath Ledger opened the publicrsquos eyes to this danger He died on January 22 2008 as a result of an accidental overdose of prescription medications According to authorities none of the drugs he consumedmdashtwo sleep medications two anti-anxiety drugs and two narcotic painkillersmdashwere taken in excess The actorrsquos parents issued this statement ldquoHeathrsquos accidental death serves as a caution about the hidden dangers of combining prescription medications even at low dosagesrdquo
Heath Ledgerrsquos death is an example of what can happen when additive or synergistic drug effects become too much for the body to handle These effects are defined as follows
Additive EffectWhen two or more drugs from the same class ( see note below) are combined any potential side effects or dangers get duplicated Consider a person who takes an anti-anxiety medication (depressant) which slows heart rate and breathing If she then takes a sleep aid (also a depressant) her heart rate and breathing will slow even more potentially reducing these rates to dangerously low levels The drug combination produces an effect that is like simple addition such as in the equation 1 + 1 = 2
Synergistic EffectA combination of two or more drugs produces an effect that is like multiplicationmdashthat is the effect of the combined drugs is greater than the sum of the drugsrsquo individual effects such as in the equation 1 + 1 = 3 Consider a person who drinks alcohol while taking a prescription painkiller and an anti-anxiety medication All three of these drugs are depressants When alcohol is added to the other two depressants it magnifies their effect making each medication stronger than it would be alone
NOTE The three main drug classes are depressants stimulants and opioids
NEVER TAKE DRUGS IN COMBINATION without clear instructions from your doctor or pharmacist
Name ________________________________dangers of PolyPharMaCy
Fact sHeet 7
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
32
Possessing or using prescription drugs without a valid prescription is illegal It also is illegal for any pharmacy to sell any prescription drugs without requiring a valid prescription from a doctor By law prescription drugs must be prepared and sold by licensed pharmacists Completing an online health questionnaire that is then reviewed by a doctor who works for the online pharmacy does not count nor does a prescription that is faxed by the purchaser
ldquoRoguerdquo pharmacy websites which are nothing more than illegal marketplaces for prescription drugs continue to plague the Internet The National Center on Addiction and Substance Abuse (CASA) at Columbia University which tracks the growth of these illegal pharmacies finds that the number of these pharmacies grows every year with nearly 200 identified in 2006
Rogue sites often sell unapproved drugs drugs that contain the wrong active ingredients drugs that may contain too much or too little of the active ingredient or drugs that contain dangerous toxic ingredients Some websites sell counterfeit drugs that may look exactly like FDA-approved medicines but in fact are not Although a rogue online pharmacyrsquos website may present an illusion of safety and legitimacy the drugs they sell are often made and stored under unsanitary conditions or marked with unreadable labels that contain no dosage directions or warnings
Some clues that a site might be a rogue Internet pharmacy include
d The website is advertised via ldquospamrdquo email messages
d The site fails to provide a telephone contact number
d The website offers prices that are dramatically lower than the competition
d The website sells medicine without requiring a proper prescription
d The address of the pharmacy is not in the United States
Obtaining drugs from a rogue Internet pharmacy site is risky Ryan Haight an 18-year-old athlete and top student died February 12 2001 after overdosing on a prescription pain medication he ordered over the Internet without a prescription In 2006 Marcia Bergeron a woman from British Columbia died of toxic metal exposure after taking counterfeit drugs she bought online Large quantities of aluminum tin arsenic and other harmful metals were found in her system
The Ryan Haight Act a law passed after Ryanrsquos death requires that a doctor conduct a face-to-face examination of a patient before prescribing medication The law also required that online pharmacies present a valid physical address the license numbers of their pharmacists and their endorsement from the US Drug Enforcement Agency in order to sell medications over the Internet Legitimate online pharmacies are certified as Verified Internet Pharmacy Practice Sites (VIPPS) by The National Association of Boards of Pharmacy
internet PharMaCies
Fact sHeet 8
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate33
The federal government classifies all illegal drugs as ldquocontrolled substancesrdquo Many prescription drugs are also considered controlled substances if they have a high potential for abuse The lower the schedule number the higher the drugrsquos potential for abuse
d Illicit drugs like heroin are Schedule I drugsd Most opioid pain medications and prescription stimulants (ADHD medications) are Schedule II drugsd Most prescription central nervous system depressants (anxiety and sleep medications) are Schedule IV drugs
It is illegal for anyone other than pharmacists or other professionals to manufacture distribute or sell any controlled substance These crimes are known as ldquodrug traffickingrdquo It is also illegal to possess a controlled substance Laws that regulate drug trafficking and drug possession vary by state but all of the following might be considered illegal
d Possessing medications that were not prescribed to you by a doctord Selling or giving drugs that were prescribed to you to othersd Buying prescription drugs from an illegal Internet pharmacyd Storing medication outside of a labeled prescription bottle (an indication that you do not have a valid prescription)
Legal consequences for prescription drug abuse can be serious The Federal Controlled Substances Act specifies penalties for drug trafficking depending upon the amount and type of drug and its schedule Here are a few examples
Drug Schedule Examples of Drugs First Offense Second Offense
IIVicodinreg OxyContinreg Ritalinreg
Up to 20 years in prison or 20 years to life if death or serious injury resulted from the trafficking Fine of up to $1 million
Up to 30 years in prison or life sentence if death or serious injury resulted from the trafficking Fine of up to $2 million
IV Xanaxreg ValiumregUp to 3 years in prison and fine of up to $250000
Up to 6 years in prison and fine of up to $500000
Name ____________________________ legal ConseQuenCes of PresCriPtion drug abuse
Fact sHeet 9
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
34
Prescription drugs are essential for treating many illnesses and disorders However they must be prescribed appropriately and properly used under the supervision of a physician If you have been prescribed a drug itrsquos important to use it exactly as the instructions dictate If taken in the correct amount at the correct intervals a prescription drug can relieve your symptoms without making you addicted
If a doctor prescribes medicine for you follow the directions exactly Here are other ways to protect yourself
1 Tell your doctor about any other medications you are taking
2 Ask your doctor if there are any other drugs substances or activities that should be avoided while you are on the medication
3 Always follow medication directions carefully Save the information from the pharmacist and re-read it often to remind yourself of what you should avoid
4 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
5 Call your doctor if you are concerned about any side effects that you experience
6 Donrsquot increase or decrease the dose of your medication without checking with your doctor firstmdashno matter how yoursquore feeling
7 Do not take the medication more frequently than indicated
8 Do not continue taking any medication beyond the prescribed length of time
9 Do not crush or break pills
10 Understand the drugrsquos possible side effectsmdashincluding the effects it may have on driving and other daily tasks
11 Learn about the drugrsquos potential interactions with alcohol other prescription medications and over-the-counter medicines
12 Never use someone elsersquos prescription And donrsquot allow a friend to use yours Not only are you putting your friend at risk but you could suffer too Giving medication to someone else is considered a crime you could find yourself in serious legal trouble
Sources lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt US Food and Drug Administration
taking MediCations safely Fact sHeet 10
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
35
If someone you know has a problem with drugs there are things you can do to help
Signs of a drug problemIf a friend or family member shows one or more of these signs he or she might have a problem with prescription drugs
d a compulsive need to take the drugd changes in weight mood or sleeping habitsd unusual agitation or irritabilityd loss of interest in things that used to be importantd hiding or lying about drug used missing school or workd going to school or work while highd seeking prescriptions from more than one doctor
Helping a friendWhen someone you know has a drug problem itrsquos not always clear what you can do These tips can help you talk to a friend about his or her prescription drug use
d Find a quiet place to talk to your friend about your concerns Tell him or her that yoursquore worried about the drug use Point out ways in which the friend has changed but donrsquot be accusatory or aggressive Emphasize that you are worried about your friendrsquos health and safety Be supportive and caring not judgmental
d Listen to what your friend says in return He or she might know there is a problem but not know what to do about it
d Tell your friend that yoursquore there to help
d Encourage your friend to talk to a trusted adult such as a parent doctor school counselor or nurse Offer to go with your friend to talk to someone
d If your friend is not willing to get help talk to a trusted adult about the situation Tell the adult that you think your friend is abusing drugs and needs help
Sources of helpSeveral anonymous resources exist to help people struggling with drug abuse
The National Suicide Prevention Lifeline (1-800-273-TALK)This crisis hotline can help with many difficult life issues not just suicide
Treatment Referral Helpline (1-800-662-HELP)This hotline refers callers to treatment facilities support groups and other local organizations
what Can i do Fact sHeet 11
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
36
Overdose A drug overdose is the accidental or intentional use of a drug in an amount that is higher than is normally used A drug overdose does not necessarily have to occur with only one drug It can also occur when one drug interacts with another For example people may take their prescribed dose of a sedative and then overdose if they drink alcohol (another depressant drug) in combination with the sedative
If you see any of the overdose symptoms listed below seek medical treatment immediately Donrsquot think you can just let someone ldquosleep it offrdquo Respiratory depression from depressant and pain reliever overdose can cause brain damage or death if not treated promptly by a medical professional If you donrsquot want to identify yourself make an anonymous call to 911 or to your friendrsquos parents
Signs of a Drug Overdose
agitation
dilated pupils
seizures
unconsciousness
extremely high (or low) body temperature or pulse
rapid breathing or extremely slow breathing
sleepiness mental confusion or unconsciousness
cool clammy skin or hot dry skin
chest pain or shortness of breath
abdominal pain or nausea
vomiting or diarrhea
signs of oVerdose
Fact sHeet 12
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
37
Cool Stuff (Downloads) from NIDA for Teens lthttpteensdrugabusegovpeerxcool-stuffgt
Discovery School Deadly Highs lthttpschooldiscoverycomschooladventureshealthdeadlyhighsgt
Freevibecom Drug Facts lthttpwwwfreevibecomDrug_Factgt
Governorrsquos Prevention Partnership lthttpwwwpreventionworksctorgrxinfogt
KidsHealth What You Need to Know about Drugs lthttpwwwkidshealthorgkidgrowdrugs_alcoholknow_drugshtmgt
MedlinePlus lthttpwwwnlmnihgovmedlineplusprescriptiondrugabusehtmlgt
National Clearinghouse for Alcohol and Drug Information A Guide for Teens lthttpwwwhealthorggovpubsphd68gt
National Institute on Drug Abuse (NIDA) lthttpwwwdrugabusegovgt
National Institute on Drug Abuse for Teens lthttpteensdrugabusegovgt
Neuroscience for Kids Explore the Brain and Spinal Cord (click on ldquoDrug Effectsrdquo) lthttpfacultywashingtoneduchudlerintrobhtmlgt
Office of National Drug Control Policy lthttpwwwwhitehousedrugpolicygovdrugfactprescr_drg_abusehtmlgt
Partnership for a Drug-Free America lthttpwwwdrugfreeorggt
PeerX The Facts lthttpteensdrugabusegovpeerxthe-factsgt
This fact sheet is continued on the next page
Fact sHeet 13a
helPful resourCes
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
38
Prescription Drug Abuse lthttpwwwprescription-drug-abuseorggt
SAMHSArsquos National Clearinghouse for Alcohol and Drug Information (NCADI) lthttpncadisamhsagovgt or 1-800-729-6686
Scholasticrsquos Headrsquos Up Real News about Drugs and Your Body lthttpteacherscholasticcomscholasticnewsindepthheadsupindexhtmgt
Substance Abuse and Mental Health Services Administration (SAMHSA) lthttpwwwsamhsagovgt
Teen Challenge Prescription Drug Information lthttpwwwteenchallengecomdrugsprescriptiondrugscfmgt
TeensHealth lthttpkidshealthorgteendrug_alcoholdrugsprescription_drug_abusehtmlgt Trouble in the Medicine Chest Rx Drug Abuse Growing lthttpncadisamhsagovgovpubsprevalertv64aspxgt
helPful resourCes Fact sHeet 13b
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Name _____________________________________
39
ldquoHow to Talk to Your Friendrdquo The Partnership for a Drug-Free America Revised March 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionHelpingOthersTeenTeen How_to_Talk_to_Your_Friendgt
Johnston LD OrsquoMalley PM Bachman JG and Schulenberg JE (2009) Monitoring the Future National Survey Results on Drug Use 1975-2008 Volume I Secondary School Students (NIH Publication No 09-7402) Bethesda MD National Institute on Drug Abuse 721 pages lthttpmonitoringthefutureorgpubsmonographsvol1_2008pdfgt
Levine DA (2007) ldquoPharming The Abuse of Prescription and Over-the-Counter Drugs in Teensrdquo Current Opinion in Pediatrics Vol 19 No 3 pages 270-274
National Institute on Drug Abuse NIDA InfoFacts Prescription and Over-the-Counter Medications lthttpwwwdrugabusegovinfofactsPainMedhtmlgt Bethesda MD NIDA NIH DHHS Revised July 2009 Retrieved September 2010
National Institute on Drug Abuse NIDA Research Report Prescription Drugs Abuse and Addiction lthttpwwwdrugabusegovResearchReportsPrescriptionPrescriptionhtmlgt NIH Publication No 05-4881 Bethesda MD NIDA NIH DHHS Revised August 2005 Retrieved September 2010
ldquoPrescription Drug Abuserdquo The Mayo Clinic Revised June 2010 Retrieved September 2010 lthttpwwwmayocliniccomprintprescription-drug-abuseDS01079 METHOD=printampDSECTION=allgt
ldquoPrescription for Danger A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse among the Nationrsquos Teensrdquo Office of National Drug Control Policy January 2008 ltwwwtheantidrugcompdfsprescription_reportpdfgt
ldquoSigns Someone is Using Drugs or Alcoholrdquo The Partnership for a Drug-Free America Revised June 2006 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionArticles Signs_Someone_Is_Usinggt
ldquoStages of Substance Abuserdquo The Partnership for a Drug-Free America Revised April 2008 Retrieved September 2010 lthttpwwwdrugfreeorgInterventionWhereStartStages_of_Substance_Abusegt
Substance Abuse and Mental Health Services Administration (2009) Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies NSDUH Series H-36 HHS Publication No SMA09-4434) Rockville MD lthttpwwwoassamhsagovnsduh2k8nsduh2k8ResultscfmTOCgt
Fact sHeet 14
bibliograPhy
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40
Human relations meDia PrescriPtion Drugs uPDate
Visit our website for detailed descriptions of the above programs
Available from Human Relations Media
41 Kenisco DriveMount Kisco NY 10549
Phone 800431-2050 bull Fax 914244-0485 bull Web wwwhrmvideocom
Human relations meDia
other PrograMs
Buzz in a Bottle The Dangers of Caffeine-Spiked Energy Drinks video and print
The New Marijuana Higher Potency Greater Dangers video and print
Anatomy of a Puff video and print
Addiction and the Human Brain video and print
Everything You Need to Know about Alcohol in 22 Minutes video and print
Straight Talk The Truth about Alcohol and Sex video and print
Legal But Deadly Abusing Prescription Drugs video and print
Everything You Need to Know about Tobacco in 22 Minutes video and print
Everything You Need to Know about Substance Abuse in 22 Minutes video and print
DUI The Hard Truth video and print
Drugs Crime and Punishment video and print
Tales from the Prom The Good the Bad and the Ugly video and print
The Myths of Marijuana Debunked video and print
Spit This The Hazards of Smokeless Tobacco video and print
Abusing Over-the-Counter Drugs video and print
Drugged Driving The Road to Disaster video and print
The Top Ten Myths About Alcohol and Drugs video and print
Pharm Parties A Lethal Mix video and print
Rushing Crashing Dying The Meth Epidemic video and print
Understanding Fetal Alcohol Syndrome video and print
40