Presenters Presenter name Date (Title slide – insert presenter names and date, if desired) We are here to raise awareness about a serious and growing public health problem – the misuse and abuse of prescription medications. This program was developed by the Generation Rx Initiative at the Ohio State University College of Pharmacy, with the support of Cardinal Health.

Generation Rx – keep your family safe The prescribing of medications is the most common type of medical treatment – nearly 4 billion outpatient prescriptions are issued in the U.S. annually. The term “Generation Rx” has been used to describe all of us in American society, because we use medications at unprecedented rates at every age, we expect “quick fixes” to our health problems, prescription drugs are marketed directly to us (note: the U.S. and New Zealand are the only developed countries that allow this), and the use of pharmaceuticals has become normalized within our day-to-day lives. This use of prescription medications obviously has many beneficial effects. We are living longer and healthier lives, and previously fatal diseases are being converted to chronic conditions. So the use of prescription medications under proper medical supervision can certainly be very helpful or even life-saving. But any medication can produce adverse effects as well, especially when misused or abused. These behaviors include using a medication that is not prescribed for you, taking different amounts of a medication than that prescribed, and using prescription medications for non-medical purposes (e.g., to “get high” or study for an exam). Even if you intend to treat a self-diagnosed condition such as pain or anxiety with someone else’s prescription medication, you are still misusing drugs.

There’s a reason for the prescription When sharing isn’t caring. Generation Rx is prone to self-diagnosing and self-prescribing due to easy access to information about medications (e.g., on television and the Internet). Self-diagnosing is the act of identifying yourself as suffering from a medical condition without using the expertise of a medical professional. Self-prescribing is “treating” a self-diagnosed condition by obtaining medications without a prescription. The Food and Drug Administration (FDA) is responsible for approving any medication for use in the United States. In some cases, medications are approved for non-prescription (or “over-the-counter”) use. In many other cases, approved medications require a prescription for use. This protection, which has evolved from U.S. laws and regulations since the beginning of the 20th Century, indicates that medical experts do not feel that it is safe for patients to use these particular drugs without professional supervision. When we use prescription drugs without medical supervision, we circumvent this protection. So, giving your prescribed medications to others is irresponsible (“sharing isn’t caring”) and taking medications that you obtain from others can lead to serious harm or even death.

America’s biggest drug problem isn’t on the streets… …it’s in our medicine cabinets. The adverse effects from medications, especially when they are misused or abused, cost our healthcare system many billions of dollars every year. They are responsible for harming people, are the reason for many emergency department visits or hospitalizations, and can even lead to death. In fact, researchers have shown that we spend more in our healthcare system on drug-related problems than on drug products. Most people who abuse medications like prescription painkillers get them from family members or friends, often from the medicine cabinet. It is important that patients keep their medications in secure and locked locations, protected from others who may wish to abuse them. When we are no longer using medications it is also important to properly dispose of them. Certain medications which are no longer needed can be flushed down the toilet. Others should be mixed with noxious materials and put in the trash. The Food and Drug Administration provides guidance about proper medication disposal at www.fda.gov.

Prescription medication abuse – on the rise Between 6 and 7 million Americans have abused prescription medications in the past month. Nearly 7,000 Americans initiate medication misuse or abuse every day. Everyday, approximately 2,500 young people between 12 and 17 years of age abuse a prescription painkiller for the first time. Four out of the top five drugs abused by 12th graders are prescription or non-prescription medications. Data from the National Survey on Drug Use and Health (Substance Abuse and Mental Health Services Administration, SAMHSA) indicate that the abuse of prescription medications exceeds that for all illicit “street” drugs combined, except marijuana. And for those first abusing a substance, the abuse of prescription painkillers is equivalent to that of marijuana. Between six and seven million Americans have abused a prescription medication in the past month (SAMHSA). The Office of National Drug Control Policy estimates that approximately 2,500 young people between 12 and 17 years of age abuse a prescription painkiller every day for the first time, one in three teens report knowing someone who abuses prescription drugs, and four of the top five drugs abused by 12th graders are prescription or non-prescription medications. According to the 2010 Partnership Attitude Tracking Study (Partnership for a Drug-Free America), 1 in 4 teens have taken a prescription drug without a prescription. It is important to realize that prescription drug abuse has consequences for all of us – at every age.

Examples of frequently abused prescription medications Painkillers OxyContin®, Vicodin® Sedatives & tranquilizers Valium®, Xanax® Stimulants Adderall®, Ritalin® Prescription painkillers (e.g., OxyContin and Vicodin), sedatives/tranquilizers (e.g., Valium & Xanax), and stimulants (e.g. Ritalin & Adderall) are most prone to abuse. These drugs are referred to as “controlled substances,” and there are strict prescribing and dispensing regulations for their use. Federal laws prohibit the possession of these drugs without a prescription. Slang terms used for these drugs include: OCs’, Oxy80 or Cotton for OxyContin; Vike, Watson-387 for Vicodin; Benzos, Tranks for sedatives and tranquilizers; Uppers, study or smart drugs for stimulants 3. Non-prescription medications can also be abused. Cough and cold preparations are of particular concern. These preparations which contain dextromethorphan (or DXM) can cause intoxication and even hallucinations at high doses. Slang terms in dextromethorphan include Dex, Vitamin D, Robo and Skittles.

MYTH- prescription medications are safer than street drugs Majority of teens report that prescription drugs are easier to get than illegal drugs. Many believe that abusing prescription drugs is much safer than illegal “street” drugs. “The Partnership Attitude Tracking Study” reports that: the majority of teens agree strongly or somewhat that prescription drugs are easier to get than illegal drugs; many also agree strongly or somewhat that prescription drugs (even if they are not prescribed by a doctor) are much safer that illegal drugs, that there is nothing wrong with using prescription drugs without a doctor’s prescription once in a while, and that prescription painkillers (even if they are not prescribed by a doctor) are not addictive.

MYTH- prescription medications are safer than street drugs Majority of teens report that prescription drugs are easier to get than illegal drugs. Many believe that abusing prescription drugs is much safer than illegal “street” drugs. TRxUTH – this myth is DEAD WRONG! Unintentional drug poisoning is now the 2nd leading cause of accidental death in the U.S. These myths are dead wrong! For example, unintentional drug poisonings (the majority of which are due to prescription painkillers) are now the second leading cause of accidental death in the U.S. (Centers for Disease Control and Prevention). In some states, it is the leading cause of accidental death.

TRxUTH and consequences Health, legal, social and personal development considerations. Thousands of emergency department visits every year are related to prescription medication misuse or abuse. Drug treatment admissions for prescription drug addictions have increased dramatically in recent years. The abuse of prescription drugs can lead to many negative consequences relating to health, legal, economic, social and personal development problems. Hundreds of thousands of emergency department visits each year relate to the misuse and abuse of prescription and non-prescription medications. Drug treatment admissions for addictions to prescription drugs have increased dramatically in recent years. It is against federal laws to obtain “controlled” prescription substances like painkillers, sedative/tranquilizers and stimulants without a prescription. Abusing any substance can have a negative effect on your relationships with family members and friends. Relying on any substance to be academically or professionally successful (e.g., so-called “cognitive enhancers”) without medical supervision can impede the development of healthy habits and behaviors which lead to long-term professional success.

What can I do? Store prescription drugs safely and dispose of them properly. Participate in a medication disposal day in your community. Avoid tendencies to self-diagnose and self-prescribe. Model safe medication-taking practices for others. Talk with your family members, friends and neighbors. Store prescription drugs (especially painkillers, sedatives, tranquilizers, and stimulants) in locked and secure locations. Dispose of prescription drugs properly when you no longer need them. Participate in a medication disposal day. Avoid tendencies to self-diagnose and self-prescribe. Model safe medication-taking practices for others. Talk about it! Educate others about the dangers of abusing prescription and non-prescription medications. 10

Where can I learn more? National Council on Patient Information and Education (www.talkaboutrx.org) National Institute on Drug Abuse (www.nida.nih.gov) Office of National Drug Control Policy (www.whitehousedrugpolicy.gov) Parents.The Anti-Drug (www.theantidrug.com) Partnership for a Drug-Free America (www.drugfree.org) Stop Medicine Abuse (www.stopmedicineabuse.org) created by the Consumer Healthcare Products Association Substance Abuse and Mental Health Services Administration (www.samhsa.gov) The Ohio State University College of Pharmacy Generation Rx Initiative (www.go.osu.edu/generationrx) These websites are provided on the accompanying presentation handout.

Developed by The Ohio State University College of Pharmacy The GenerationRx Initiative is a trademark of The Ohio State University College of Pharmacy. Developed by The Ohio State University College of Pharmacy This program is made possible with a grant from the Cardinal Health Foundation.