Are Your Patients Misusing Prescription Drugs?

IS YOUR PATIENT ABUSING OR MISUSING PRESCRIPTION DRUGS? KNOW THE SIGNS.A GUIDE TO UNDERSTANDING PRESCRIPTION DRUG ABUSE AND THE ROAD TO HEROIN.

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IS YOUR PATIENT ABUSING OR MISUSING PRESCRIPTION DRUGS? KNOW THE SIGNS. A GUIDE TO UNDERSTANDING PRESCRIPTION DRUG ABUSE AND THE ROAD TO HEROIN.

877-505-HOPE (4673) | RecoverGateway.org

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Contents

Prescription Drug Abuse is a Growing Trend.....3

Risks Associated with Prescription Drug Abuse.....4

Commonly Abused Prescription Drugs.....5

Signs and Symptoms of Prescription Drug Abuse.....5

Link to Heroin.....6

What is Heroin?.....7

What Does Heroin Look Like?.....7

Teen Heroin Use.....8

Signs and Symptoms of Heroin Abuse.....8

Long-Term Effects of Heroin Abuse.....9

Heroin and the Brain.....9

Treatment for Heroin Abuse.....10

Evidence-Based Practices.....10

The Joint Commission Accreditation.....12

About Gateway Alcohol & Drug Treatment Centers.....13

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The National Institute on Drug Abuse (NIH) found that, following marijuana and alcohol, prescription and over-the-counter drugs have become the most commonly abused substances by Americans 14 and older.*

The process of becoming dependent on prescription drugs can begin easily and often, innocently. “Sometimes, your patients may not finish their medication and might give it away to others who need it, or the person’s children or other family members may find it,” explains Carl Scroggins, Overdose Prevention Programs Supervisor at Gateway.

According to the NIH, these drugs are often perceived as safer than illicit drugs but, when abused, pose serious health risks including overdose. The National Institute on Drug Abuse (NIDA) found that more people die from prescription opioid overdose than all other drugs combined.

*The National Institute of Health (NIH) - 2015

Where Are Prescription Drugs Obtained?

3.9%Drug dealer or stranger

1.9%From more than one doctor

0.3%Purchased Online

Source: Drug Abuse.gov

18.1%From one

doctor

54.2%FREE from friend or relative

16.6%Bought/took from friend or relative

5%Other

The majority of unprescribed drugs are obtained from friends or relatives.

adults in the U.S. have abused prescription drugs in their lifetime. Source: NSDUH

Prescription Drug Abuse is a Growing Trend

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The risks associated with prescription drug abuse vary depending upon the drugs that are abused. Abuse of opioids/narcotics/pain relievers can result in life-threatening respiratory depression (reduced breathing).

Risks Associated with Prescription Drug Abuse

If your patients abuse depressantsincluding benzodiazepines, tranquilizers, barbiturates and sedatives, they place themselves at risk of seizures, respiratory depression and decreased heart rate.

Stimulant abuse can causehigh body temperature, irregular heart rate, cardiovascular system failure and fatal seizures. It can also result in hostility or feelings of paranoia.

If your patients abuse prescription drugs by injecting them, they can be exposed to additional risks, including contracting HIV (human immunodeficiency virus), hepatitis B and C and other blood-borne viruses.

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The commonly abused prescription drugs in the United States fall into several broad categories.

Your patients may abuse these drugs because they are an easily accessible and inexpensive means of altering a user’s mental and physical state; the effects vary depending upon the drugs they abuse.

Commonly Abused Prescription Drugs

PainkillersVicodin, Tylenol with Codeine, OxyContin, Percocet

DepressantsKlonopin, Nembutal, Soma, Valium, Xanax

StimulantsAdderall, Concerta, Dexedrine, Ritalin

• Constricted pupils, slurred speech • Personality changes, mood swings, irritability • Excessive energy, avoiding sleep • Sweating, flushed skin, loss of appetite • Forgetfulness, sleepiness and clumsiness • Patients claiming to losing pills and needed more

Signs and Symptoms of Prescription Drug Abuse

DID YOU KNOW?Adolescents are at a greater risk for addiction to OxyContin than adult users of the narcotic prescription drug?

If you prescribe medications, it’s important to know that adolescent OxyContin addiction “results in lasting functional changes in the developing adolescent brain.”*

*Source: Neuropsychopharmacology, Sept. 10, 2008 issue published by Rockefeller University research

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Research now shows addiction to prescription opioids such as Vicodin and Oxycontin may open the door to heroin abuse. Making the transition from one to the other is frequently a matter of economics and accessibility: The cost of prescription pills is $20 to $60, while the easier to access heroin sells for $3 to $10 a bag.

In the past five years, heroin use has increased by 75 percent, according to Substance Abuse and Mental Health Services Administration (SAMHSA). No longer a predominantly urban issue, its use has mushroomed in the suburbs, with the greatest increases seen in young adults aged 18 to 25. Also rising, is the number of heroin overdoses.

“Opioid overdose kills thousands of Americans every year,” Mr. Scroggins stated. “Many of those deaths might have been prevented by an inexpensive drug called Naloxone (Narcan®).”

Administered in hospital emergency rooms and at all Gateway locations, Naloxone can reverse the effect of opioids. Illinois is one of several states that allows the drug to be prescribed to family members and other third parties, which can buy precious time before EMT personnel arrives.

Link to Heroin

$20 to $60Average cost of

prescription pain pills

$3 to $10Average cost of a bag of heroin

Source: NCADD.org

Heroin and Rx Drug Abuse Is On The Rise

Secondary Drug of Choice:

Prescription Drugs

Primary Drug of Choice:

Heroin

16.5%

17.2%

23.3%

8.8%

9.2%

11.6%

Based on Gateway Alcohol & Drug Treatment Centers trends in treatment 2012-2014

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Heroin is the most abused and rapidly acting of the opiates. It has been classified by the federal government as a Schedule I narcotic with no legal use. Users most often consume heroin by snorting, smoking or needle injection.

Highly addictive, about 1 out of 4 people (23%) who use heroin become dependent on it.

A heroin high generally lasts between 4-5 hours. Users experience a euphoric “rush,” warming of the skin, dry mouth and a feeling of heaviness in the extremities.

Fast acting, once a person uses heroin, it enters the brain quickly and affects the regions responsible for producing physical dependence. After repeated exposure, heroin users develop tolerance and increase their dose to achieve the desired high. Thus, the vicious cycle of heroin addiction begins.

To make matters worse, people who want to quit heroin often find themselves using again to manage withdrawal symptoms.

What is Heroin?

Heroin is processed from morphine and usually appears as a white or brown powder. Larger blocks of heroin may also appear as a black sticky substance called black tar heroin.

What Does Heroin Look Like?

75%increase in heroin usage in the past 5 years (SAMHSA)

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Why is heroin tempting to teenagers? As prescription opiates become harder to obtain and more expensive, users of opiates are migrating to a cheaper, stronger alternative to prescription pills: heroin. 24% of high school students have abused addictive prescription drugs, a 33% increase in 5 years.

Teen Heroin Use

• Today’s portrait of a typical heroin user probably isn’t what most people imagine. The growth in heroin use is primarily among white, middle and upper class 18-22 year olds, living in America’s suburbs and rural areas.

• An increase in teen heroin use is an unfortunate outcome of another sweeping drug abuse trend among affluent teens: abuse of prescription pain medications, such as Vicodin and Oxycontin.

Signs and Symptoms of Heroin Abuse

• Withdrawal from friends and family; spends more time with new friends.

• Stealing or borrowing money from loved ones, or unexplained absence of valuables.

• Wearing long pants or long sleeves to hide needle marks, even in very warm weather.

• Poor performance in school or work. • Decreasing attention to hygiene and physical appearance. • Shallow breathing and shortness of breath. • Clouded mental functioning. • Uncontrollable feelings of itching. • Constricted pupils. • Substantial increase in time spent sleeping. • Increase in slurred or incoherent speech.

33%increase in addictive

prescription drug abuse among high school students

in the past 5 years

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RISKS OF USING HEROIN

• Heroin users do not know the purity of the heroin they are using–so both new and experienced heroin users can easily overdose.

• The impact of heroin use is more unpredictable when used with alcohol or other drugs.

• Heroin overdoses–which can result whether the drug is snorted, smoked or injected–can cause slow and shallow breathing, convulsions, coma and even death.

• Heroin can kill. Heroin is one of the most frequently reported drugs by medical examiners in drug abuse deaths.

The long-term effects of heroin abuse invade your patients emotional health. As dependency worsens, your patient may lose the ability to handle stress or make decisions without the “support” from a heroin high. Job loss, financial ruin, relationship problems and arrest for crimes committed to feed the addiction are not uncommon.

After repeated exposure, heroin users develop tolerance, which means they must increase their dose to achieve the desired high. Once tolerance develops, users no longer experience the heroin high they once did. Oftentimes, abusers with a heightened tolerance continue using heroin to simply feel normal and avoid the discomfort of withdrawal.

Long-Term Effects of Heroin Abuse

Heroin enters the brain quickly. It slows down the way a person thinks, slows down reaction time and slows down memory. This affects the way one acts and makes decisions.

When heroin enters the brain, it is converted to morphine and binds to receptors known as opioid receptors. These receptors are located in many areas of the brain (and in the body), especially those involved in the perception of pain and in reward. Opioid receptors are also located in the brain stem–important for automatic processes critical for life, such as breathing (respiration), blood pressure and arousal. Heroin overdoses frequently involve a suppression of respiration.

Heroin users also experience severe heroin cravings during withdrawal, which can precipitate continued abuse and/or relapse. Major withdrawal symptoms peak between 48 and 72 hours after the last dose of the drug and typically subside after about one week. Some individuals, however, may show persistent withdrawal symptoms for months. Although heroin withdrawal is considered less dangerous than alcohol or barbiturate withdrawal, sudden withdrawal by heavily dependent users who are in poor health is occasionally fatal.

Heroin and the Brain

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As much as you may want a patient who abuses heroin to seek addiction treatment, similar to other medical treatments, you can’t force your patient to get help.

As a medical professional you can only encourage your patient to consider substance abuse treatment as an option. Recovery will come, only if and when the substance abuser truly decides to seek a healthier lifestyle.

It’s important that when referring a patient to treatment for prescription drug or heroin abuse, your referral is to a reputable organization that utilizes evidence-based practices and is accredited by The Joint Commission.

Evidence-based counseling and therapies include treatments that integrate professional research and clinical expertise to achieve the best outcome for your patient.

Treatment for Heroin Abuse

Medication Assisted TreatmentResearch shows that medication assisted treatment (MAT) helps patients remain drug and alcohol free.

Treatment for dependency on opiates, alcohol or other substances can include the use of a few medications, including Vivitrol® and Suboxone®. In addition to prescribed medications, it’s important that the patient receives counseling to help increase their motivation for recovery and enhance overall quality of life. It also helps patients develop the skills needed to recognize events that may trigger their use of drugs or alcohol and how to cope with those situations in a healthy way.

Evidence-Based Practices

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Motivational InterviewingMotivational Interviewing has strong scientific support for being a highly effective therapy for those with a substance abuse problem.

Counselors assist patients in exploring their core values and deeply held goals. These values and goals are usually inconsistent with continued substance abuse, so they become the guiding force toward behaving in a way that is consistent with positive, healthy living.

12-Step Facilitation and 12-Step Recovery

• Explains the concepts of the twelve-step approach used to assist in recovery.

• Actively supports initial involvement in AA/NA. • Reduces anxiety about attending meetings. • Facilitates participation and helps individuals learn to turn to AA/NA as a resource in times of crisis.

Family Counseling and EducationFamily Counseling sessions address family situations caused by substance abuse. Issues are addressed in an open and respectful atmosphere. Licensed counselors listen to the challenges family members have been experiencing, and teach coping skills. The counselor sheds light on how to support a chemically dependent family member and explains what to expect in recovery.

Family Education helps family members learn about the addiction process, heal past harms and build supportive relationships. Family Education lessons vary to meet specific group and individual family needs. Family concerns in dealing with addiction are addressed to improve recovery support, such as: stages of abuse and change, how treatment works, stages of family recovery, family roles and communication skills.

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The Joint Commission Gold Seal of Approval™ is an internationally recognized symbol of quality. Organizations that earn the Gold Seal have met rigorous performance standards to obtain this distinction by becoming accredited.

Specially trained health care professionals who are experts in the field personally visited this drug treatment facility to conduct a review that monitors how well the staff:

The Joint Commission Accreditation

As of 2009, only 30% of all behavioral healthcare organizations maintain the standards to receive this accreditation.

All Gateway Alcohol & Drug Treatment Centers are licensed by the state of Illinois and accredited by The Joint Commission.

• Provides a safe environment for your care • Educates you about the risks and options for your diagnosis and treatment

• Protects your rights as a patient, including your privacy rights • Evaluates your condition, before, during and after diagnosis and treatment

• Protects you against infection • Plans for emergency situations

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Gateway Alcohol & Drug Treatment Centers provide substance abuse treatment services for teens and adults at drug treatment centers throughout Illinois including Carbondale, Aurora (Fox Valley), Chicago, River North, Lake Villa (Lake County), Springfield (Central Illinois), and the St. Louis Metro East area.

Gateway’s outpatient and residential treatment centers are licensed by the state of Illinois and accredited by The Joint Commission. Each year, Gateway’s professional clinicians help thousands of individual’s successfully complete treatment.

Learn more about Gateway’s free, confidential consultation at RecoverGateway.org, or call (877) 505-4673.

About Gateway Alcohol & Drug Treatment Centers

Healthcare

Are Your Patients Misusing Prescription Drugs?