michael o’neil, pharm.d director, center of excellence for the education and prevention of drug...
TRANSCRIPT
Understanding the Cultures of Prescription Drug Abuse, Misuse, Addiction and Diversion
Michael O’Neil, Pharm.DDirector , Center of Excellence for the education and Prevention of Drug Diversion and Substance AbuseConsultant State BCI / Federal D.E.A.Pain Management ExpertAddiction Specialist
Objectives
Discuss the general “cultures” of prescription drug abuse
Review the common agents of abuse
Review methods of prescription drug abuse deterrence
Understanding the Cultures of Prescription Drug Abuse
The first rule to NEVER forget about drug diversion and substance abuse is ..NEVER CONFUSE THE ISSUES WITH FACTS!
Prescription Drug Abuse, Misuse, Addiction, Diversion
Prescription Drug Abuse, Misuse, Addiction, Diversion
Sharing CultureSharing CultureSharing CultureSharing Culture
Adult Adolescent to Adult /
Adolescent
Adult Adolescent to Adult /
Adolescent
Adult to Child
Adult to Child
Individual or PatientIndividual or Patient
The Income Driven Culture
The Income Driven Culture
PractitionerPractitioner
Substance Abuse Culture
Substance Abuse Culture
Mood Modifiers
Mood Modifiers
ExperimentersExperimenters
The Addiction Culture
The Addiction Culture
Active AddictsActive
Addicts
The “Bridging”Population
The “Bridging”Population
Addicts in AbstinenceAddicts in
Abstinence
Recovering Addicts In
MaintenanceTherapy
Recovering Addicts In
MaintenanceTherapy
Prescription Drug Abuse in the Community: The “Sharing” Culture
Perception that Rxs are
safe for everyone -Drug -Dose -Route - “Helping” - “Self Medicating”
Availability of left-over “Scripts”
Sharing CultureSharing Culture
Adult Adolescent to Adult /
Adolescent
Adult Adolescent to Adult /
Adolescent
Adult to Child
Adult to Child
Prescription Drug Abuse in the Community: The “Income” Culture
The disabled patient
The disabled economy The Schemes - Doctor shopping - Using kids - Theft Prescriber Driven
Income
Individual or PatientIndividual or Patient
The Income Driven Culture
The Income Driven Culture
PractitionerPractitioner
Prescription Drug Abuse in the Community: The “Substance Abuse” Culture
ExperimentersExperimenters
“Pharming” Parties -Social Perception /
Acceptance -Peer pressure Planned Events Relaxation Work driven problems Home driven problems Society driven problems -Anxiety -Depression -PTSD -Bipolar -Coping
Substance Abuse Culture
Substance Abuse Culture
Mood Modifiers
Mood Modifiers
Prescription Drug Abuse in the Community: The “Addiction” Culture
Maintaining the “high” - The more you use the more
you need
Bridging the gaps between the “highs” ***
Treatment-Maintenance Therapy ****
The Addiction Culture
The Addiction Culture
Active AddictsActive
Addicts
The “Bridging” Population
The “Bridging” Population
Addicts in
Abstinence
Addicts in
Abstinence
Recovering Addicts In
Maintenance Therapy
Recovering Addicts In
Maintenance Therapy
“The Wicked Web”
Motivation for use of inappropriate substances
Physical Performance enhancers Mental Performance enhancers “Social” performance enhancers Self Medication for injuries, stressors,
mental disease (depression, anxiety, bipolar, etc)
What’s Being Abused and Why
What’s Being Abused and Why
Categories of Prescription Drug Abuse
OPIATES
Hydrocodone Oxycodone Hydromorphone Codeine Morphine Fentanyl Methadone Buprenorphine
BENZODIAZEPINES
Clonazepam Alprazolam Diazepam Lorazepam
Categories of Prescription Drug Abuse
ANTIPSYCHOTICS
Seroquel Haloperidal Risperadal
STIMULANTS
Methylphenidate Dextrose-
amphetamines
15
Categories of Prescription Drug Abuse
ANTIDEPRESSANTS
Zoloft Lexapro Cymbalta Prozac Effexor Paxil
Muscle Relaxants Flexeril Skelaxin
ANTIHYPERTENSIVE
Clonidine Lopressor Atenolol Propranolol
Anticonvulsants Neurontin Carbamazepine pregabalin
Categories of Prescription Drug Abuse
ANTIDEPRESSANTS
Zoloft Lexapro Cymbalta Prozac Effexor Paxil
ANTIHYPERTENSIVE
Clonidine Lopressor Atenolol Propranolol
Categories of Prescription Drug Abuse
Antiemetics Phenergan Benadryl Atarax Zofran
Sex Enhancers Viagra Cialis Levitra
There are “cocktails” and THEN there are “Cocktails”
Outcomes
+
=
Questions