Prescription drug abuse

Prescription drug abuse

Misuse of prescription drugs means

taking a medication in a manner or dose other than prescribed;

taking someone else’s prescription, even if for a legitimate medical complaint such as pain;

or taking a medication to feel euphoria (i.e., to get high).

Everyday thousands of teenagers use prescription drugs to get high for the first time. Prescription drug abuse is STILL DRUG ABUSE.

Although prescribed originally by a medical doctor, the abuse of prescription drugs has escalated into an epidemic. People somehow believe prescription drugs are harmless and not as bad as other illegal drugs, like cocaine or heroin. Due to their potential for abuse and addiction, many prescription drugs have been categorized in the same category as opium or cocaine. These include Ritalin and Dexedrine (stimulants), and the painkillers OxyContin, Demerol and Roxanol.

The persons that are mostly abusing prescription drugs are woman, elderly people and teenagers. Painkillers, sleeping tablets and anti-anxiety drugs  are the drugs most abused.

Medicine schedules in South Africa: what do they really mean?

Medicine schedules are there to keep us safe and protect us from things like accidentally becoming addicted to codeine. A medicine schedule is the number given to pharmaceutical products based on their benefits and risks — in a nutshell, the lower the risk, the lower the medicine schedule.

There are three main types of medicine schedules

Unscheduled medicines

Unscheduled medicines have a schedule of 0 (S0 medicines).
You can buy them on the shelves at places like pharmacies, supermarkets, health shops or service stations.
Things like aspirin, vitamins and even some topical creams are considered schedule 0 medicines.

Over-the-counter medicines

It’s all in the name really; over-the-counter medicines (or OTC medicines) are medicines that can be given to you over the counter without a prescription.
Over-the-counter medicines have a schedule of 1 or a schedule of 2 (S1 and S2 medicines).
Although you don’t need a prescription for schedule 1 and 2 medicines, you can only buy them from a pharmacy and they must be given to you by a pharmacist.
In South Africa, pharmacists are required by law to write down your name and the name and quantity of the medicine whenever you buy a schedule 1 or 2 medicine.
Things like cold and flu remedies, antihistamines and anti-inflammatories are considered schedule 1 and 2 medicines.
The reason why these medicines are behind the counter is because you should be consulting the pharmacist about the best treatment for your condition based on things like other medication you might be on, your weight and age and other complicating factors. Pharmacists are trained to help, so use them!

Prescription medicines

In South Africa, any medicine classified as schedule 3 or higher is a prescription medicine.
To get prescription medicine, you need: a prescription from a doctor, dentist or allied health professional, which you then take to a pharmacy to be filled. The pharmacist should explain how to take the medicine — ask as many questions as you like and only leave when you’re sure you understand how to take the medicine.
By law, you can only get a 6-month repeat prescription for schedule 3 and schedule 4 medicines.
Medicine with a high scheduling status (usually schedule 5 and above) is treated differently because of its habit-forming nature and potential harmful side effects — pharmacists keep a record of all sales, and repeat prescriptions are limited or not given, and need to be renewed.

Schedule 4:  Anti-infectives for example antibiotics & anti-retro-virals / Prescription only, available from the pharmacy dispensary,  prescription can be renewed for 6 months.

Schedule 5: Psycho-active medicines like sedatives & anti-depressants / Prescription only, available from the pharmacy dispensary,  repeats stipulated.

Schedule 6:  Narcotic painkillers/ Prescription only, available from the pharmacy dispensary.

Schedule 7: Drugs like cannabis & heroin / Controlled substances

Schedule 8: Amphetamine, dexamphetamine & Nabilone / Strictly controlled substances

Classification of prescription medicine that is abused

1. Stimulants

Dexedrine, Desoxyn, Ritalin, Preludin, Didrex, Plegin, Nuvigil, Tenuate, Fastin, Lonamin, Adipex, Sanorex, Mazanor, Provigil, Meridia

2. Opiates

Morphine, Pethidine

Short-term effects of opioids and morphine derivatives include:
  • Drowsiness
  • Slowed breathing
  • Constipation
  • Unconsciousness
  • Nausea
  • Coma
Long term effects

Continued use or abuse of opioids can result in physical dependence and addiction. The body adapts to the presence of the drug and withdrawal symptoms occur if use is reduced or stopped. These include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, and cold flashes with goose bumps (“cold turkey”). Tolerance can also occur, meaning that long-term users must increase their doses to achieve the same high.

3. Tranquilizers / Depressants

Major tranquilizers: Haldol, Thorazine, Prolixin, Etrafon, Compazine
Minor tranquilizers: Xanax, Klonopin, Valium, Ativan

Depressants: short-term effects
  • Slow brain function
  • Slowed pulse and breathing
  • Lowered blood pressure
  • Poor concentration
  • Confusion
  • Fatigue
  • Dizziness
  • Slurred speech
  • Fever
  • Sluggishness
  • Visual disturbances
  • Dilated pupils
  • Disorientation, lack of coordination
  • Depression
  • Difficulty or inability to urinate
  • Addiction

Addiction is a chronic, often relapsing brain disease. It causes compulsive drug seeking and use despite harmful consequences to the addicted person as well as the people around that person. The abuse of drugs — even prescription drugs — leads to changes in the structure and function of the brain.

It is often one of the most difficult dependencies to recognize or diagnose. Although the medicine might be prescribed for a certain time, the body becomes accustomed to it and the user will experience withdrawal symptoms once they stop the medication. This might be so uncomfortable that the user is too scared to stop the medication. Thus an addiction to prescription medication develops.

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A person that is developing an addiction to prescription medication could be very irritable, especially when prescriptions are not available. They could have difficulty sleeping, suffer from mood swings and consume larger quantities of alcohol in order to cope with withdrawal symptoms.

Signs of addictive behaviour could be:

  • Frequent requests for refills from physicians
  • Losing prescriptions and requesting replacements regularly
  • Crushing or breaking pills
  • Stealing or borrowing prescription medications from family members, friends, or co-workers
  • Consuming prescriptions much faster than indicated
  • Visiting multiple doctors for similar conditions
  • Inconsistent answers to questions about prescription usage
  • Stealing or forging prescriptions
  • Consumption of over-the-counter drugs for the same conditions that a doctor has prescribed other medication
  • Ordering prescription medications over the internet

Self help

Safety rules when taking prescription medicine

  • Always follow the prescription medication directions carefully.
  • Don’t increase or decrease medication doses without talking with your doctor first.
  • Never stop taking medication on your own.
  • Don’t crush or break pills (especially important if the pills are time-released).
  • Know the drug’s effects on driving and other daily tasks.
  • Prescription medication can interact negatively with other medication or alcohol
  • Tell your doctor if you have  a history of substance abuse.
  • Never allow other people to use your prescription medications and don’t take theirs.

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Keep prescription medication safely locked away from children, to prevent accidental overdose.

What to do in case of an overdose:

Drug overdoses can be accidental or intentional. They occur when a person takes more than the medically recommended dose, or the wrong medication or use it to get high intentionally. However, some people may be more sensitive to certain medications, so the low (more dangerous) end of a drug may be toxic for them; a dose that is still within the range of acceptable medical use may be too much for their bodies to handle.

Illicit drugs, used to get high, may be taken in overdose amounts when a person’s metabolism cannot detoxify the drug fast enough to avoid unintended side effects.

  • Home care should not be done without first consulting a doctor or poison expert.
  • You are not expected to know when a drug overdose is serious. If you cannot reach a qualified professional by telephone to discuss the overdose, it would be prudent for you to take the overdosed person to the nearest hospital’s emergency department or medical facility.
  • A person unwilling to go to the hospital may need persuasion by trained professionals in emergency medical services (paramedics and ambulance personnel) or law enforcement officials. You may call 911 for these services. Family members are also often helpful in persuading the person to seek medical care.
  • Anyone who is with a person who overdoses on drugs can assist by finding all medication or chemical containers and bringing them to the emergency department doctor.
  • Treatment will be dictated by the specific drug taken in the overdose. Information provided about amount, time, and underlying medical problems will be very helpful.
  • People who take a drug overdose in an attempt to harm themselves generally require psychiatric intervention in addition to poison management.
  • Everyone who suffers an overdose needs to be seen by his or her doctor for follow-up. In part, this is to ensure that there are no delayed injuries to any organ system.

MOBIEG Helpline

If you want to know more about prescription drug abuse, you can chat to an online facilitator on the LIVE CHAT.

The service is free and you may stay anonymous.

We are online for counselling Sundays 18h00-20h30

Mondays – Thursdays: 19h00-21h30

Quiz

You can do a self-test on Substance Abuse: Substance Abuse Quiz