How can you prevent your child or loved one from becoming addicted?
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Left: Anne Moss Rogers, annemoss.com, Right: Chris Baker, addict in recovery. Facebook LIVE: What can we do to stop the faucet of prescription meds in our communities? Watch it on Facebook.
6/24/2019 update- Since this aired, research on MAT, Medication Assisted Treatment, has changed and an important aspect of keeping someone alive and able to live life until they are mature enough for long term recovery. Recovery doesn’t look the same nor do all who go through recovery do it the same way and it’s important to be open-minded about MAT. More info here: Interview Part 2: Dr. Peter Coleman on Addiction MAT and Recovery
You can listen in the car on the way to work with your smartphone, you can read, comment and you can share. Punctuated with large headlines so you can find the info you want.
These are the things WE can do our community to curb this plague of drug addiction which was started with the prescribing of opiate medication and our medicine cabinets. If we all follow some best practices, we can curb this epidemic and save our children and other loved ones that could fall victim to this epidemic.
Surgeon General Letter & Guidelines
The Surgeon General in August 2016, sent all prescribing physicians a letter to not use opioids as their first line of pain relief.
First, let’s establish the top addictive and abused medications, opiates and benzodiazepines (often referred to as benzos)
What are opiates?
Sometimes called narcotics, some of the brand name opioids are:
- Vicodin (acetaminophen and hydrocodone),
- Percocet (Oxycodone and Acetaminophen)
- OxyContin (oxycodone)
- Morphine, Dolophine (Methadone)
- Suboxone (buprenorphine and naloxone)
- Dilaudid (Hydromorphone Hydrochloride)
- Codeine cough syrup
- Ultram (Tramadol – Also used for canines)
What are benzodiazepines?
Used to treat anxiety and sleep problems:
- Xanax (Alprazolam)
- Valium (diazepam)
- Klonopin (Clonazepam)
- Librium (chlordiazepoxide)
- Ativan (lorazepam)
- Restoril (temazepam)
What are stimulants?
These are often prescribed. However, if you have other siblings and teens in the house, they can be swiped.
Used to treat ADHD and narcolepsy:
- Adderall,Dexedrine, ProCentra, Dextrostat, Dexedrine or Zenzedi (Amphetamine/ Dextroamphetamine) Prescribed for your child’s ADHD but you need to make sure it’s not “skimmed” by other kids that come into your home
- Ritalin and Concerta (Methylphenidate)
- Metadate CD (methylphenidate hydrochloride)
- Focalin (Dexmethylphenidate)
- Desoxyn (Methamphetamine)
- Vyvanse (Lisdexamfetamine)
Surgery can create 7 million new addicts per day in the US
According to a national survey, one in ten patients admit they’ve become addicted to or dependent on opioids after being exposed to these powerful medications following an operation.
- Many addictions start with leftover meds in medicine cabinets or stimulants left in a convenient spot for a sibling
- Another starting point is when opiate and narcotic prescription medications are prescribed in bulk for wisdom teeth removal and after surgery
- Many athletes succumb to addiction after receiving opiates for pain following a surgery for an athletic injury
Teens leaving dental surgery are besieged with requests for their leftover medication. I have the proof here. One pill can trigger addiction. Why take the chance of losing your child to this opiate epidemic?
With 70 million surgical patients in the U.S. receiving an opioid annually, these findings suggest that as many as 7 million patients could develop an opioid addiction or dependency this year after surgery. These findings indicate that even prescribing these drugs for short-term post-surgical pain can put patients at serious risk.
Post Surgical Addiction Rates
- 10% addiction rates for adults
- Among younger people 18-29, the incidence is 15-18 percent*;
- For those living in the western region of the U.S., it soars to 18 percent.*
With over 300 overdoses per day, that doesn’t include all opiate-related death such as car accidents, bacterial infection from needles or suicide.
One pill can trigger an addiction in those predisposed
Charles, my son that died by suicide while going through withdrawal, got his first opiate at the hospital when he cracked his skull.
Prior to that, opiates did not show up on any of the drug tests he took. Afterwards, they did. One pill. It might not for you but to an addict, it is an entirely different feeling.
Where do people get prescription meds?
- Your medicine cabinets, your mom’s your neighbor’s cabinet
- Your handbag, glove boxes, kitchen cabinet (popular for canine meds and stimulants for other children in the house)
- Friend calls you and says she twisted her ankle and is in Pain. Do you have any leftover medicine?
- From aging parents who suffer from pain or are in hospice care
- Doctors: Primary care, orthopedic surgeons, oral surgeons, OB after baby etc.
- On the street, at school, delivered to your driveway, on street corners in your neighborhood, through the mail from the internet (deep internet)
- If they steal from your prescription, they take just a few so you won’t notice
What can we do? Lock it up!
Lock up meds including ones for the dog and stimulants for other children! Kids get hooked by finding medications in OUR cabinets. Not the drug dealers. They also sell them. Peer pressure is tremendous.
- Buy a safe – I ended up buying one off the internet for $250 (There are safes for less but ones with a key tend to get broken into.)
- Alternative is a Gun box – This one recommended by a law enforcement professional. $118
- Lock up stimulants for younger children as well as medicines used for the dog. Even if your teen doesn’t use them, their friends might and there is peer pressure to sell
- Open to other suggestions for locking up medicines
What can we do? Dispose of them!
- Get rid of them! Safely dispose of medications
a. Drug disposal buy backs – Bremo Pharmacy on Staples Mill here in Richmond, VA
c. Richmond Police stations all have a kiosk to disposed of old medicines
e. FYI- Fentanyl patches can be deadly to pets and young children! Use safe disposal protocols
What can we do? Be proactive
- Ask your pharmacist if they use Prescription Monitoring Program (PMP- The link is for Virginia but all states have them)?
- Tell your doctor you don’t want them to prescribe large quantities or prescribe them to anyone under 21 especially.
- Tell your doctor WHY. One pill can trigger a LIFETIME addiction which is a life-threatening illness
- Handy tool: Who is prescribing the most pain meds in your area? Look it up.
Talk to your doctors! Plan ahead for surgery pain!
Tell your doctor you don’t want opiates or benzos prescribed and discuss alternatives. Have the conversation BEFORE surgery. This also applies to dental surgery and wisdom teeth removal
- Go to Planning against pain before surgery
- Tell your doctor NO for opiates (often called narcotics) for your kids especially. Under 25 as they have a 15-18% chance of opiate addiction
- Alternatives are: (Please discuss with your doctor. You might have certain conditions that don’t allow for an NSAIDs.)
Some prescription alternatives
For dental or surgery pain, these have been suggested. Talk to your doctor and try PlanAgainstPain.com for planning for surgery pain without opiates.
- Spritz. Nasal spray – NSAID
- Etodolac Pills – NSAID
- Non narcotic muscle relaxer – Flexeril (cyclobenzaprine-there are warnings with Flexeril for long time use and abuse potential and it is not a benzodiazepine)
Natural alternatives
- Physical therapy, acupuncture
- Arnica – Like everything else, check with your doctor and try a little first. It might not agree with you.
- Ice! With orthopedic surgery not involving a cast, this helps tremendously. Insurance will usually pay for a ice cooler post surgery.
Heroin laced with elephant tranquilizer
- Heroin laced with elephant tranquilizer hits the streets – CNN
- Elephant Tranquilizer Could Be Linked to Wave of Heroin Overdoses in Midwest – NY Times
Why hospitals and some practices prescribe pain meds
As part of the Affordable Care Act, performance scores on publicly reported patient satisfaction surveys, including questions on how well a patient’s pain is controlled, are used to determine a portion of a hospital’s reimbursement from the Centers for Medicare & Medicaid Services (CMS).
Numerous medical experts and organizations have called for CMS to remove those pain-related questions, arguing it unintentionally encourages the overprescribing of opioids to obtain high scores on the pain management section of the survey.
This language in the Affordable Care Act is being addressed. See Melissa’s comment below.
- Stop Prescription Drug Abuse – More info for parents and loved ones
Thank you
Thank you to my special guest, Chris Baker, research help, Melissa Early (nurse), Connie Petoc and Terri from Midlothian Dental Arts.
Please share!
It’s the parents that are not tuned in who may inadvertently leave medication out and create another addict. So please share. That’s another thing that can educate and keep more opiates off the streets.
Walk with me in Richmond VA Sept 17! Out of the Darkness. Team Charles
Sources below:
- New Research: Opioid Addiction and Dependence After Surgery is Significantly Higher than Previously Known
- CDC: Injury Prevention & Control: Opioid Overdose
- See other Facebook LIVE events
Positive strides related to the patient survey’s pain related questions being tied to reimbursement:
According to a press release from HHS Secretary Sylvia Burwell on July 6, 2016:
“In order to mitigate even the perception that there is financial pressure to overprescribe opioids, the Centers for Medicare and Medicaid Services (CMS) is proposing to remove the HCAHPS survey pain management questions from the hospital payment scoring calculation. This means that hospitals would continue to use the questions to survey patients about their in-patient pain management experience, but these questions would not affect the level of payment hospitals receive.”
HHS announces new actions to combat opioid epidemic http://www.hhs.gov/about/news/2016/07/06/hhs-announces-new-actions-combat-opioid-epidemic.html#.V65BCTaNY6o.
I believe it is of significance to note that the concern for adequate pain relief is still addressed and is no longer tied to financial reimbursement. Breaking that connection, in my opinion, is a positive motivator to implement new evidence based practices for pain pain management that do not involve opioids as mentioned in the press release.
Thank you Melissa!
Baby steps yes, and any forward progress is a step in the right direction.