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Substance Abuse

All You Need To Know About U-47700

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In July 2016, reports came out of a new drug that was found in the body of music legend Prince, who died on April this year. The investigations disclosed that while it was an overdose of the drug fentanyl that caused his death, there was a cocktail of drugs in his system that may have contributed to the fatality.

The drug cocktail included a new designer drug called U-47700. The substance took longer to be detected as it required more sophisticated laboratory equipment and testing techniques.

In other news reports, concern has been expressed over the drug U-47700, which has been the cause of about 17 U-47700 overdose cases in at least 10 states in the country since the first documented incident in Knoxville, Tennessee in June 2015.

Furthermore, it has also contributed to about 50 deaths nationwide, prompting law enforcement officers to seek an immediate ban on the substance. As of June 2016, the states of Kansas, Wyoming, Ohio, and Georgia have taken action to have U-47700 banned.

What is U-47700?

U-47700 is an opioid analgesic drug that was developed by a pharmaceutical manufacturer called Upjohn in the mid-1970s. It was derived from an earlier opioid AH-7921. It is known to have 7.5 times more potency than morphine. Some of its popular street names include Pink or Pinky.

According to Barry Logan, head of Pennsylvania-based NMS Labs forensic toxicology, U-4770 is a product of several experiments and was developed by the pharmaceutical as their analysts were looking for a synthetic alternative to morphine.  In particular, the scientists were studying the molecular activity of a number of chemical compounds that affect the opioid receptors in the brain. It was not originally intended for human consumption but for research purposes only.

Currently, the drug is produced by companies in China and is smuggled into the U.S., where it is being sold over the internet. Most buyers may not even be aware of the compounds of U-4770 or its dangers.

How Does U-47700 Work?

U-47700 works by binding to and activating the µ-opioid receptor. Like other opioids, it mimics the endogenous endorphins which are found in the body. The effect is the production of euphoria, pleasure, general excitement, sleepiness, and pain relief.  It has been said that the effects produced by U-47700 are similar to those elicited by the opioid oxycodone.

U-47700 also works as an agonist for the kappa-opioid receptor system. As a result, it has become the lead compound of some kappa-opioid receptor ligands including U-50488 and U-69,593 which also have similar structures.

Side Effects of U-47700

The physical side effects produced by the drug includes pain relief, physical euphoria that may be less intense than morphine, feelings of warmth and physical comfort, itchiness as a result of the strong histamine actions of the body, respiratory depression that tends to be stronger in comparison to that produced by other opioids such as heroin and morphine, semi-consciousness or unconsciousness, sedation, cough suppression, constipation, urinary retention, pupil constriction, nausea, vomiting, slurred speech, flushed skin, and decreased libido.

The drug also affects cognition and behavior. Some of the effects include overwhelming feelings of emotional bliss and happiness, suppression of anxiety, impaired judgment, confusion, and compulsive redosing or addiction.

U-47700 also produces after effects that occur after the peak has passed or during the “comedown” or “crash.” These effects include cognitive fatigue, thought deceleration, anxiety, depression, and irritability.

Potential for Toxicity and Long-Term Damage

Because of its potency, it can produce long-term effects that include diminished libido and memory loss.

It has the potential to produce lethal effects when used in conjunction with depressants such as alcohol and benzodiazepines.

In addition, the nasal administration (snorting) of the drug’s crystals can cause damage to the mucous membranes. If vaporized, however, it can seriously harm the lungs.

Potential for Tolerance and Addiction

Chronic use of U-47700 can lead to dependence and addiction. As with other opioids, it is considered to have a high potential for abuse and can cause psychological dependence among users. When tolerance sets in, users will have to keep increasing the dose consumed. This puts them at a higher risk of fatal overdose.

Users who develop an addiction to the substance will develop compulsive patterns and will keep seeking ways to use the drug despite knowledge of its ill-effects. When the use is stopped abruptly, they are likely to experience withdrawal symptoms.

Dangerous Drug Interactions

The use of U-47700 in conjunction with other drugs or substances can produce serious and life-threatening effects. Some of the drugs that are known to be potentially dangerous when combined with U-47700 are the following:

Depressants

When U-47700 is used with depressants, there is an increased risk of developing fatal respiratory depression, muscle relaxation, sedation, loss of consciousness, and amnesia.

Dissociatives

The combination of U-47700 and any form of dissociatives can induce vomiting during unconsciousness. This episode can trigger suffocation and death.

Stimulants

Generally, stimulants and depressants are dangerous combinations. When U-47700 is used in conjunction with any stimulant, there is an increased risk of excessive intoxication. Stimulants reduce the sedative effect of U-47700. However, when the effects of the stimulant wear off, the effects of U-47700 are considerably increased. This is potentially dangerous.

U-47700 may come in different forms, such as a pink pill like this one.

U-47700 may come in different forms, such as a pink pill like this one.

U-47700 Similarity to Heroin

According to the World Drug Report published by the United Nations Office on Drugs and Crime, addiction to U-47700 and other synthetic opioids in the U.S. is increasing even as these are used to replace heroin. These may be due to the availability and accessibility of U-47700 in the country.

Because U-47700 is available in both powder and granular form, it is relatively easier to use and abuse compared to other prescription opioids. This is because the latter are formulated to prevent abuse and are difficult to inject or snort. Thus, U-47700 is fast becoming a drug of choice among opioid addicts.

Some evidence suggests that the drug also induces a euphoric high that is similar to heroin although the effects last for a shorter period. This may be one of the reasons why it is also becoming an alternative drug among heroin users.

Conclusion

U-47700 now represents a part of the growing crisis of opioid addiction in the country. As with most synthetic drugs, law enforcers and lawmakers are struggling to cope with the developments of the drug trade in the market and are trying to pass immediate measures to classify and ban the substance.

Substance Abuse

Federal Bill Proposal Aims To Create Database of Designer Drugs

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Brooklyn Rep. Nydia Velazquez recently introduced a bill to allocate $2.5 million in federal funding to start an outreach and educational campaign, as national efforts against synthetic drugs continue to push on. The bill aims to help in the campaign to combat synthetic drug use, and develop a comprehensive database of designer drugs that will require the help of several government agencies.

In a news statement, Velasquez said that this is in response to the surge of overdose cases in July, which rendered the busy streets of New York looking like a scene out of a Walking Dead episode. In a single week, more than 130 victims have been recorded to have suffered from health problems due to the use of synthetic drugs. This prompted Velasquez to create a bill that will help in funding her cause.

This fight against the epidemic of synthetic drugs includes unregulated chemicals that can cause adverse side effects and increase danger for other users.

The bill is entitled “Synthetic Drug Overdose Prevention and Education Act”, and it requires the Centers for Disease Control and Prevention (CDC) to develop necessary measures and comprehensive strategies to prevent the use of synthetic drugs. CDC will have a year to come up with new strategies in the rehabilitation of the users. The proposed bill now calls for the Drug Enforcement Administration (DEA) together with Secretary of Health to jointly develop a national database for synthetic drugs.

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Substance Abuse

What is Clonazolam and Why Is It Dangerous?

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Another drug that has recently become popular among benzodiazepine users is one called Clonazolam. This is currently being sold online as a designer drug and is easily accessible through online vendors.

Various forums and threads such as those found on Reddit discuss accounts of user’s experiences when using the drug. They also exchange information as to how and where to purchase it, as well as its effects, advantages and disadvantages. Some threads also show users comparing the drug with others of the same class such as Etizolam and Xanax. The number of entries would probably surprise a reader as to the number of people who are probably hooked on benzodiazepines and are always looking for new ones that could work better than the previous drug.

What are Benzodiazepines?

Benzodiazepines, also known as “benzos” are a class of psychoactive drugs that affect the neurotransmitter called gamma-aminobutyric acid (GABA). The drug acts as a sedative, anxiolytic, anticonvulsant, and muscle relaxant. These drugs are medically prescribed for conditions such as anxiety, agitation, insomnia, alcohol withdrawal, seizure control, muscle relaxation, and inducing sleep before surgical procedures.

When used appropriately and for a short duration, benzodiazepines are relatively safe. However, they have the potential for developing tolerance, dependence, and abuse. Long-term use can cause impairment and unpleasant behavioral effects such as aggression and rebound anxiety. The sleep-inducing properties of benzodiazepines have also been found to decrease in effect for users who have been taking for a relatively long time.

Some of the most familiar names are Valium, Xanax, and Ativan. While there are approximately more than 2,000 benzodiazepines that have been produced and are available in the market today, only 15 of these have been currently approved in the United States. New types, however, have come out and are sold over the internet. One of which is the drug called Clonazolam that is also becoming a trend among benzodiazepine chronic users.

What is Clonazolam?

Clonazolam, also known as Clonitrazolam is a medium-duration psychoactive drug that also belongs to the class of benzodiazepines. It produces anxiolytic, sedative, hypnotic, muscle relaxant, anticonvulsant, depressant, and amnesic effects. It is a derivative of the FDA-approved benzodiazepines clonazepam and alprazolam.

Compared to the other mentioned drugs, however, clonazolam has been reported to be more fast-acting and its effects can be felt within 20 to 60 minutes. It also has the reputation of being highly potent as it produces very strong sedation and effects even when taken in small doses such as 0.5 mg. As such, it may be more dangerous that the other benzodiazepines available in the market.

As with most benzodiazepines, abrupt discontinuation of use can pose serious threats to the frequent users including seizures and sudden death. It is medically recommended that one’s dose is tapered off gradually before it is stopped altogether. Quitting clonazolam abruptly may produce intensive withdrawal effects.

Effects of Clonazolam

The physical effects of clonazolam include extreme sedation which can result in severe lethargy. It has been reported that some users may feel extremely sleep deprived and may even feel as though they are on the verge of passing out. This forces them to avoid engaging in regular activities. This may cause them to fall into complete unconsciousness.

The other physical and cognitive effects include respiratory depression,  dizziness, muscle relaxation, seizure control, spasms control,  loss of coordination, amnesia,  impaired cognitive skills, impaired motor skills, lapses in judgement, thought deceleration, and reduced reaction time.

Long-term use of clonazolam can result in increased seizures among epileptics, aggression, increased anxiety, violent behavior, loss of impulse control, irritability, and suicidal tendencies. These effects have been observed among recreational users, people diagnosed with mental disorders, elderly patients, and those who take the drug at high doses.

Potential for Tolerance and Addiction

Compared to other benzodiazepines, clonazolam has been found to be both physically and psychologically addictive. Tolerance may develop within a few days of continuous use.

As with characteristics of other tranquilizers or sedatives, withdrawal symptoms may be experienced by the patient or user when consumption is ceased abruptly. To avoid this, users are advised to observe a gradual reduction in dosage instead of stopping the use immediately.

Because of clonazolam’s potent sedating effects, the withdrawal symptoms may be more severe. There is an increased risk for hypertension, seizures, and death. Painkillers such as tramadol should be avoided during the withdrawal period.

Potential for Dangerous Interactions

Clonazolam can be dangerous when used in conjunction with other pharmaceutical preparations. The combined effect can produce life-threatening results. Some of the drugs that may produce some dangerous interactions when used with clonazolam are the following:

Depressants

The combination of clonazolam and depressants such as alcohol, barbiturates, and opioids can cause fatal respiratory depression. Depressants have the tendency to maximize the sedative and muscle relaxant effects of clonazolam. The combined effect can produce unexpected loss of consciousness when taken at higher doses. There is also the increased risk of vomiting during sedation which can lead to suffocation and death.

Dissociatives

When combined with any form of dissociative, there arises a risk of vomiting during unconsciousness. This can also lead to suffocation and death.

Stimulants

It is never advisable to combine stimulants with benzodiazepines. Stimulants alter the effect of benzodiazepines by decreasing their sedative effects. However, once the stimulant wears off, the effects produced by benzodiazepines are increased. When using both cannot be avoided, users should strictly limit the dosage of the benzodiazepine.

Conclusion

In recent years, novel benzodiazepines have also proliferated as part of designer drugs sold online or in the black market. They are very accessible and can be bought at a minimal cost, making them very attractive to recreational users and to those who practice self-medication.

Because most of these drugs do not have recognized medical purposes and are not medically prescribed in other countries, they can cause great harm to those who use the drugs recreationally. As such, law enforcers and the public in general should be forewarned of the dangers of these substances as they have a high potential for abuse that may lead to fatal consequences.

Health & Wellness Substance Abuse

New Painkiller Drug Removes Risk of Overdose

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An elite group of international researchers led by scientists from Stanford University, University of North Carolina and the Friedrich-Alexander University Erlangen-Nürnberg in Germany has developed a new drug that works as a painkiller like morphine but without triggering and eliciting dangerous side effects such as respiratory suppression.

In a research study recently published in Nature, researchers said that they have identified the new opioid drug by using the computational techniques that allowed them to experiment and explore more than four trillion different chemical effects and interactions. The team of researchers also noted that they used the atomic structure of the brain’s receptors to reverse-engineer the novel drug that promises to block pain but does not have the potentially dangerous side effects.

While the drug compound has only been studied and tested on mice, the indication and implication of the drug may be massive. In the research experiment, the mice were exposed to a solution that contains the compound in varying degrees. Results showed that the mice displayed alternating and indifferent attitudes, which suggest that it has low addictive potential.

This novel drug compound is also known to not interfere with breathing, which remains to be the main cause of death in overdosing on painkillers. Moreover, the new drug also appears to bypass the brain’s dopamine-driven addiction to prevent drug-seeking behavior on mice.

More work still needs to be established to make sure that the compound is truly non-addictive. More tests are also needed to confirm it is as safe and effective in humans as it is for rodents. If this is confirmed, this drug could transform the fight against the ongoing epidemic of prescription painkiller addiction.

Substance Abuse

The Real Danger of Scopolamine Abuse

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Chemical structure of scopolamine.

Another lethal drug that is being used recreationally and in connection with the commission of certain crimes is a substance called scopolamine. While it is an approved prescriptive medication, it is now being used as a party and date-rape drug.

Scopolamine has been found to produce side effects that are potentially dangerous, and its properties have been found to have the potential for abuse.

What is Scopolamine?

Hyoscine hydrobromide, also known as scopolamine hydrobromide, is a prescription medication used in the treatment of conditions including motion sickness, postoperative nausea and vomiting, gastrointestinal spasms, renal spasms, Parkinson’s disease, muscle spasms, involuntary movement in the lungs or urinary tract, bowel cholic, irritable bowel syndrome, hypersalivation, and eye inflammation. It has also been used to treat asthma, depression, and chemotherapy-associated nausea.

Scopolamine belongs to a class of drugs called anticholinergics, which act to block the activity of the neurotransmitter acetylcholine that triggers nausea and vomiting.

The medication may be administered orally, subcutaneously, ophthalmically, intravenously, and via transdermal patch (e.g. Transderm-Scop, Transderm-V).

Scopolamine Abuse

The main ingredient of scopolamine is burundanga, which is derived from comes from a datura plant called “Borrachero tree.” The drug is also known as “devil’s breath” and has been used as a mind control agent.

Burundanga plant, from which scopolamine is extracted.

Burundanga plant, from which scopolamine is extracted.

The practice of using scopolamine to reduce a person’s free will and force him into submission is common in Columbia, where the tree naturally flourishes. It is associated with crimes such as rape, abduction, theft, and robbery. It is estimated that the number of annual scopolamine incidents in the country amounts to about 50,000.

These occurrences are common in night clubs and bars which are frequented by male predators who target attractive and unsuspecting women. The tablets are usually crushed and slipped into drinks or food. The effects produced are similar to the date-rape drug Rohypnol and has been reported to render the victim unconscious for more than 24 hours. The victim may not remember the incident the following day.

Other than being used illicitly by criminals to render their victims helpless and submissive, it is also used recreationally by abusers who seek the feelings of euphoria that the drug elicits. It is commonly abused as a party drug by users who prefer it for its hallucinogenic properties.

Signs and Symptoms

Abuse of scopolamine causes a person to appear extremely “relaxed.” Users have the tendency to be more truthful and submissive. They are unable to resist following suggestions and may be coerced to do some against that are normally against their will.

The high produced by the drug can be addicting. Heavy or frequent users are likely to encounter several health effects as well as troubles with work, school, or finances.

Dangers of Scopolamine Abuse

Even when taken at regular doses, Scopolamine can cause confusion, agitation, rambling speech, hallucinations, and paranoia. It can trigger allergic reactions that are manifested by difficulty of breathing, constriction of the throat, and swelling of the lips and tongue.

Other side effects include drowsiness, dizziness, headache, dry mouth, blurred vision, dilated pupils, dry or itchy eyes, flushing, rashes, seizures, constipation, decreased sweating, restlessness, agitation, confusion, rapid heartbeat, and poor coordination.

Children and elderly are more susceptible to these side effects compared to other patients.

Drug Warnings

Those who are diagnosed of conditions such as kidney disease, liver disease, coronary artery disease, tachyarrhythmia, cardiac conduction disorder, brain damage, enlarged prostate, stomach obstruction, bladder problems, ulcerative colitis, open-angle glaucoma, psychosis, hypertension, hyperthyroidism, and toxin-medicated diarrhea should discuss these health concerns with their doctor before taking scopolamine. It is usually not recommended that people with these conditions be prescribed scopolamine. However, when the medication becomes necessary, its administration and dosage should be closely monitored by a medical professional.

In patients with Parkinson’s disease, abrupt discontinuation of the use of transdermal patch may result in adverse effects such as headache, nausea, vomiting, and dizziness. These withdrawal effects may appear more than 24 hours from the removal of the patch.

Pregnant women should likewise consult their physicians before taking the drug as it is not yet known whether scopolamine may be harmful to the fetus.

Scopolamine interacts with the metabolism of other drugs such as other anticholinergics, tricyclic antidepressants, antihistamines, analgesics, diuretics, and muscle relaxants. The drug is known to intensify the effects of such medications.

Since the side effects of Scopolamine include drowsiness, dizziness, and blurred vision, driving and operating machinery while under the influence of the drug can be potentially hazardous. As much as possible, performing these activities should be avoided by those who are taking the medication. Excessive exercise and underwater activities should likewise be avoided.

Chemical structure of scopolamine.

Chemical structure of scopolamine. [Photo by Edgar181 via Wikimedia Creative Commons]

Treatment for Scopolamine Abuse

The psychoactive properties of the drug can get people addicted. Some users have reported developing withdrawal symptoms after the cessation of drug use. These include feelings of depression, confusion, and psychotic episodes.

The treatment of scopolamine addiction often involves individualized treatment and regular therapy sessions. Various counseling approaches may be utilized to help the patient recover from the addiction.

Recommended Dosage

Scopolamine tablets usually come in 0.4 milligrams and should be taken every 8 hours or as directed by the doctor.

The transdermal patch is for external use only and is applied behind the ear. It delivers 1 mg of scopolamine which is enough to last for 3 days. It should be applied 4 hours ahead of time to prevent motion sickness. Only one patch should be worn at a time.

Scopolamine Overdose

Scopolamine overdose is dangerous, and medical attention should be sought immediately. Some of the overdose symptoms are tachycardia, arrhythmia, hyperventilation, blurred vision, double vision, night blindness, disturbed color perception, pounding in the ears, dry mouth, skin flushing, gastrointestinal motility, decreased urination, painful urination, painful urination, headache, dizziness, drowsiness, seizures, irritability agitation, anxiety, hallucinations, fatigue, sluggishness, and loss of consciousness.

Drug overdose is usually treated with medications such as physostigmine and supportive therapy.

Scopolamine is intended to be used for medical purposes only and should be used according to the instructions of a physician. It is not safe to be taken as a recreational drug. Those who know do so may develop a physical and psychological dependence on the substance which is dangerous in the long run. If so, treatment centers should be contacted as soon as possible for the appropriate intervention and therapy.

[Burundanga image by Jorge Lascar via Flickr Creative Commons]

Substance Abuse

Loperamide Abuse Emerging As A New Prescription Drug Problem

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According to research from the U.S. Food and Drug Administration (FDA), roughly 44 people die every day due to overdose from prescription drugs.

Recently, FDA released a report that warns about taking high doses of over-the-counter and prescription drugs such as loperamide, which can lead to abuse and health problems. This stern warning stems from several cases of people who want to achieve heroin-like highs by turning to abusing loperamide.

In this article, we will discuss the emerging problem on loperamide abuse, and how it’s affecting the world at large.

What is loperamide?

Loperamide is an over-the-counter prescription drug used to control diarrhea, and it is available in liquid, tablet and capsule forms. Loperamide hydrochloride is an active ingredient that acts as an anti-motility drug, and works by slowing down the muscular contractions of the intestine.

Loperamide allows more time for water and electrolytes to be re-absorbed, making it effective to control and regulate the movement in the intestinal tract because it acts as a multi-opoid receptor.

The maximum approved dose of Loperamide for adults is 8 to 16 milligrams per day.

Concern on loperamide use

Because Loperamide is an opioid, it can induce adverse brain effects especially when consumed in massive amounts. This can be toxic and may lead to cardiac dysrhytmia and ileus, a form of paralysis of the intestine.

The American College of Emergency Physicians issued and released a case report that reveals how opiod addicts are leaning towards over-the counter medication to address their addiction, leading them to dangerous consequences. The report showcases the rise of use of loperamide as a recreational drug, which has already claimed lives.

The issue of loperamide abuse

Since 2011, the number of oral loperamide abuse posts in web-based forums has increased dramatically. Several of these online discussion boards talk about using loperamide for recreational purposes.

Loperamide abuse is a growing problem in the United States, and there is an increase in the usage of this drug to self-treat opioid addiction. In an online publication of Annals of Emergency Medicine, a case study was published to outline the history of substance abuse and its direct effect to massive loperamide addiction. The case study published in Annals of Emergency Medicine is authored by Dr. William Eggleston of the Upstate New York Poison Center.

The study outlined the case of two patients (with history of substance abuse) who are undergoing opioid withdrawal. Both patients called emergency services and were treated with standard Advance Cardiac Life Support. The research study discussed and documented two loperamide-induced deaths, and highlighted the extreme danger of loperamide abuse.

“Loperamide’s accessibility, low cost, over-the-counter legal status and lack of social stigma all contribute to its potential for abuse,” said Eggleston in a news release.

Loperamide is chemically designed not to have any psychoactive effects and it does not produce a high. High intake of loperamide can reduce symptoms of opioid withdrawal but can generate heroin-like effects. Psychoactive effects are recognized when 10 or more loperamide doses more than the recommended amount are taken.

In related news, the Upstate New York Poison Center noted a dramatic increase in relation to loperamide abuse and misuse from 2011 through 2015.

Loperamide does not require a doctor's prescription for purchase.

Loperamide does not require a doctor’s prescription for purchase.

Effects of loperamide abuse

In 2014, more than 47,000 cases of drug overdose were recorded by the FDA. About 61 percent of these account for opioid drug abuse and misuse.

The epidemic and continuous rise of opioid addiction gave birth to another form of drug abuse for addicts who cannot get their hands on prescription painkillers. This drug of choice is anti-diarrhea medication, more popularly known as Imodium and Pepto.

The primary ingredient of these medicines is loperamide, which usually produces psychoactive effects when taken in high dosages. Overdosing on this particular medication can be toxic and life-threatening. Loperamide abuse and overdose can lead to health risks and heart problems.

One potential health issue is cardiac dysrhythmia, a heart ailment characterized by an abnormal heartbeat. It can potentially be life-threatening because the heart rate can range from low to high in a second. There are two classifications in the case of irregular heartbeats:

  • Bradycardia is a slow heart rhythm and is characterized under 60 beats per minute.
  • Tachycardia is a fast heart rhythm with over 100 beats per minute.

Another possible health effect of loperamide abuse is central nervous system and respiratory depression. This medical condition causes slow breathing to the point of stopping. This physiological depression of the central nervous system may result to a decreased heart beat and may lead to loss of consciousness, and eventually to coma and early death. This condition is usually caused by depressant drugs and drug overdose, and it leads to inhibited brain activity.

High dosage of loperamide can also increase the risk of kidney and liver failure, while withdrawal symptoms of the drug may lead to cardiovascular toxicity, severe anxiety and vomiting.

Actions to take against loperamide abuse

Loperamide is fast becoming a drug of choice because it is cheap and readily available over the counter. This is one of the reasons behind the unintended epidemic in the misuse of loperamide.

Based on all of the things mentioned above, the following actions may help address the growing problem on loperamide abuse:

  • It is important that health care professionals be made aware of this dilemma.
  • The federal government must work with health care officials to investigate on this particular drug abuse problem.
  • It is highly recommended to ensure that the use of these drugs should be monitored closely, and possible make loperamide a prescription drug to avoid unnecessary abuse of the medication.
  • Proper information dissemination is needed. All health officials should be aware of the increasing incidence of loperamide abuse and its cardiac toxicity.
  • The drug should be used with precaution and must be carefully directed to the consumers and patients. The proper use of loperamide should be between 8 to 16 milligrams a day, and no more. Anything higher than that must be monitored and prohibited.
Loperamide intake must be monitored closely.

Loperamide intake must be monitored closely.

Final words

Loperamide intake may be habit-forming and may increase a patient’s tolerance for the medicine. In case of loperamide abuse, urgently discontinue the drug and start the appropriate therapy for the patient. There is a high chance that the patient will undergo opioid withdrawal, and several symptoms may manifest such as excruciating physical pain, muscle ache, anxiety and diarrhea.

The biggest take home point in this discussion is that loperamide is an effective drug in treating gastrointestinal problems, and that’s why it’s readily available over the counter. However, since it has addictive properties especially when taken and consumed in large amounts, precaution is a must.

Patients advised to take loperamide must religiously follow the dosing recommendations as prescribed by the doctors and pharmacists. Also, loperamide usage should not taken lightly. Patients and consumers should take the medication only if advised by doctors and health care professionals.

[Loperamide tablets image by Kristoferb via Wikipedia Creative Commons]

Substance Abuse

Everything You Need To Know About The Prescription Drug Abuse Problem

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The drug abuse problem in the United States isn’t limited to the category of illicit drugs. Legal medicines such as prescription and over-the-counter drugs are also a huge component of the drug abuse epidemic.

Prescription drugs are among the most frequently abused substances in the country, along with marijuana and alcohol. In fact, the 2014 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that about 15 million people from the age of 12 used prescription drugs for non-medical reasons in the past year. It also reports that an estimate of 6.5 million people of the same age used psychotherapeutic drugs non-medically in the past month.

The prevalence of prescription drug abuse is attributed to the accessibility of the products and to the popular misconception among abusers that these drugs are safer to use compared to illicit substances. In truth, the risk for developing drug dependence and addiction is high.

The use of these drugs is regulated in the sense that they should not be taken without prior medical consultation. Medication usage and dosage should also to be supervised by a physician or health care professional. Taking these drugs for non-medical reasons can lead to health complications, overdose, and death. Prescription drug abuse accounts for 60% of overdose-related deaths and for about 1.4 million emergency room visits each year, according to this article.

Misuse or abuse of prescription drugs occurs in three possible ways: by using the medication without a doctor’s prescription or prior medical advice such as by taking a friend or relative’s prescribed medication; taking it in higher doses or administering it in a way other than as prescribed by the physician such as by crushing the tablets and snorting or injecting the powder; or using it for the purpose of experiencing the feelings that the drug elicits.

prescription drug abuse cocktail drugs

Prescription Drugs Commonly Abused And Their Effects

The drugs most commonly abused include opioid pain relievers, central nervous system depressants, stimulants, and over-the-counter drugs. Here is a brief description of each type and a discussion of the effects of drug abuse:

Opioids

Opioids are prescribed to relieve and manage acute or chronic pain. These medications work by reducing the intensity of pain signals sent to the brain. Some examples of opioids are hydrocodone, acetaminophen, oxycodone, fentanyl, methadone, codeine, and morphine.

Some of the side effects from taking opioids are drowsiness, nausea, constipation, and disorientation. Taken in larger doses, the drugs can produce a sense of euphoria. Those who abuse the drugs primarily seek to experience increased levels of elation and to further intensify their experience, they may inject or snort the drugs rather than take them orally, as intended. This manner of abuse can lead to several complications including overdose, severe respiratory depression, and death.

Taking the medications for longer periods than prescribed can lead to physical dependence and increased tolerance for the drugs. Eventually, dependence leads to addiction and the user will experience withdrawal symptoms when use of the drugs are reduced or stopped altogether.

Opioid misuse and abuse continues to be a major public health problem in the United States. From 1999 to 2013, the rate of death from opioid pain reliever overdose nearly quadrupled.

Central Nervous System Depressants

Tranquilizers and sedatives fall under the general classification called central nervous system depressants. These are used to treat common conditions such as anxiety, and insomnia as well as more complicated psychiatric disorders such as depression, schizophrenia, bipolar disorder, and other related illnesses.

These medications should be prescribed by a physician only after careful evaluation of the patient’s symptoms. They must be administered with utmost caution and their use must be supervised by a doctor. These type of drugs are susceptible to overdose and can cause potentially dangerous effects. Among frequently used depressants are benzodiazepines, barbiturates, and quetiapine.

These drugs slow down brain activity and induce drowsiness and a sense of calm. They are popularly known as “downers” and are used non-medically by abusers who seek sleep as a form of escape from the reality of their troubles.

Abuse of tranquilizers and sedatives can cause lethargy, nausea, confusion, respiratory depression, and death.

Both tranquilizers and sedatives should not be taken with other medications unless under a physician’s supervision. Taking them with other substances, especially alcohol, can cause dangerous and life-threatening complications.

prescription drugs

Stimulants

These drugs are prescribed to treat or manage conditions such attention deficit hyperactivity disorder (ADHD) and narcolepsy. Taking these medications help patients with the said conditions stay calm and focused. Examples of these drugs are methylphenidate, dextroamphetamine, and amphetamines.

Stimulants are known to increase alertness and energy levels. They can also cause an increase in heart rate, blood pressure, and blood sugar. Because these drugs affect the brain’s dopamine levels, taking them in appropriately can produce feelings of elevated euphoria.

Some drug abusers take stimulants in the belief that doing so would improve their cognitive performance because of the drugs’ known effects of increasing energy levels. Stimulant abuse is common among students who take the drugs to improve alertness during examinations and rigorous academic activities.

Taking stimulants non-medically increases risks of addiction, cardiovascular diseases, seizures, and strokes. Repeated use of stimulants can cause paranoia, hostility, and psychosis.

Anabolic Steroids

Anabolic steroids are synthetic substances that are associated with the male sex hormones. They are used to treat conditions such as delayed puberty in male adolescents, impotence in men, breast cancer in women, anemia, endometriosis, and other hormonal imbalance conditions. These medications include methandrostenolone, methyltestosterone, danazol, stanozolol, and oxandrolone.

Most anabolic steroids are administered orally while some are injected intramuscularly. Some come in gel or cream form and are used by applying the substances on the skin.

In the United States, these drugs are categorized as Schedule III Controlled Substances because of the probability of harmful adverse effects brought about by the alteration in hormonal production.

Abuse of anabolic steroids is common among those who want to “bulk up” their muscles’ size and reduce body fat. Athletes use anabolic steroids to enhance performance and prolong endurance.

Anabolic steroid abuse can cause severe acne, hair loss and baldness, altered mood, irritability, aggression, depression, infertility, liver disease, kidney disease, cardiovascular disease, hypertension, and cancer. Female steroid abusers may experience irregular menstrual cycle and develop male features such as excess facial hair or deepening of voice.

Over-the-counter (OTC) Medications

These are drugs that are readily available at supermarkets, convenience stores, retail shops, and drug stores. They can be purchased even without presenting a physician’s prescription.

The problem isn’t really the drugs but the addictive substances they contain. For instance, cough and cold medications often contain the component called dextromethorphan (DXM) which is intended to suppress cough. However, when taken in higher doses, the ingredient in the drugs cause an “out-of-body” experience, a feeling of being “high”, and can trigger hallucination. Thus, cough medications are the most commonly abused OTC drugs.

Among the effects of cough medication overdose are vomiting, rapid heartbeat, dizziness, nausea, hallucination, high blood pressure, and liver damage.

Antihistamines that are sold over-the-counter are also subject to abuse. Some users take these substances for their calming and sleep-inducing effects.

Use of diet supplements are abused for their slimming and fat reducing effects. Most weight-loss products, including herbal preparations, contain a dangerous ingredient called ephedrine. The side effects of ephedrine include insomnia, restlessness, nausea, headache, vomiting, diarrhea, palpitations, and hallucinations.

As with diet supplements, laxatives and diuretics are also chosen for their properties that help promote weight loss. The use is prevalent among teens and young adults who are weight and figure-conscious. Abuse of these substances can cause serious dehydration, electrolyte and mineral imbalance.

Caffeine pills and energy drinks are also frequently abused OTC products. They are taken to achieve higher energy levels and improve performance. Abuse of these substances is common among students and professionals. Large doses can cause adverse effects such as palpitations, anxiety, insomnia, gastric reflux, and increased blood pressure.

While over-the-counter drugs are safe for medical purposes and are beneficial when taken in moderation, they can be harmful when taken in larger doses. They are especially injurious when use is combined with alcohol and illicit drugs.

excess prescription drugs

Signs and Symptoms

Spotting the signs of prescriptive drug abuse can be challenging because the symptoms vary according to the substance taken. Also, some people are more predisposed to addiction than others due to several factors such as genetics, biological make-up, social environment, and age. These presence of these factors also influence the rate and manner at which the signs become manifest. The more number of risk factors, the greater the chances for a person to develop substance addiction.

Among the common symptoms of abuse include confusion, loss of coordination, nausea, sleeping disorders, mood swings, headaches, dizziness, and vomiting.

Some signs of prescription drug abuse among teens and young adults may involve behavioral changes. These include withdrawal from family and friends, change in hobbies and interests, hostile or aggressive behavior, abrupt change in academic performance, mood swings, and changes in sleeping patterns.

When parents, relatives or friends observe these behaviors in teens and adolescents, it is best that they seek professional advice immediately and implement the appropriate intervention methods to prevent prolonged abuse that can be potentially damaging to their health.

Treatment Approaches

Prescription drug abuse can be treated effectively. For better chances of recovery, the patient’s treatment plan should be customized according to the substance subject of abuse. In many instances, a combination of approaches is necessary to achieve long-term detoxification and rehabilitation goals.

One popular prescription drug abuse treatment approach is behavioral therapy. This is implemented through individual, group, and family counseling sessions. During these sessions, patients are taught strategies to avoid drug use, and to function normally without need for the substances. Effective counseling helps the patients develop improved interpersonal relationships and work functionality.

Some addictions, particularly those where there is significant physiological dependence on the substance, require pharmacological treatments. Medications may be necessary to manage or prevent cravings, as well as to cope with withdrawal symptoms.

As mentioned, it is best that the patient’s treatment plan integrates a combination of these methods to achieve optimum recovery.

Prescription drug abuse is a persistent public health threat in the country that various federal agencies and state legislation are still trying to combat. These efforts include implementation of several regulation, monitoring, treatment, and prevention measures.

However, successful treatment and prevention begins with the individual and within the home. Individuals should not take medications or alter dosages without first seeking a physician or health care professional’s advice. Neither should they pass on these medications to their family members or friends. Personal monitoring and prevention is still the best way to fight this growing crisis.

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Substance Abuse

Leftover Prescription Drugs Not Disposed By Parents

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excess prescription drugs

In a poll survey conducted among 1,200 participants, results showed that one third of the participating parents said their children received narcotic painkillers, as reported in a news release. About 8 percent of parents said they returned excess medicine to the doctor or pharmacy. Another 30 percent of them said they disposed the medicines by flushing it in the toilet or simply put it in the garbage. A good six percent reported keeping the leftovers to be used by other family members, while 9 percent of them said they misplaced the pills.

In addition to all the illicit drugs being used in the U.S., prescription painkillers have become agents of substance abuse due to excess medicine left unattended by parents with children aged 5-17 years old.

Opioid painkillers like Oxycontin or Percocet are used to treat severe to chronic pain due to surgery and illnesses. However, an overdose of these drugs can lead to physiological, cognitive and behavioral problems.

In the U.S. some physicians overprescribe opioid drugs, which may lead to the opportunity to misuse the medication. Oftentimes, the amount of prescribed drugs for pain is far greater than what the patient actually needs.  In the case of children prescribed with painkillers, parents simply keep the excess pills instead of taking these back to the prescribing doctor or the pharmacy.

The issue on leftover prescription drugs not disposed by parents can lead to early addiction of young adults who are very curious, said Sarah Clark, co-director of the C.S. Mott Children’s Hospital National Poll on Children’s Health.

Clark also added that parents may lose the opportunity to inhibit their kids from misusing prescribed medicines. Ignorance and apathy towards the treatment of leftover prescription medication may result to drug addiction in their teenage children.

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Addiction Real Drug Stories

SAMHSA Launches Opioid Recovery Mobile App Challenge

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mobile smartphone opioid recovery app

The world is now on the offensive when it comes to drug addiction prevention, treatment and recovery. In the U.S., the federal government continues to fund programs and create initiatives towards this goal.

One exciting and recent initiative involves the use of technology to help in opioid addiction recovery. The Substance Abuse and Mental Health Services Administration (SAMHSA) plans to develop a mobile application that aims to “provide opioid recovery support for patients receiving medication-assisted treatment for opioid use disorders.” While the Opioid Recovery Support app is still not available, the organization is tapping onto the skills of mobile app developers by launching an app-making contest.

SAMHSA believes that mobile technology can have a significant impact on the lives of opioid addicts who are currently in recovery. The benefits of mobile apps on other diseases may also be translated to aid in addiction recovery measures. “Just as there are apps to help people with diabetes manage their disease, people in recovery from opioid use disorder could benefit from an app that provides features and information that support their recovery,” said SAMHSA in a statement.

The project is looking into five areas where a mobile app could be of effective use:

  1. Medication-assisted treatment (MAT), specifically on checking for dosages and side effects of recovery drugs such as methadone and naltrexone.
  2. How to live through MAT, such as parenting and family involvement
  3. Prevention of relapse through habit formation, engagement in healthy activities, or involvement in recovery support meetings.
  4. Motivational tools to support relapse prevention, such as calendar alerts, access to family and hobby photos, and link to motivational videos and online resources
  5. Management tools to help manage doctor’s appointments, treatment times, and work-life schedules

Legal residents in the U.S. 18 years old and above may take part in the competition. Entries may be developed by individuals, teams, or organizations of up to 100 employees.

The contest will run until May 28, 2016. Prizes available are as follows:

  • First prize: $15,000, and a complimentary entry to the 2016 AATOD conference in October to present the app
  • Second prize: $7,500
  • Third prize: $5,000
  • Honorable mention: $1,000 for each of the five areas / insights

For more information, visit the Hackathon page and read the contest rules.

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Substance Abuse

Obama Unveils Federal Government Plans For Drug Abuse Treatment During National RX Summit

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president barack obama at 5th national rx drug abuse and heroin summit in atlanta

The federal government is serious in its drive against substance abuse, as it forwarded a proposal last February to significantly increase allocation for the enhancement of treatment programs for prescription drug abuse.

At the 5th National RX Drug Abuse and Heroin Summit in Atlanta last March 29, President Barack Obama revealed a number of plans and initiatives that the federal government is planning to unfold as part of the nationwide campaign against drug abuse. In his statement reported via a news release, Obama mentioned that opioid overdose has surpassed vehicular accidents in terms of the number of fatalities. “We’ve spent a lot of time and resources to reduce traffic fatalities. It’s been successful. We have to take a systematic look at the data and science and develop strategies,” Obama said.

The National RX Summit became an opportunity for the U.S. president to sit down with event organizer Operation UNITE, a non-profit organization that “leads education, treatment and law enforcement initiatives in 32 counties in southern and eastern Kentucky.”

Some of the government initiatives in line with this vision include the following:

  • Creation of a Mental Health and Substance Abuse Disorder Parity Task Force
  • Integration of a disorder parity in Medicaid
  • Provision of $11 million in several U.S. states to prevent opioid overdose fatalities
  • Improvement of coordination between medical professionals and law enforcement agencies through the High Intensity Drug Trafficking Areas initiative by the Office of National Drug Control Policy.

In response to and support of Obama’s statement, U.S. Surgeon General Dr. Vivek Murthy reminded medical professionals about their role in fighting drug abuse. “Those of us who practice medicine can lead the way in ending the epidemic of prescription drug overdoses,” Murthy said.

[Image from RX Summit Facebook Page]

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