on-line, off-shore and mexican pharmacies this list has been added because of the requests we...

On-line, off-shoreand Mexican pharmacies

• This list has been added because of the requests we receive for pharmaceutical advice. In particular, site visitors ask where they can obtain pain-relieving medications that alone make their life worth living, but which their physician denies them owing to our prohibitionist drug laws. Some, but not all, of the pharmacies listed here may be of uncertain reliability. In a more enlightened age - and in a free society - none of them will be necessary. (last updated September 2010)

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Controlled Prescription Drugs, 2004-2008

Adolescent Abuse of Prescription Drugs

Margot L. Waitz, DO

Christiana Care Health Systems

Wilmington, DE

Historical Perspective

http://en.wikipedia.org/wiki/File:BayerHeroin.png

Overview of the Problem

• In the 2009 Partnership/MetLife Foundation Attitude Tracking study, teens were noted to have had an increase in the use of alcohol, marijuana and ecstasy from 2008.

• This followed a decade of declines in teen drug use.

Overview of Problem

• In 2009 teens in grades 9 – 12 were significantly more likely to have drunk alcohol in the past month than in 2008.

• All measures of use of marijuana – ever tried, past year use, past month use – significantly increased between 2008- 2009.

• The use of ecstasy also increased among teens in grades 9 – 12.

Overview of Problem

• Teen abuse of prescription and OTC medicines remained stable between 2008 – 2009.

Overview of Problem

• 1 in 5 teens (19%) report abusing a prescription medication at least once in their lives

• 1 in 10 teens (10%) report having abused a prescription pain reliever in the past year

• About 7% of teens abused OTC cough medicine in the past year

• 2008 Partnership Attitude Tracking Study on Teen Drug Abuse

Past Year Initiates for Specific Illicit Drugs Among Persons Aged 12 and older, 2006

First Time Users of Pain Relievers Continue to Surpass All Other Drugs

The Partnership for a Drug Free America - 2006

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006500

1,000

1,500

2,000

2,500

3,000

Ecstasy

Stimulants

MarijuanaPain Relievers

Overview of Problem

1 in 5 teens report being offered Rx medicine from a friend or peer to

get high

Sources: Partnership Attitude Tracking Study; Partnership Mapping Study 2006

37%

20% 19% 18%

10% 10% 10%8% 8%

6%4% 5% 4%

Lifetime Trial Among Teens

Marijuana

Inhalants

RX Medicines

RX pain relievers

Cough Medicine

Ketamine

Ecstasy

RX stimulants

Crack/ Cocaine

Meth

LSD Heroin

GHB

Source: Partnership Attitude Tracking Study (PATS) Teens 2006

Pain Reliever Abuse

• Past-year nonmedical use of Vicodin and OxyContin increased during the last 5 years among 10th-graders and remained unchanged among 8th- and 12th-graders.

• Nearly 1 in 10 high school seniors reported nonmedical use of Vicodin; 1 in 20 reported abuse of OxyContin.

• NIDA InfoFacts: High School and Youth Trends

Nonmedical Use of Prescription Pain Relievers in the Past

Month, by Age Group: Percentages, 2002 to 2007

Pain Reliever Abuse

•1 in 3 teens report having a close friend who abuses Rx pain relievers to get high

Source: Partnership Attitude Tracking Study 2006

Pain Reliever AbuseObtaining medication

• About 52 percent of 12th-graders said they were given the drugs or bought them from a friend or relative.

• 30 percent reported receiving a prescription for them

• A negligible number of 12th-graders reported purchasing the narcotics over the Internet.

• NIDA InfoFacts: High School and Youth Trends

Source of Rx Drugs among Those Who Used in Last Year

Grade 12, 2007-2009 (percentages)

Bought on InternetTook from friend/relative without asking

took from friend took from relativeGiven for free by friend or relative

by a friendby a relative

Bought from a friend or relativefrom a friendfrom a relative

From a prescription I hadBought from drug dealer/strangerOther method

weighted N=

Narcotics other than heroin2007-2008 2009

2.3 0.024.2 18.6 ---- 3.6 ---- 17.950.5 51.5 ---- 46.1 ---- 10.137.1 33.6 ---- 33.6 ---- 2.940.2 30.318.6 13.0 8.5 10.0

361 153

Monitoring the Future Study, 2009

Stimulant Abuse

• Between 2004 and 2009, a drop in past-year use of methamphetamine was reported for all grades, and lifetime use dropped significantly among 8th-graders, from 2.3 to 1.6 percent.

Stimulant Abuse

• SAMHSA's National Survey on Drug Use and Health estimated that about 510,000 youth aged 12 to 17 (2%) used stimulants (including methamphetamines) nonmedically in the past year in 2006.

Past Year Methamphetamine Initiates among Persons Aged 12 or Older and Mean Age at First Use of

Methamphetamine among Past Year Methamphetamine

Initiates Aged 12 to 49: 2002-2007

Stimulant Abuse

• According to the DAWN for 2004, an estimated 7,873 drug-related emergency department visits involved methylphenidate or amphetamine-dextroamphetamine

• The most frequent reason for these ADHD stimulant medication related visits was nonmedical use (48%), followed by adverse reactions associated with medical use (34%), accidental ingestion (10%), and suicide attempts (8%).

Stimulant Abuse

• Over 71% of youth who used stimulants nonmedically in the past year compared with 34% of youth who did not use stimulants nonmedically also engaged in at least one of the six types of delinquent behaviors in the past year that were included in SAMHSA's National Survey of Drug Use.

Stimulant Abuse

• These delinquent behaviors were: – got into a serious fight – took part in a group fight against another

group – sold drugs – stole anything valued more than $50 – attacked someone – carried a handgun

Cough Medication Abuse

• The cough suppressant dextromethorphan (DXM) is found in more than 140 over-the-counter (OTC) cough and cold medications.


• In the NSDUH, 2006 about 3.1 million persons aged 12 to 25 (5.3%) had ever used an over-the-counter cough and cold medication nonmedically.

• Nearly 1 million persons aged 12 to 25 (1.7%) had used an over-the-counter cough and cold medication to get high in the past year.


1 in 4 teens report having a close friend who abuses cough medicine to get high



• According to the DAWN for 2004, an estimated 12,584 emergency department visits (0.7% of all drug related emergency department visits) involved pharmaceuticals containing dextromethorphan.

• DAWN – Drug Abuse Warning Network

Attitudes Affecting Teen Medicine Abuse

• Medicine Abuse “Normalized” in Teen Culture

• Misperception that abusing medicine is not dangerous

• Misperception that abusing medicine is safer than “street drugs”


Attitudes Affecting Teen Medicine Abuse

• Three quarter of teens reported that the number one reason for using drugs is to cope with the pressure at school.

• 65% of students noted that using drugs to feel better and to look cool were the other top reasons.


Multiple Perceived Benefits of Medicine Abuse Amongst Teens

• Helps me deal with my problems

• Helps me manage my life

• Enhances my performance

• To get high


Teens’ Perceived Ease of Access

• Medicine cabinet, at home or friend’s house

• Another person’s prescription, familyor friend

• From many sources on the Internet

Sources: Partnership Attitude Tracking Survey; Partnership Mapping Study 2006

Prevention

Teens Perceptions

• Peer approval of getting high significantly increased between 2008 – 2009.

• Decrease in social disapproval and risk in using marijuana.

• Between 2005 – 2009 there has been a decrease in the perception of risk of using ecstasy along with an increase in the acceptability of use.

Partnership for a Drug-Free America and Metlife Foundation 2009 Parents and Teens Attitude Tracking Study Report, 3/2/10

Teens Perceptions

• Decrease in learning from parents, schools and media about the risks of using alcohol and drugs between 2008 – 2009.

• Less exposure to anti-drug commercials on TV between 2004-2009.


Parent Education

• Only 7% of parents thought that teens might use drugs to deal with stress– 73% of students reported the top reason for

using drugs was to cope with school pressure.• Parents often have a hard time accepting

that their teen may have a problem.• Parents may ascribe the regular use of

drugs by their teens as normal teenage experimentation


Parent Education

• Parents of teens who use drugs more regularly may feel that they have no influence on their teen’s decision and do not feel that they can enforce any rules about substance abuse.


Need to IncreaseParental Involvement

• Only 31% of teens “learn a lot about the risk of drugs” from their parents.


Rx and OTC Medicine AbuseEducation Campaign

• Multi-media public service advertising • National consumer public relations (parents) • Web-based parent resources• Interactive teen web-site • Parent brochure, hard copy and online• Research tracking and evaluation

www.drugfree.org

Partnership for a Drug-Free America

http://www.drugfree.org/

www.drugfree.org

• Teachable Moments

• Show Kids You Care

• Tips for Talking: Approach Your Teen About Their Possible Alcohol and Drug Use

• Know What Drugs Kids Face Today

www.drugfree.org

• Time To Act– Step by step guidance from experts in the

field of substance abuse for parents who have concerns about their teen.

https://www.deadiversion.usdoj.gov/SEARCH-NTBI

On September 25, 2010, DEA will coordinate a collaborative effort with state and local law enforcement

agencies to remove potentially dangerous controlled substances from our nation’s medicine cabinets.

Collection activities will take place from 10:00 a.m. through 2:00 p.m. at sites established throughout the country.

The National Take-Back Day provides an opportunity for the public to surrender expired, unwanted, or unused pharmaceutical controlled substances

and other medications for destruction. These drugs are a potential source of supply for illegal use and

an unacceptable risk to public health and safety.This one-day effort is intended to bring national focus to the issue

of increasing pharmaceutical controlled substance abuse.

The program is anonymous. Prescription and over the counter solid dosage medications, i.e. tablets and capsules accepted. Intra-venous solutions, injectables, and needles will not be accepted. Illicit substances such as marijuana or methamphetamine are not a part of this initiative.

National Drug Intelligence Center National Prescription Drug Threat

Assessment 2009 April 2009

Teens and Prescription DrugsOffice of the National Drug Control Policy

Executive Office of the PresidentJanuary 2008

Executive Summary

• Teens are turning away from street drugs and using prescription drugs to get high. New users of prescription drugs have caught up with new users of marijuana.

• Next to marijuana, the most common illegal drugs teens are using to get high are prescription medications.

Executive Summary

• Teens are abusing prescription drugs because they believe the myth that these drugs provide a medically safe high.

• The majority of teens get prescription drugs easily and for free, often from friends and relatives.

Executive Summary

• Girls are more likely than boys to intentionally abuse prescription drugs to get high.

• Pain relievers such as Oxycontin and Vicodin are the most commonly abused prescription drugs by teens.

• Adolescents are more likely than young adults to become dependent on prescription medication.

on-line, off-shore and mexican pharmacies this list has been added because of the requests we...

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