Breaking Bad at the Pharmacy

April 25, 2014

By Medical Discovery News

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Drug abuse is not confined to street drugs like methamphetamine, heroin, and cocaine. America is facing an epidemic of prescription drug abuse, particularly with pain relievers, depressants, and stimulants. In 2010, 7 million Americans abused prescription drugs every month.

People are able to abuse such medications by taking medicines prescribed for someone else, using them in excess, or by taking them in a way not prescribed, such as crushing and snorting pills or liquefying and injecting them to hasten the effects needed to produce a high.

Depressants, sedatives, and tranquilizers are abused by more than 2.5 million people each month. The mood-altering drug Zoloft ranks sixth on the list of abused pharmaceuticals and earned more than $500 million in sales. It is prescribed for depression, obsessive compulsive disorder, post-traumatic stress disorder, and social anxiety disorder. The 10th most abused prescription drug is Xanax (alprazolam), called Xany, blue footballs, Xanybars, or just bars on the street. Xanax had sales of almost $275 million in 2012. This drug is intended to treat anxiety or panic disorders. It is often abused because it creates what is described as a sense of wellbeing, but can be fatal when abused.

The sleeping pills Ambien and Lunesta are the fourth and seventh most abused drugs from the pharmacy, with sales of $670 and $450 million respectively in 2012. Both are used to treat difficulties falling or staying asleep but can produce hallucinations when abused. Tom Brokaw of NBC News inadvertently experienced these symptoms from Ambien while covering the last presidential campaign.    

Drugs used to treat attention deficit hyperactivity disorder (ADHD) are also widely abused, usually by students seeking a way to stay awake and intensely focus on a project or test. Other than marijuana and synthetic marijuana, Adderall is the most-used drug by high school seniors and the eighth most abused prescription drug in the country. Its sales top $400 million. Other stimulants of the central nervous system, Ritalin and Concerta, are the third and fifth most abused pharmaceuticals. Stimulants can have significant side effects like irregular heartbeat, heart failure, seizures, and behavioral changes like paranoia or hostility. 

Some of the most abused drugs are opioid analgesics used clinically as pain relievers. These drugs are involved in 75 percent of all pharmaceutical overdose deaths – more than 16,000 people a year. An estimated 5.1 million people abuse these drugs each month. This included the most abused pharmaceutical drug – Oxycontin. In 2012, sales of this drug reached about $2.5 billion. The second most abused prescription drug, Suboxone, is used as a maintenance treatment for opioid dependence. Its sales brought in almost $1.4 billion. Another opioid, Opana ER (oxymorphone), ranks ninth on the list of most abused pharmaceuticals and is used to treat severe and chronic pain. It earned $300 million in sales in 2012.

Prescription drugs like these are a double-edged sword. They do a lot of good for a lot of people, and many genuinely need them to function. New regulations that govern the use of these drugs, while annoying for people who need them, help limit some of the abusive behavior of those breaking bad.

The Case Against Propofol

By Medical Discovery News

May 12, 2012

Until the death of pop king Michael Jackson, few people had ever heard of the drug Propofol.  The doctor who injected him with the general anesthetic has since been convicted of being reckless with a drug that’s potent and potentially lethal. Propofol is not classified as a controlled substance, but since Jackson’s death, several scientific papers have begun to urge the U.S. Drug Enforcement Administration to regulate the drug.

I Own Myself... Don't I?

For that to happen, health officials would need to establish that Propofol is being abused recreationally. To date, it’s still largely found in hospital operating rooms and intensive care units where patients are highly monitored. Propofol works within seconds of injection, acting on the central nervous system to sedate a patient. A mistake can cause a drop in blood pressure, obstructed airways, and respiratory failure.

A study of trauma patients who possibly died from Propofol side effects show their EKG readings fluctuated before going into cardiac arrest. This suggests that in some patients, Propofol may be toxic to the heart.  It can also cause pancreatitis, an inflammation or bleeding of the pancreas, which can be fatal.

Though the side effects are risky, recent scientific papers document cases of medical personnel abusing the drug. Several involve anesthesiologists. One in particular self injected 10 to 15 times daily, and another was found dead of an overdose at the hospital where she worked.

One study in the 1980s tried to establish Propofol’s potential for abuse.  The subjects given Propofol described a broad range of feelings, from euphoria and sexual disinhibition to a general sense of well being.  The study’s authors concluded Propofol may be addictive.

Propofol

However, the qualities for abuse extend further to include withdrawal symptoms and tolerance for the drug. In past studies, people showed a range of behaviors when taken off Propofol. Some described intense food cravings, hallucinations, and anxiety. A few studies, limited to patients in the intensive care unit, suggest they grew tolerant to the drug. But there’s not enough data to prove either withdrawal or tolerance for Propofol exists.

Over the years, Propofol use has increased mostly because it is not controlled, works quickly, and doesn’t last long. These properties make hiding Propofol abuse very easy, especially for medical personnel with access to the drug. Between 1992 and 2009, at least 45 documented cases of Propofol abuse were published in medical findings, including Michael Jackson’s recent death.  

The scientists who support regulation believe Propofol should be secured and not openly available to medical personnel, which is the case in many hospitals today. Making Propofol a controlled substance would require hospitals to regulate its use and deter an increasing interest as highlighted by Michael Jackson’s death.

 For a link to this story, click here.