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| Danger in Your Medicine Cabinet |
Keep tabs on your prescription and non-prescription drugs
Alison DeLory
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One day, Liz Fielder (a pseudonym) was surprised to see her 23-year-old son, Jason, return home from work at 11 a.m. A Toronto law student, Jason had been sent home from his summer job as a paralegal when his employer could see he wasn’t sober. Turns out Jason had been liberally helping himself to a range of prescription painkillers, including the opioid oxycodone, which Liz kept in her medicine cabinet to manage her severe chronic back pain. “I just like being high,” he told his angry mother when she demanded an explanation. Jason also fessed up to selling the occasional “ox” from Liz’s supply to supplement his income.
Jason’s is far from an isolated case; opioid misuse is all too common in Canada. According to Ontario’s chief coroner, Dr. Andrew McCallum, about 150 Ontario deaths a year are due to oxycodone toxicity. In the past two years, addiction workers in Manitoba say they’ve seen an alarming rise in the number of Manitobans addicted to painkillers such as oxycodone and fentanyl. And the rash of recent deaths due to opioid abuse in Nova’s Scotia’s Annapolis Valley is further proof that the problem is widespread.
Some people wrongly believe that the drugs in their medicine cabinets are safer than illegal street drugs such as the hallucinogen phencyclidine (PCP) or crack cocaine. But used improperly, prescription and non-prescription drugs — from potentially addictive opioids to seemingly benign acetaminophen — can be dangerous. Sometimes patients accidentally overdose but other times they endanger themselves intentionally by mixing drugs with alcohol for a bigger buzz or by taking drugs prescribed for someone else.
Dr. Peter Zed, clinical pharmacy co-ordinator at Capital Health and an associate professor in the College of Pharmacy and Department of Emergency Medicine at Dalhousie University in Halifax, calls prescription and non prescription misuse a “big problem” that regularly lands patients in emergency departments. “There are dangers associated with all drugs. They can interact with other drugs and negatively impact existing health conditions,” he says.
Let’s take a look inside a typical medicine cabinet to see what potentially harmful prescription and nonprescription drugs it might contain.
“THERE ARE DANGERS associated with all Drugs. They can interact with other drugs and Negatively impact existing health conditions”
Prescription drugs
OPIOIDS Prescribed for pain, these include oxycodone, hydromorphone, morphine and codeine-containing drugs. Opioids work on the central nervous system — the brain and spinal cord. They numb perceptions of pain, alter psychological reactions to pain and can induce lethargy or sleep. Opioid addiction is a combination of physical dependence, psychological habituation and body tolerance. Opioids can cause nausea, confusion, slurred speech, constipation and itchiness, and should never be taken with alcohol. Zed says patients often arrive in the emergency department with opioid toxicity because their initial dosing levels were too high or because they used them improperly or excessively.
BENZODIAZEPINES Prescribed for anxiety, acute stress reactions and panic attacks, these common drugs include diazepam, lorazapam and clonazepam. Benzodiazepines slow brain activity, and when usage is discontinued, the brain can rebound and race out of control, potentially leading to seizures. Other side effects aree dizziness, weakness, lethargy, diarrhea, stomach upset, insomnia, headaches and depression.
CENTRAL NERVOUS SYSTEM (CNS) STIMULANTS Prescribed for attention deficit hyperactivity disorders, these include amphetamines and methylphenidate. These stimulants increase dopamine levels in the brain and when they do so in a rapid and amplified manner, euphoria may result. They may also increase blood pressure, heart rate and body temperature as well as disrupt sleep and reduce appetite. If your child is taking a CNS stimulant such as methylphenidate (Ritalin), you may wish to monitor quantities and have your child take the medicine in front of you: there’s a potential schoolyard market for these drugs. Zed says that athletes have been known to use them for performance enhancement.
ANTIBIOTICS They kill or slow the growth of bacteria, but they should never be shared or saved. Your doctor chooses antibiotics based on your individual medical history along with the type of bacteria causing your infection. As with all drugs, never assume that an antibiotic prescribed for someone else will be effective for you and never save up antibiotics for your own later use. As for other old medications, Zed advises that before taking any of these, patients should consult with a physician, nurse or pharmacist. “What might have been safe for them to use two years ago might not be safe or appropriate now,” he cautions.
Over the counter agents
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COUGH AND COLD MEDICATIONS If you see these medicines lying about your house after your teenager’s party, don’t assume it’s because several kids had serious viruses. Used in large amounts, preparations containing the cough suppressant dextromethorphan can produce highs, as well as confusion, dizziness, distorted vision, slurred speech, co-ordination problems, drowsiness, rapid heartbeat, nausea, vomiting, hallucination, and loss of motor control.
PAIN RELIEVERS Acetaminophen has been linked to acute liver failure with overuse and especially when combined with alcohol. When taken in excess, non-steroidal anti-inflammatory drugs, including ibuprofen and naproxen, can increase blood pressure, exacerbate heart failure and cause stomach ulcers, GI bleeding and kidney failure.
DIET PILLS, LAXATIVES AND DIURETICS Taken in excess to hasten weight loss, these drugs can cause digestive and kidney problems, dehydration, nervousness, tremors, rapid heartbeat, high blood pressure and heart failure.
MOTION SICKNESS PILLS Consumed in large doses (an entire package or more), the antihistamine and antiemetic drug dimenhydrinate can cause sedation or hallucinations.
It’s important to recognize the potential for prescription and non-prescription drug misuse and addiction. Children and teens should not have open access to your medicine cabinet. Return any unused drugs to your pharmacy for safe disposal. “Open communication with your health-care providers is key,” says Zed. Just because you bought drugs legally doesn’t mean they can’t hurt you or others who may help themselves.
