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Adrian G, a pharmacist to promote pharmacy practice and to raise an awareness of common drugs at risk for abuse in our community.
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The Community PharmacistDispensing Good Medicine…Preventing Drug Abuse
Adrian Goram, PharmD, CPhPharmacistPublix PharmacyPensacola, FL
Pensacola BizNet
MeetingMay 1, 2014
7:30am
DisclosureI am here today as a pharmacist
to promote pharmacy practice and to raise an awareness of common drugs at risk for abuse in our community.
I am currently employed by Publix Pharmacy, Pensacola, FL.
No financial compensation was provided for this presentation.
Objectives
Describe the practice of good medicine
Identify several prescription (Rx) and Over the Counter (OTC) drugs and drug classes commonly abused
Describe the pharmacist’s efforts to fight drug abuse
Local Pharmacy Practices
Sacred Heart(Pensacola &
Destin)
Baptist (Pensacola & Gulf
Breeze)
West FloridaSanta Rosa
MedicalFWB Medical
WalgreensWal-Mart Sam’s ClubC V S
Rite-Aid
A & ECantonmen
t DrugsEnsley Drugs
Pensacola ApothecaryRx Express
PublixTargetKroger
Winn Dixie
Pharmacists Do More Than Just Dispense Pills
Drug Indication?Side Effects?Compliance?
What if I miss a dose?
OTC recommendatio
n?CAN I DRINK?
COUNSEL
Right patientRight drugRight dose
Right amount
DISPENSE
Drug AllergiesFood Allergies
Drug Interactions
Contraindications
SCREEN
PatientHealthcare
ProviderDrugDose
SupplyValid Rx
Valid MDInsurance
COST
VERIFY
Excessive Alcohol Use: Common Denominator for Rx & OTC Abuse
Which teenage gender drinks the most?Boys
Girls
Excessive Alcohol Use: Common Denominator for Rx & OTC AbuseRef: Partnership for a Drug Free America 2009
Which teenage gender drinks the most?Boys 52%
Girls 59%
For a full report go to:
www.dcf.state.fl.us/programs/samh/publications/fysas/08Survey/EscambiaCounty.pdf
www.dcf.state.fl.us/programs/samh/publications/fysas/10Survey/county_slideshows/Santa%20Rosa%20County.pdf
Tampons, Skittles & Gummy Bears Soaked with Vodka
Alternative Alcohol Sobriety Test
Prescription (Rx) Drug Abuse: A Widespread Concern Among TeenagersThe rate for Rx drug abuse is the fasting
growing epidemic in the U.S.48 million teenagers (>12 years old) used
Rx drugs for illicit or recreational uses.Nearly 14% met the criteria for abuse or
dependence.Nearly 3 million youths (age 12-25 years)
become new Rx Abusers each yearFemales; the most frequent abuser of Rx
drugs across ALL age groups
Ref: Chertoff JL:PharmCon 0798-0000-11-095-H01-P
Common Triggers for Rx and OTC Drug Abuse
Strong Media InfluenceInternet Savvy
Strong Peer PressureStress
BULLYING
Ease of AccessEasily
ConcealedCheap & Legally
Purchased
Thrill SeekersSheer
BoredomDysfunction
al Family Issues
Three Pharmacologic Classes of Rx Drugs Commonly Abused
OPIOID ANALGESICS
BENZODIAZEPINES
AMPHETAMINES
Pain Relievers Anti-AnxietySedatives/
Tranquilizers
Stimulants
OXYCODONEOxyContin, Percocet
ALPRAZOLAMXanax
METHYLPHENIDATERitalin, Concerta
HYDROCODONENorco, Lortab, VicodinVicoprofen
CLONAZEPAMKlonopin
AMPHETAMINE +DEXTROAMPHETAMINE MIXED SALTSAdderall
MORPHINEMS Contin, Avinza, Kadian
DIAZEPAMValium
DEXTROAMPHETAMINEDexedrine
HYDROMORPHONEDilaudid
***NON-BENZOs*** Sleep Aids
CODEINE ZOLPIDEMAmbien
METHADONEDolophine
ESZOPICLONELunesta
FENTANYLDuragesic
A Recent Study of Nearly 9 Million Drug Abusers Report:
5.3 Million Abuse Pain Relievers
2 Million Abuse
Tranquilizers
1.3 Million Abuse
Stimulants
Three OTC Drug Products Commonly AbusedPseudoephedrine
(PSE)Caffeine Dextromethorpha
n (DXM)Cough/Cold ProductsSudafed, Allergra-DClaritin-D, Zyrtec-D, Mucinex-D, Alka-Seltzer-D, Tylenol Sinus
No Doz Vivarin Awake
Cough/Cold ProductsMucinex-DM Robitussin DMCorricidin DM
Pain RelieversCo-Advil,
Pain RelieversGoody’s Powders, BC Powders, Anacin, Excedrin, Vanquish
Weight Loss Hydroxycutt, Diet Fuel
BeveragesCoffee, Energy Drinks, Red Bull, Monster, etc.
Four Pivotal Areas to Prevent Rx Drug AbuseRef: Epidemic: Responding to America’s Prescription Drug Abuse Crisis 2011
Education Tracking & Monitoring
Proper Drug Disposal
Enforcement
PARENTAL VIGILENCE• Inspect your kid’s bedrooms, Internet
accounts, laptops, cellphones, etc.• Changes in behavior, habits, friends,
hangouts, etc.• Home drug test kits• Referral source to Law Enforcement
and Drug Addiction & Treatment Centers
• HEALTHCARE PRACTITIONERS• MDs, Dentists, RNs, NPs, PAs• Compliance to evidence-based
guidelines
Federal & State Supported Prescription Drug Monitoring Programs (PDMP)Monitoring and Tracking of PSE SalesPatients who “Doctor Shop”Unethical and Suspicious Prescribing:• Narcotics & Pill Mills• Forgeries, Stolen Prescription Pads• Self-Medication• Beyond the respective scope of
practice
Clean Your Medicine Cabinet• 70% of illicit users of pills were
retrieved from family & friends, as compared to 5% from drug pushers
• Properly dispose of unwanted & expired pills
• DO NOT FLUSH IN TOILET• Place disposed meds in a zip-lock
sealed bag or Tupperware-like container filled with cat litter or coffee ground then place in trash
• ANNUAL PRESRIPTION DRUG TAKE-BACK DAY Collects all unwanted pills at a participating pharmacies
•www.deadversion.usdoj.gov/drug_disposal/takeback
•CHARITABLE MED DONATION DROP OFF?
Partner with local law (Narcotics) enforcementIdentify Pills Share data among pharmacies for unlawful or unethical activities:• Doctor Shopping• Unscrupulous Prescribing Patterns• Forgeries• Stolen Prescription Pads • Increased Customer Traffic for PSE
Sales
Local Drug Abuse & Treatment Centers
Meridian1920 N. J St.
(850) 469-3502
Teen Challenge of Pensacola(
www.pensacolamen.teenchallenge.cc
) 8600 Hwy US 98
(850) 453-4300
Lakeview Center Pathway (
www.bhcpns.org) 6425 Pensacola Blvd
(850) 453-7722
New Beginnings Recovery Homes (www.newbeginningsrecovery.com) 820 Gerhardt Dr (850) 439-1522
Acceptance Counseling 3 W. Garden St
Lakeview Center Medication
1800 N Palafox St (850) 466-3400
Drug & Alcohol 24 Hour Helpline
(850) 944-7802
Drug & Alcohol Rehab in Florida at Twelve Oaks
(www.twelveoaks.crchealth.com) 2068 Health Core Dr.
Navarre, FL(850-763-6340)