June 2013
May 23, 2013

Student pill abuse a concern for health care professionals

Author: Liza Frenette
Source: NYSUT United
photo illustration health care
Caption: ILLUSTRATION BY DANA FOURNIER. PHOTO BY MARTY KERINS JR.

Blue pills. Yellow pills. Oblong pills. Tablets. Pills for anxiety. Pills for pain. Pills for insomnia. Pills to pay attention.

While some people may need medication for a serious problem, others can receive prescriptions for short-term situations - and then can become hooked.

Illicit use of prescription medicine has become one of the nation's fastest-growing drug problems, according to the Centers for Disease Control and Prevention (CDC).

"America's prescription drug abuse crisis has been classified as epidemic," said Jeffrey Shepardson, investigator with the New York Bureau of Narcotic Enforcement. He spoke recently with those who are among the best equipped to identify drug dependency - school and hospital nurses, counselors, social workers, dentists and physical and speech therapists - at a NYSUT professional development forum for health care workers that spanned an array of topics. Issues explored at the Professionals Issues Forum on Health Care also included the legal ramifications of electronic documenting; trends in health care education; working with medically complex children and teens; and the role of the school nurse in the Dignity for All Students Act.

"It was an eye-opener to see how these types of drugs are something [students] can find very easily," said Rosemarie Thompson, a United Federation of Teachers guidance counselor at a Bronx high school and member of NYSUT's Health Care Professionals Council. "It was very daunting."

The information, she said, made her think about new questions she could ask her students. "Sometimes students look inebriated or aloof, or you see they are deteroriated," she said. With the absence of alcohol, it can be hard to determine the problem. Learning about the depth of the pill problem will help, she said, as will the reminders about how important it is to collaborate with school nurses to help detect pill abuse.

"Bringing in experts like Shepardson helps steer NYSUT's health care members to the information they need to deal with the growing problem of prescription drug abuse," said Kathleen Donahue, NYSUT vice president whose office oversees health care concerns. Abuse of prescription drugs is skyrocketing for teens and college students, in particular, said Judith Barrett, RN, pharmacy consultant and co-presenter. The problem, she said, is exacerbated by drug companies that relentlessly promote their products, and by doctors who are writing a lot more prescriptions and who "may need more education on prescribing and alternative treatments."

Consider: In New York, 1.5 million prescriptions were filled for Alprazolam (Xanax) in 2008; in 2012 it was 2 million. Prescriptions filled for Oxycodone numbered 2.1 million in 2008 and 3.5 million in 2012. Clonezepan (Klonopin) went from 1.2 million scripts filled in 2010 to 1.4 million just two years later.

"In the last documented year, more than 22 million prescriptions for painkilling drugs were written - without refills - in a state with only 19.5 million people," said Sen. Kemp Hannon, R-Garden City, chair of the Senate Health Committee. Shepardson said prescription drug abuse has allure - if a person has a script, it is not illegal, and health insurance pays for it.

"Kids don't realize what the doctor writes can hurt them," Shepardson said. If they get hooked, "they're still drug addicts."

An estimated 70 percent of people who abuse prescription painkillers obtain them from friends or relatives, according to the CDC.

Of growing concern, Shepardson said, are so-called "pharm parties," where young people throw pills into a bowl, mix them up, pluck some out and then swallow cocktails of stimulants, depressants and narcotics.

Defensive moves to combat the problem are underway in New York state. A new Internet System for Tracking Over-Prescribing (I-STOP) Act takes effect in August. It will:

  • enact a prescription monitoring registry for practitioners and pharmacists;
  • require all prescriptions to be electronically transmitted to help eliminate alteration, forgery or theft of prescription paper;
  • improve distribution safeguards for specific prescription drugs prone to being abused;
  • develop medical education courses and public awareness regarding pain management and prescription drugs; and
  • require state health officials to establish a safe disposal program for unused medications.

School nurses often face the dilemma of what to do with leftover, unused student medication sent in by parents. Barrett advised them to write to the parent and send it home with an adult family member.

Permission has to be requested from the state Department of Health to destroy the medication, or else a school health care worker can be written up for a violation of public health law, Shepardson said.

As part of I-STOP, DOH will work with local police departments to establish secure disposal sites for controlled substances, where individuals can voluntarily surrender unwanted and unused controlled substances.

DID YOU KNOW

Health care professionals can call the state health department's Bureau of Narcotic Enforcement at 866-811-7957 about a concern, or if they suspect a student is using drugs.

Health professionals can also visit www.nyhealth.gov/ professionals/narcotic; or email narcotic@health.state.ny.us. There are regional offices in Buffalo, Rochester, Syracuse and New York City; the central office is in Troy.

Fold-out, laminated brochures that depict size, color and shape of a host of prescription medications, as well as a description of common symptoms of prescription drug abuse are available. School presentations also can be arranged.

Stark facts from CDC

Nearly 15,000 people die every year of overdoses due to prescription painkillers. In 2010, 1 in 20 people in the United States over the age of 11 reported using prescription painkillers for non-medical reasons in the past year.

From 1999 through 2008, overdose death rates and substance abuse treatment admissions related to prescription painkillers increased substantially. Sales of opioid painkillers QUADRUPLED between 1999 and 2010. Enough opioid painkillers were prescribed in 2010 to medicate every American adult with 5 mg of Hydrocodone every four hours for a month.