Michael O’Neil, Pharm.D Director, Center of Excellence for the education and Prevention of Drug Diversion and Substance Abuse Consultant State BCI / Federal D.E.A. Pain Management Expert Addiction Specialist

 Discuss the general “cultures” of prescription drug abuse  Review the common agents of abuse  Review methods of prescription drug abuse deterrence

The first rule to NEVER forget about drug diversion and substance abuse is..NEVER CONFUSE THE ISSUES WITH FACTS!

Prescription Drug Abuse, Misuse, Addiction, Diversion Sharing Culture Adult Adolescent to Adult / Adolescent Adult to Child Individual or Patient The Income Driven Culture Practitione r Substance Abuse Culture Mood Modifiers Experimenters The Addiction Culture Active Addicts The “Bridging” Population Addicts in Abstinence Recovering Addicts In Maintenance Therapy

Prescription Drug Abuse in the Community: The “Sharing” Culture Perception that Rxs are safe for everyone -Drug -Dose -Route - “Helping” - “Self Medicating” Availability of left-over “Scripts” Sharing Culture Adult Adolescent to Adult / Adolescent Adult to Child

Prescription Drug Abuse in the Community: The “Income” Culture  The disabled patient  The disabled economy  The Schemes - Doctor shopping - Using kids - Theft  Prescriber Driven Income Individual or Patient The Income Driven Culture Practitione r

Experimenters  “Pharming” Parties -Social Perception / Acceptance -Peer pressure  Planned Events  Relaxation  Work driven problems  Home driven problems  Society driven problems -Anxiety -Depression -PTSD -Bipolar -Coping Substance Abuse Culture Mood Modifiers

Prescription Drug Abuse in the Community: The “Addiction” Culture  Maintaining the “high” - The more you use the more you need  Bridging the gaps between the “highs” ***  Treatment- Maintenance Therapy **** The Addiction Culture Active Addicts The “Bridging” Population Addicts in Abstinence Addicts in Abstinence Recovering Addicts In Maintenance Therapy

 Physical Performance enhancers  Mental Performance enhancers  “Social” performance enhancers  Self Medication for injuries, stressors, mental disease (depression, anxiety, bipolar, etc)

OPIATES  Hydrocodone  Oxycodone  Hydromorphone  Codeine  Morphine  Fentanyl  Methadone  Buprenorphine BENZODIAZEPINES  Clonazepam  Alprazolam  Diazepam  Lorazepam

ANTIPSYCHOTICS  Seroquel  Haloperidal  Risperadal STIMULANTS  Methylphenidate  Dextrose-amphetamines

ANTIDEPRESSANTS  Zoloft  Lexapro  Cymbalta  Prozac  Effexor  Paxil Muscle Relaxants  Flexeril  Skelaxin ANTIHYPERTENSIVE  Clonidine  Lopressor  Atenolol  Propranolol Anticonvulsants  Neurontin  Carbamazepine  pregabalin 15

ANTIDEPRESSANTS  Zoloft  Lexapro  Cymbalta  Prozac  Effexor  Paxil ANTIHYPERTENSIVE  Clonidine  Lopressor  Atenolol  Propranolol

Antiemetics  Phenergan  Benadryl  Atarax  Zofran Sex Enhancers  Viagra  Cialis  Levitra

 Tagamet  Zantac

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