1 / 37

Prescription drugs

adolescent abuse of prescription and over-the-counter drugs michael nerney and associates PO Box 93 long lake, NY 12847-0093 518-624-5351 mcnerneyll@frontiernet.net. Prescription drugs. In the United States: Food and Drug Administration Sole agency responsible

avital
Download Presentation

Prescription drugs

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. adolescent abuse of prescription andover-the-counter drugsmichael nerney and associatesPO Box 93long lake, NY 12847-0093518-624-5351mcnerneyll@frontiernet.net

  2. Prescription drugs • In the United States: • Food and Drug Administration • Sole agency responsible • Center for Drug Evaluation and Research • Ten to Twelve Years Average • 5 out of 5000 go to clinical trials • 1 out of 5 is approved

  3. Prescription drugs • Investigational New Drug Application • Preclinical, lab, animal, safety • Phase 1 • Healthy subjects, 20-80 • ED(50), TD(50), LD(50) • Phase 2 • Target subjects, 100-300 • Effective against disease or disorder

  4. Prescription drugs • Investigational New Drug Application • Phase 3 • Large randomized double blind • 1000-3000 patients • Minimum/maximum doses • Combinations • Adverse effects/Contraindications • IND vs. Placebo

  5. Prescription drugs • Investigational New Drug Application • New Drug Application • Filed with FDA • 100,000 pages of data • Review time, 8-12 months • Up to 2 years • Phase 4 • Post marketing

  6. Prescription drugs • 3 Basic Outcomes • Intended effect • Adverse effect • Idiosyncratic effect

  7. Overview • Perceptions • GRASE • ACCESS

  8. overview • Motivations • Bio-Psycho-Social • Dynamics • Dose, Contaminants

  9. sources • Doctor Shopping • Home Visits • The Streets • The Internet

  10. patterns • As Needed • Medication for Feelings • 4 out of 10 • Negative Emotions

  11. patterns • Recreation • Disinhibition • Anxiety Reduction • Euphoria

  12. patterns • Cross-generational • 3 generations • Parents use children's drugs • Kids use grandparents’ drugs

  13. Drug combinations • Enhance Primary Drug Effect • Boost the initial drug • Slow metabolism • Grapefruit juice

  14. Drug combinations • Alleviate Withdrawal • Mask the withdrawal symptoms • Two separate systems • One system suppression

  15. Drug combinations • Reduce Negative Side Effects • Minimize unpleasant effects

  16. Systems Investigated • Structural • Gray Matter • White Matter

  17. concerns • New Research on the Brain • Glutamate System Suppression • Too much DA • Chemical/Structural Changes • Protein interference • Loss of flexible learning

  18. CONCERNS • New Research on the Brain • Reward System Shutdown • Too much DA • CREB • Gene code • Synthesize Dynorphin

  19. Concerns • New Research on the Brain • Embedded Memory • Too much DA • Delta FosB • Chemical Changes • Protein shift • PKMzeta • Stores the high

  20. Abuse of Prescription Drugs • Prescription Stimulants Brief History • Mechanism of action • Reuptake • Site of activity • PFC, Limbic • Neurotransmitters • DA, NE, 5HT

  21. Prescription Stimulants • Potential for Abuse/Addiction • High • Risks • Physical, Behavioral • Psychological

  22. Abuse of Prescription Drugs, continued • Prescription Tranquillizers Brief History • Mechanism of action • Second Messenger • Site of activity • Limbic • Neurotransmitters • GABA

  23. Prescription tranquillizers • Potential for Abuse/Addiction • Risks

  24. Abuse of Prescription Drugs, continued • Prescription Narcotics Brief History • Mechanism of Action • Direct • Site of activity • Limbic, Brain Stem • Neurotransmitters • Endorphin Receptors

  25. Prescription narcotics • Potential for Abuse/Addiction • High • Risks • Multiple

  26. Abuse of Prescription Drugs, continued • Other Drugs

  27. Interactions with other drugs • Alcohol • Marijuana

  28. Interactions with other drugs, continued • Ecstasy • Over-the-Counter • Aeroshots • Allergy Meds

  29. Over the counter • Robo-shots • Dextromethorphan • Opioid cough suppressant • Plus alcohol • Rapid and powerful intoxication • Motor control • Impulse control • Delusional

  30. Treatment Issues • Detoxification/Withdrawal

  31. Treatment issues • Treatment Model

  32. Current and Experimental Medications as Treatment Adjuncts • For Opioid Dependency: Trexan Vivitrol Buphenex

  33. Current and Experimental Medications as Treatment Adjuncts • For Cocaine/Methamphetamine/Stimulant Dependency: • Selegiline • Amantidine • Baclofen • Modafinil • Disulfiram

  34. The Practice of Recovery • The Clinical Connection • Access to Qualified Treatment Providers • Therapeutic Alliance • Multiple Models • Access to Support • 12 Step Programs

  35. Emotional Competencies • Self Awareness • Verbal Access • Emotional Regulation • Empathic Response • Passionate Interest

  36. Key Aspects • Fluid Intelligence • Monitoring Performance • Managing Emotions

  37. The Practice of Recovery • Practice and Repetition • Learn from Failure

More Related