The Dangers of Prescription Drug Sharing
Carolyn Baird, RN has seen it all when it comes to the sharing of controlled substances.
"I have seen a number of cases of young women taking someone else's medication (with and without the other person's knowledge)," says Baird, a co-occurring disorders therapist at Isaly Counseling Associates and an adjunct professor at Waynesburg University in Waynesburg, Penn. "The situation I have encountered the most is a teenage female taking pills from a friend and passing out at school from an overdose."
Nearly seven million Americans abuse prescription drugs, according to the Drug Enforcement Administration. That's more than the number of people abusing cocaine, heroin, hallucinogens, Ecstasy and inhalants combined.
Of course, not everyone sharing pills is an addict. When Cheryl Loux's husband suffered a severe backache, she bypassed Advil and went straight to Vicodin, a painkiller prescribed to her following complications from breast surgery. Like many people, it never occurred to her that she could be putting her husband in danger. In fact, he even took a double dose, reasoning he weighed more and needed more medication to feel an effect. Cheryl's husband didn't suffer any side effects. He was extremely fortunate considering that, according to the Department of Health and Human Services, prescription painkillers kill more Americans than heroin and cocaine put together.
Others aren't so lucky. Keith Carlson, RN, BSN saw the negative effects of sharing medications in a couple who both had HIV. Rather than checking with a doctor or clinic, the husband took his wife's medications for several months. "This can be very dangerous because each person has their own unique set of genotypic resistance, meaning that their body has mutations of HIV virus that their partner or another person may not have," explains Carlson. "Taking a particular medication to which they are not sensitive can cause their HIV to mutate further, decreasing the number of meds that will be effective for them." Not only did this patient cause some damage to his health, he also lost access to many medications that he might have been able to use in the future.
How to Spot Pill Sharing
Part caregiver, part detective, nurses can serve as an important line of defense in spotting pill sharing. Baird suggests being on the lookout for physical symptoms that don't match the environment such as dilated pupils in bright light, sweating in a cold room or freezing when the temperature is warm. Other clues might be symptoms that don't match the known side effects of the individual's prescribed medication (anything from nausea and vomiting to a rapid heart rate or breathing difficulties) and/or a sudden onset of certain psychological issues such as anxiety or manic behavior.
Another clue is watching the behavior of those who accompany the patient. Carlson recalls a husband and wife where the wife was the one with the complaint of pain, yet the husband did most of the talking and got upset when the doctor resisted writing a prescription. "This behavior is always a red flag," he says.
Taking a complete drug history is recommended if physical, psychological or behavioral symptoms raise questions. Specific things to ask should include, "What medications are prescribed for you? Do you take them as prescribed? What medications have you been taking (prescribed for you or someone else)? What have you taken in the last month (prescribed, over-the-counter or someone else's)? What have you taken in the last 24 hours?" says Baird.
In addition to offering care and treatment, nurses can also be on the forefront of patient education. Whether talking to an addict or someone who occasionally takes or gives a prescription pill, "this is definitely a 'teachable moment,'" says Baird. "The best approach is to educate the giver and receiver about the dangers of sharing medication."