Safe Use

• Do establish a good relationship with your pharmacist and stay with the same one.  Over time your pharmacist will learn all about your health needs and will be better able to assist you in the safe use of prescription and over-the-counter drugs as well as vitamins and herbal remedies. 
  MedsCheck is a program that allows you a 30-minute free annual discussion with your pharmacist. 
  Click here for more information.
• Do follow the recommended dosage on the label for over-the-counter medications and prescription drugs.
• Do take as much time as you need to get all your questions answered by your doctor or pharmacist before taking the drug.  It is important to know what you are taking, why you are taking it and for how long.  These medical questions will help you get all the information you need.
• Do Not share your prescription drugs with others.  The doctor prescribed that drug and dose specifically for you based on your medical history, your present condition and needs.  You cannot assume that the drug is safe for anyone else; another person may suffer bad side effects, negative drug interactions or allergies.
• Do keep the drug in its original container to reduce confusion.
• Do store in a dry place that can be locked–not in the bathroom where it is too humid.
• Do keep out of reach of children.
• Do learn from the pharmacist how best to take the medication.  Some foods and herbal remedies can mix badly with medication for certain health situations (e.g., blood pressure, high thyroid, prostate enlargement).  For example, grapefruit juice can increase the risk of  side effects for most cholesterol-lowering and blood pressure medications.
• Do take the prescription as recommended and for the duration indicated on the package.
• Do check with your doctor or pharmacist to see if it is safe to consume alcohol while taking prescription or over-the-counter drugs.
• Do consider using a pill organizer or getting the drugs blister-packed by your pharmacist, if you have a number of medications to take.  This avoids the confusion over dosage and times for taking the medications and reduces the potential hazards of mixing the wrong drugs.
• Do Not remove the label or change the directions for dosage.
• Do Not mix drugs.  Be sure to tell your doctor about all the medications you take including over-the-counter drugs and herbal remedies.
• Do Not mix with alcohol.  Alcohol can prevent the benefits your drugs are supposed to offer.  In addition, of the 100 most frequently prescribed drugs, more than half contain at least one ingredient that reacts badly with alcohol. 

Safe Disposal

• Keep an eye out for expiration dates.  Do not use prescription or over-the-counter drugs, vitamins or herbal remedies beyond the expiration date.
• Do not throw drugs in the garbage. Do not pour down the drain or flush in the toilet–the water will be contaminated.
• Contact your local pharmacist to find out if they will accept expired or unused drugs.  Gather all unused and expired drugs, vitamins and herbal remedies and bring them to your local pharmacy.
• Having one pharmacy for all your medication needs will help protect you and help in appropriate disposal of unused medications.
  
  

Medications: Misuse and Addiction

Although many prescription drugs can be abused or misused, there are three classes of prescription drugs that are most commonly abused:

1. Opioids, which are most often prescribed to treat pain (see below);

2. Central nervous system (CNS) depressants, which are used to treat anxiety and sleep disorders; and

3. Stimulants, which are prescribed to treat the sleep disorder narcolepsy and attention-deficit hyperactivity disorder (ADHD).

For more information on these, visit Prescription Drugs: Abuse and Addiction

Opioid pain medications include a broad range of drugs that have morphine-like effects such as morphine, codeine and oxycodone. They are marketed under many different brand names, including Percocet®, OxyContin®, Demerol®, Dilaudid® and Tylenol No.3®.  Low doses of opioids suppress the sensation of pain and the emotional response to pain. They may also produce euphoria, drowsiness, relaxation, difficulty concentrating, constricted pupils, slight decrease in respiratory rate, nausea, vomiting, constipation, loss of appetite and sweating. With higher doses, these effects are more intense and last longer.

When used as directed, opioid pain medications are effective and the side effects (e.g., drowsiness, nausea, constipation, etc.) are generally manageable. However, long term medical use misuse of these medications can have serious health effects and may lead to addiction and possible overdose.

• 464 people overdosed from oxycodone (the active ingredient in Percocet® or OxyContin®,) in Ontario during 2004-2009.
• Treatment admissions for prescription pain relievers are on the rise.
• There were over 20 drug overdose deaths in 2008 in the City of Peterborough.

Click below for more information:
Opioid Medication (Health Canada)
Opioid Pain Medications Frequently Asked Questions (Health Canada)
Do you know... Oxycontin® (Centre for Addiction and Mental Health)
Do You Know…Opioids (Centre for Addiction and Mental Health)

Prescription opioids are being diverted and misused in Peterborough:

• One in five Ontario students (Gr. 7-12) have used prescription opioids non-medically.
• 74% report that they get them from home.
• The street value of opioids seized by police has risen from $2,000 in 2006 to $24,000 in 2008.
  
  
  

For more information on Prescription Opioid-related concerns in Peterborough, read this backgrounder.

Children

• Many parents are already raising awareness with their children about the dangers of drugs and alcohol.  What may be missing in this conversation is the respect we must show for over- the-counter and prescription drugs as well as vitamins and herbal remedies.  Any substance we put in our body can be dangerous if used inappropriately.  It is important to teach our children from a young age about the responsible use of these drugs.  For more information, visit to help Your children understand the safe use of medicine
• Medications are the most common cause of poisoning in young children. If you have children, it would be wise to keep the Ontario Regional Poison Information Centre or place the toll-free number near your phone. Their number is 1 800 268-9017.  In the Toronto area, you can call (416) 813-5900.  They are available 24 hours a day, 7 days a week.  Some helpful resources they provide are:
• Poison Proof Your Home
•  "Pills or Candy.  Can You Tell the Difference?"
  (Poison Information Centre's poster)

Youth

• Some youth (and adults) abuse prescription drugs (e.g., Ritalin®, Codeine®, Percocet®) for the purpose of getting high. 
• 1 in 5 Ontario students report using prescription pain relievers non-medically

74% say they got them from home. (Ontario Student Drug Use & Health Survey, 2009)
Many teens don’t realize that medications can be just as dangerous and addictive as street drugs. Many who would never try street drugs might feel safe abusing prescription drugs.

•  According to an article entitled "Drugstore Dangers" in the July 2004 issue of Prevention magazine, "A teen is 18 times more likely to die from an overdose of an over-the-counter drug than from an illegal drug."  The article went on to say that "in the late 1990s, poison centers nationwide [U.S.] logged 50 teen DXM abuse calls a month; by the end of 2001, that number jumped to 300 per month..."  DXM stands for dextromethorphan, a common drug used in cough suppressants.

Information for Parents:
Over-the-Counter and Prescription Drug Misuse Prevention

• Parents: The anti-drug.com
• Not in My House

Other drug-related information and advice for parents:

Parents: The Anti-Drug
Links for Parents

• My kid on drugs: What can I do?
• Ten tips for talking to your kids about substance use
• What Parents Need to Know about Teens: Facts, Myths and Strategies

Links for Youth

Above the Influence   USA site

xperiment   Canadian site

Pregnant Women

• "Pregnancy, whether planned or a pleasant surprise, brings with it important concerns about prescription and over the counter drugs.  Not every medication poses a risk to your unborn baby.  However, some do. 
• Talk to your doctor.  Discuss the relative risks and benefits of any prescribed drug therapy and DO NOT take over-the-counter drugs or naturopathic remedies without first consulting your physician."  The same cautions apply to store-bought herbal remedies. 
• If you do not have a family doctor, please speak to another health care provider including your pharmacist.   For more, visit the Motherisk website at Drugs in Pregnancy.

Purchasing Prescription Drugs Over the Internet

• Avoid buying drugs over the Internet.If you buy drugs online, you may be putting your health at serious risk. This is especially true if you order prescription drugs without being examined in person by a health care practitioner. Visit Health Canada's website to learn more about Buying Drugs over the Internet

Direct-to-Consumer Advertising (DTCA)

• It is illegal in Canada for pharmaceutical companies to advertise their products directly to consumers.  However, the U.S. has recently relaxed their standards and with so many Canadians having access to U.S. television, Canadians are now "indirectly" receiving direct- to-consumer advertising. 
• Keep in mind that pharmaceutical companies are interested in sales.  Please do your research very carefully before you go to your doctor asking for some drug you saw advertised in the media. 
  
  

Older Adults


• The Healthy Elderly program at the Peterborough County-City Health Unit has produced a brochure called "Getting the Most Out of My Trip to the Doctor" which is available at the Health Unit.

• "The body changes as people get older.  As they age, most people have slower organ function, slower blood circulation, and more body fat.  These all allow drugs to stay in the body longer, and again increase the chances of side effects..." 
  ABC's of Drugs and Seniors
   
• For more information...
  Alcohol and Medication Interactions
  Alcohol and Herbal Remedies