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By Expediente Rojo

Approximately 15,000 people in the U.S. die every year from perscription drug overdose.

In the last 10 years, there’s been a drastic rise in the number of deaths caues by overdosing on doctor prescribed pain killers. Close to 15,000 people die every year as a result of this type of abuse, a number greater than the combined total of deaths due to heroine and cocaine overdose.

According to a recent analysis from the Centers for Disease Control and Prevention (CDC), during 2010, one out of every 20 people in the U.S. aged 12 or older used prescription medication not for medical reasons, but rather for the euphoric feelings that they trigger.

Without a doubt, prescription drugs kept in the medicine cabinet or cupboards at home can pose a serious threat not only to adults but to kids and teenagers for whom abuse is reaching epidemic levels.

According to the Drug Enforcement Agency (DEA) more than 7 million Americans abuse prescription drugs.

The Partnership for a Drug Free America estimated that 2,500 teenagers take drugs everyday for the first time with a drug found at home. Abuse can cause addition to analgesis, tranquilizers, and stimulants.

There is also more talk of painkillers or so-called “pain medications” that can lead to death when they are mixed into a fatal cocktail with other drugs. Overdoses with prescription painkillers are part of a family of drugs that include hydrocodone, methadone, oxycodone and oxymorphone.

Despite recent reductions in the consumption of certain drugs among adolescents, especially marijuana, a growing number are consuming prescription and OTC drugs.

It is important to differentiate between a “prescription drug”, which is one which can only be obtained with the authorization of a licensed physician, or a “over-the-counter” medication which is sold without a prescription in pharmacies and used to combat allergies, flu, headaches, and other aches and pains.

But both types of drugs have explicit instructions on how to be consumed to avoid negative consequences. The Food and Drug Administration is the body responsible for approving all drugs that are on the market. New laws have made it harder to purchase drugs in large quantities which are intended to provide relief for certain ailments but are often used to manufacture illegal drugs such as methamphetamines.

Health authorities insist that both over-the-counter medications and prescription drugs can be as dangerous as illegal or street drugs such as cocaine, heroine, methamphetamines, or marijuana. And, when consumed without a prescription, they are just as illegal.

According to the DEA, the death toll in the U.S. due to the consumption of illegal and prescription drugs reached 31,000 last year. They also confirmed that 7 million people are addicted to illegal drugs, a similar number to those that use prescription medication.

Although experts don’t know exactly why this type of drug use is increasing, they believe that easy access has become part of the problem as doctors prescribe more drugs for health issues than ever before and internet pharmacies have made it easier to obtain drugs without a prescription, some of which are disguised as bathsalts, plant food, or home cleaning products.

Some recent statistics on drug abuse in the U.S.:

• One in five teens (19% or 4.5 million) have used prescription drugs like painkillers such as Vicodin and OxyContin, or stimulants like Ritalin and Adderall to get high.
• One in 10 (10% or 2.4 million) adolescents has used cough medicine to get high.
• Two in five teens (40% or 9.4 million) agree that taking prescription drugs, although not prescribed by a physician, is “much safer” than illegal drugs.
• Nearly one-third of teens (31% or 7.3 million) believe that “there is nothing wrong with” using prescription drugs without a prescription “once in a while.”
• Almost three in 10 teens (29% or 6.8 million) believe that pain relievers, even if not prescribed by a doctor, are not addictive.
• More than half of teens (55% or 13 million) don’t think it’s dangerous to get high off cough medicine.
• In 2008, about 15,000 people died of overdoses attributed to prescription drugs for pain in the U.S. This is more than triple the 4,000 people who died for the same reason in 1999.
• In 2010, about 12 million Americans (12 years and older) reported having used prescription drugs for pain last year.
• There are 500,000 emergency room visits each year as a result of painkiller abuse.

Sources: Partnership for a Drug Free America, the Centers for Disease Control and Prevention, and the U.S. Drug Enforcement Agency

[Photo By  ianturton]

Miscommunication between patients and healthcare providers can hurt you.

An elderly woman sent home from the hospital develops a life-threatening infection because she doesn’t understand the warning signs listed in the discharge instructions. A man confused by a form in a doctor’s office reflexively writes “no” to every question because he doesn’t understand what is being asked. A young mother pours a drug that is supposed to be taken by mouth into her baby’s ear, perforating the eardrum. And a man in his 70s preparing for his first colonoscopy uses a suppository as directed, but without first removing it from the foil packet.

These are not isolated events. According to the AMA, poor health literacy is “a stronger predictor of a person’s health than age, income, employment status and race.”

Health literacy includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor’s directions and consent forms, and the ability to negotiate complex healthcare systems. Health literacy is not simply the ability to read. It requires a complex group of reading, listening, analytical, and decision-making skills, and the ability to apply these skills to health situations. As a result, patients often take medicines on erratic schedules, miss follow-up appointments, and do not understand instructions like “take on an empty stomach.”

A 2006 study by the U.S. Department of Education found that 36% of adults have only basic or below-basic skills for dealing with health material. This means that 90 million Americans can understand discharge instructions written only at a fifth-grade level or lower.

Vulnerable populations include:

• The elderly (age 65+) – Two thirds of U.S. adults age 60 and over have inadequate or marginal literacy skills, and 81% of patients age 60 and older at a public hospital could not read or understand basic materials such as prescription labels.
• Minority populations
• Immigrant populations
• Low income – Approximately half of Medicare/Medicaid recipients read below the fifth-grade level.
• People with chronic mental and/or physical health conditions

Reasons for limited literacy skills include:

• Lack of educational opportunity – people with a high school education or lower
• Learning disabilities
• Cognitive declines in older adults
• Use it or lose it – Reading abilities are typically three to five grade levels below the last year of school completed. Therefore, people with a high school diploma, typically read at a seventh or eighth grade reading level.

Communicate in a manner that meets the patient’s needs

The Joint Commission, which accredits hospitals, is requiring them to use plain-language materials and to “communicate in a manner that meets the patients oral and written communication needs” in providing care. For example, instead of “myocardial infarction,” use heart attack; instead of “febrile,” use fever; replace “hyperlipidemia” with high cholesterol. Doctors are also encouraged to replace “diet” with food because many people when they hear diet believe doctors want them to go on a diet. It is also recommended replacing “exercise” with walking, because, in this case, when patients hear exercise they believe they have to go to the gym. Replacing ”medicalese,” with plain language will save lives.

If you want to be sure you’re getting the right care, you have to be able to understand instructions. If you don’t understand, speak up! Don’t be embarrassed; you’re not alone. These are life and death situations. There is no room for shame!

References:

• http://www.usatoday.com/news/health/2007-03-25-patient-illiteracy_N.htm
• http://nnlm.gov/outreach/consumer/hlthlit.html
• Report on the Council of Scientific Affairs, Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association, JAMA, Feb 10, 1999.
• Williams, MV. JAMA, December 6, 1995.
• http://www.medicarerights.org/maincontentstatsdemographics.html

Jeff Kreisberg is a patient advocate, educator, scientist author of the book “Taking Control of Your Healthcare,” and, until his retirement, a professor at the University of Texas Health Science Center in San Antonio, Texas. Jeff also blogs regularly on health issues on his website, Taking Control of Your Healthcare. Follow him on Twitter: @kreisberg

[Photo By misspixels]

By Marlen Castañeda, Pharmacy Technician in McKinney, Texas

I am a certified, registered pharmacy technician. A pharmacy tech works alongside a pharmacist and assists in typing and filling prescriptions. We can do almost everything a pharmacist does — except counsel patients. Counseling is very important in the pharmacy because it covers so much information in such little time.

When a patient arrives at a pharmacy they are greeted by me, a tech. I am usually the one to type the labels on their prescriptions. Being that I am bilingual, I sometimes type the instructions in Spanish at the patient’s and doctor’s request. The problem with this, though, is that sometimes the tech who is typing the script doesn’t speak, read or write Spanish, so the directions are written incorrectly.

The pharmacist is required to verify everything the tech does with a prescription before it leaves the pharmacy so that he/she can catch any mistakes, such as dosage, strength, etc. These common mistakes are usually corrected at this point wjem filling a prescription.

However, when a prescription is being translated from English to Spanish, it is difficult if a pharmacist isn’t bilingual, because he/she is unable to catch simple mistakes. So, even if a pharmacist does their job in verifying a prescription, errors can slip by unnoticed.  We can’t always rely on the computers to auto-translate because that’s when mistakes occur.

The most important and simplest way to avoid any dangerous mistakes and to verify that the patient knows how to take the medicine as prescribed by their doctor is by allowing the pharmacist to counsel you. Most patients decline the counsel and walk away confident they know what to take and how — and that’s not always the case. Usually a doctor explains to the patient how to take their medications. Then, when the patient leaves the pharmacy, they walk away feeling confident in what they are taking and how.

A pharmacist counseling a patient not only repeats those instructions, but goes into further detail, also advising against allergies, side effects, interactions etc. In other words, things that the doctor may not have gone over with the patient. So I advise that all patients accept pharmacy counsel, request someone to translate for them, and ask questions. Especially for those patients receiving new prescriptions and those who speak English as a second language.

It takes 2 minutes of their time and may save their life and prevent any life-threatening mistakes. Not all patients have the luxury of having their adult children check medications for them. Not all patients have a doctor who carefully monitors their medications —  at least not as closely as their pharmacist typically would.

I also recommend that patients fill all their medications at one single pharmacy — always. This allows the pharmacist to know all the medications one patient takes at any given time. Allowing him/her to monitor for interactions and other potential problems. When patients fill at several pharmacies, it is difficult for one pharmacist to know what medications patients are taking. Even the over-the-counter (OTC) medications that seem harmless might present a risk, which brings me to my next point, never hesitate to ask your pharmacist about those medications that are OTC. They can always provide valuable information that your doctor may overlook.

People today are too casual towards prescriptions, and that’s always a dangerous attitude. Medications can save and and help make our lives more fulfilling, but with this casual attitude, they can also be deadly.

[Photo By e-MagineArt]