The Safety of Prescription Drugs
In order for a drug to be sold in the U.S., it has to undergo rigorous testing by the FDA. Only drugs that are deemed "safe and effective" make the cut.
But there's a hidden phrase in there. It should read, "safe, when used as directed," or "safe, when used under the supervision of a physician." Those distinctions are critical and need to be enforced in a time when many are turning to prescription drug abuse as a "safe" alternative to street drugs.
A Devil’s Bargain: Street or Rx?
For the addict, there is no safe drug. The drugs available on the street are of unknown quality and dose. They may, and often do, have harmful diluents added to bump up the profit margin, and there's not much in the way of quality assurance. Even the least dangerous – marijuana – can have pesticide residues.
Some of the diluents found mixed into street drugs include:
- Ground glass
- Lead (to increase weight)
- Sugars (to add bulk)
- Antihistamines (for their sedative side effects)
- Acetaminophen (adds bitterness to disguise poor quality of illicit drugs)
- Caffeine (stimulant properties)
- Lidocaine (to mimic numbness of cocaine)
So doesn't than mean prescription drugs are safer? No, it doesn't. Prescription drugs, when abused, are being taken outside of their normal dosing levels and in ways they aren’t designed for.
For example, some narcotics (Oxycontin, for example) are ground up and injected. This defeats any safety factor of the other substances in the pill (fillers, resins, bonding agents, dyes), when the pill was designed to be taken orally. There is also no guarantee of sterility. But even with oral dosage forms, taking narcotics outside of a doctor's direction can add dangers.
Acetaminophen (Tylenol) is a common additive in prescription pain killers. It is found in Tylenol with Codeine, Vicodin, Lortab and others. When abused, users take enough of the pills to get the high they desire, but also get an overdose of the Tylenol in the pill as well. In this situation, the danger comes as much from the acetaminophen as the narcotic.
What About Non-prescription Drugs?
Unfortunately, over-the-counter (OTC) drugs are not exempt from these cautions. The labels clearly state, "Use as directed” or "Follow package directions," but consumers often don't. They sometimes feel that if a little is good, more is better.
Acetaminophen has been linked to more deaths than any other OTC pain reliever. But the potential for harm exists with aspirin, ibuprofen and naproxen as well.
Other OTC drugs are intentionally taken in high quantities to get a mood-altering effect, whether from the alcohol in the mix or from the base drug itself. Some cough suppressants, if taken in large enough doses, can mimic hallucinogens.
The Bottom Line
We need to adjust our attitudes when it comes to both prescription and non-prescription drugs. They are medical tools with great benefits, but they have to be treated with the respect they deserve. Locking medicine cabinets (containing both Rx and OTC drugs) to keep meds out of the hands of curious teens is one simple thing that can be done. Another is to track usage when a loved one is on a prescription drug – both addictive drugs and "normal" drugs.
By simply counting pills, you can determine if a senior has become confused about their dosage regimen, or detect overuse of pain medications. Paying attention and catching mistakes (or intentional abuse) can save a life.
Get rid of expired medications or medications that are no longer being used. You can ask your pharmacist how to do this safely – turn-in locations are becoming very popular as a community service. Don’t throw medications in the trash or flush them down the toilet – some drugs can show up in ground water and affect the environment, even at microscopic dilutions.
Finally, and most importantly, pay attention to the dosages and warnings that appear on drug packaging or the information given with a prescription drug. Pharmacies include patient information with every newly prescribed drug and you can get more information by asking.