PSY 6110 Compare and Contrast Use and Abuse of Prescribed and OTC Analgesics

PSY 6110 Compare and Contrast Use and Abuse of Prescribed and OTC Analgesics

PSY 6110 Compare and Contrast Use and Abuse of Prescribed and OTC Analgesics

Prescription Pain Medication

Although every prescription medicine has the potential to be abused, analgesics, usually referred to as narcotics, opiates, or opioids, are one of the most frequently misused.

Prescription opioids are often used to treat moderate to severe pain, even though certain opioids can also be used to manage coughing and diarrhea.

Opioids may also make users feel very relaxed and “high,” which is the reason they are occasionally taken for non-medical reasons. Examples include meperidine, codeine, morphine, oxycodone, and hydrocodone.

The Risks Associated

Opioids may cause unpleasant side effects including constipation, motion sickness, drowsiness, and mental fog.

Using prescribed opioids has additional hazards, such as dependency and addiction. If you abuse medications, you run a higher chance of developing dependency and addiction (Squeglia et al., 2019).

Routes of Administration

  • Oral (PO)
  • Intravenous (IV)
  • Epidural
  • Intrathecal (Sofuoglu et al., 2019).

Absorption

qMorphine is absorbed, under the alkaline conditions of the upper gastrointestinal and rectal mucosa. Morphin is bioavailable in 80 to 100% of cases (Sofuoglu et al., 2019). Because of the significant first-pass metabolism, oral intake must be six times larger than parenteral doses to provide the same effect.

Site of Action

Opioids have actions at both the presynaptic nerve terminals and postsynaptic neurons. Post-synaptic opioid actions are frequently inhibitory.

Opioids are hypothesized to inhibit neurotransmitter release by presynaptic action, which is their principal neurological function.

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Morphine is a drug that binds to mu, kappa, and delta opioid receptors (Sofuoglu et al., 2019). The majority of this

PSY 6110 Compare and Contrast Use and Abuse of Prescribed and OTC Analgesics
PSY 6110 Compare and Contrast Use and Abuse of Prescribed and OTC Analgesics

medication’s analgesic effects are achieved through binding to mu-opioid receptors located in the CNS and PNS.

Pharmacological Effects

Generate analgesia.

Sedation and dizziness are additional central nervous system side effects.

Some typical side effects of morphine include euphoria. respite from discomfort. Unusual tiredness or sleepiness (Abuse, 2020).

Respiratory depression, apnea, and, to a lesser extent, cardiovascular depression, respiratory distress, shock, and cardiac arrest are serious adverse events related to morphine sulfate injection USP.

OTC Pain Relievers

Some of the top over-the-counter (OTC) painkillers include ibuprofen, aspirin, naproxen, acetaminophen, and aspirin/citric acid/sodium bicarbonate.

The most potent anti-inflammatory painkiller without a prescription is naproxen (SAMHSA, 2020).

It works particularly well for ailments including arthritis, sunburns, and sprains. Naproxen tends to have a longer half-life than other over-the-counter painkillers at comparable dosages.

The most frequent adverse effects of naproxen include rashes, fatigue, headaches, buzzing in the ears, alterations in eyesight, and disorientation.

Risks and Mechanism of Developing a Substance Use Disorder

  • Risk factors include genes, side effects of medications, peer pressure, emotional distress, anxiety, grief, and environmental stress.
  • When a patient has a drug use disorder, they exhibit a pathologic behavioral pattern in which they continue to use the substance in question while having serious issues with it (Sofuoglu et al., 2019).

Age Groups

The greatest opioid overdose fatalities occur in the 35 to 44-year-old age group, with 20,137, a 73% rise from 2019 and a 20% increase from 2020 (Sánchez-Sánchez et al., 2021).

Currently, 71% of opioid-related deaths that might have been prevented happen to adults between the ages of 25 and 54, and the mortality rate for people over the age of 55 is increasing significantly.

Professional Recommendations

Dose reduction, symptom management, opioid rotation, and modifying the route of administration are methods to reduce the negative effects of opioids.

The misuse of OTC drugs can be decreased with pharmacist attention (Algarni et al., 2022).

There are two sorts of interventions for preventing drug use disorders. The first category includes measures designed to prevent drug misuses and abuse, such as the adoption of PDMP programs and their required usage, legislation banning doctor shopping and mandating medical provider education, and physical exam requirements.

The second set of initiatives is to increase access to and support substance abuse services (Coombes & Cooper, 2019).

Some of these techniques include the adoption of good Samaritan legislation, regulations that make it easier to get rescue medications, and other overdose harm reduction programs.

This group also recommends devoting resources to the development and continuous support of drug misuse programs.

Summary

Opioid-related government policies and regulations come in a variety of shapes and sizes, including Medicare/Medicaid rules, opioid prescription practices regulation, and medication scheduling through the Drug Enforcement Administration.

Data show the potential benefits of several regulations, including Good Samaritan laws, naloxone access laws, and PDMP standards, in lowering drug usage (Coombes & Cooper, 2019).

Legislative action is still needed on several issues, including the regulation of pain control clinics, the requirement of tamper-resistant prescription forms, physical and psychological status examination laws, laws against physician shopping, laws regarding prescription monitoring, and laws regarding access to naloxone.

Healthcare practitioners and the general public must get an education. Community education programs might focus on prescription medicine storage, usage, and disposal.

Prescribers of pain medications must be trained in pain diagnosis and treatment, alternative modalities, drug misuse screening, psychiatric illness evaluations, and therapeutic interventions for vulnerable groups.

References

Abuse, N. I. on D. (2020, June). Summary of Misuse of Prescription Drugs. National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/misuse-prescription-drugs/overview

Algarni, M., Jalal, Z., Hadi, M. A., & Alghamdi, S. (2022). Community pharmacists’ views and experiences toward over-the-counter medicines misuse and abuse in Saudi Arabia: A qualitative study. Frontiers in Pharmacology, 13. https://doi.org/10.3389/fphar.2022.997342

Coombes, H., & Cooper, R. J. (2019). Staff perceptions of prescription and over-the-counter drug dependence services in England: a qualitative study. Addiction Science & Clinical Practice, 14(1). https://doi.org/10.1186/s13722-019-0170-4

SAMHSA. (2020, December 17). Rise in Prescription Drug Misuse and Abuse Impacting Teens. Www.samhsa.gov. https://www.samhsa.gov/homelessness-programs-resources/hpr-resources/rise-prescription-drug-misuse-abuse-impacting-teens

Sánchez-Sánchez, E., Fernández-Cerezo, F. L., Díaz-Jimenez, J., Rosety-Rodriguez, M., Díaz, A. J., Ordonez, F. J., Rosety, M. Á., & Rosety, I. (2021). Consumption of over-the-Counter Drugs: Prevalence and Type of Drugs. International Journal of Environmental Research and Public Health, 18(11), 5530. https://doi.org/10.3390/ijerph18115530

Sofuoglu, M., DeVito, E. E., & Carroll, K. M. (2019). Pharmacological and Behavioral Treatment of Opioid Use Disorder. Psychiatric Research and Clinical Practice, 1(1), 4–15. https://doi.org/10.1176/appi.prcp.20180006

Squeglia, L. M., Fadus, M. C., McClure, E. A., Tomko, R. L., & Gray, K. M. (2019). Pharmacological Treatment of Youth Substance Use Disorders. Journal of Child and Adolescent Psychopharmacology, 29(7), 559–572. https://doi.org/10.1089/cap.2019.0009