Facts About Over-the-Counter
Drug Abuse
The American Society of Anesthesiologists
(ASA) is concerned about the abuse of over-the-counter
medications. There seems to be a public perception
that if a medication can be purchased without a
prescription, then it can't really cause any harm.
The truth is that, even though these medications
are an important tool for consumers to use in treating
their own minor illnesses, these products are safe
only if used according to package directions.
Anesthesiologists, particularly those involved
in critical care medicine, often are called upon
to care for patients who are in very serious condition
because they have taken an overdose of an over-the-counter
drug.
A recent fad among teens and young adults is the
abuse of cough and cold medicines containing the
ingredient dextromethorphan, or DXM, in order to
get high. When taken in large quantities, this ingredient
can cause nausea, vomiting, life-threatening seizures,
hallucinations, and even death. At least 14 people
have died from taking excessive amounts of DXM.
Would you recognize these
symptoms in a family member or friend?
Here are some other symptoms that DXM abusers may
experience:
- Confusion
- Impaired judgment and mental performance
- Blurred vision
- Slurred speech
- Loss of coordination
- Rigid motor tone and involuntary muscle movement
- Tremor
- Dizziness
- Excessive sweating
- Irregular heartbeat
- Numbness of fingers or toes
ASA urges young people and their parents to be
aware of the dangers of experimenting with DXM or
any drug found in over-the-counter products.
In addition to the symptoms mentioned above, parents
should watch for clues such as:
- Bookmarked Web sites about "robotripping"
or DXM
- Packages of cough medicines containing dextromethorphan
- Sleep masks or cotton balls in a teen's room,
indicating they may using sensory deprivation
to enhance the DXM "high"
Did you know?
Critical care anesthesiologists are uniquely positioned
to help overdose patients survive, due to their
extensive training in airway management, respiratory
support and cardiovascular resuscitation. Here are
some of the ways that this training helps anesthesiologists
and critical care physicians to treat these patients:
- When people have abused certain drugs, the
normal protective reflexes no longer work, and
they cannot protect their own airway. Anesthesiologists
are well trained in airway management, or helping
patients to breathe and avoid choking.
- Drug overdoses can cause some form of abnormal
heart rhythm or heart collapse. Anesthesiologists
have excellent skills in the areas of resuscitation
pharmacology and cardiovascular support.
- To treat overdose patients, physicians often
give them medications to reverse the drug's effects.
Because a critical care anesthesiologist understands
the pharmacological interactions between illicit
drugs and controlled substances, his/her choice
of what medications to use to reverse the overdose
effect may be better or different than a physician
that does not have this extensive training.
More about critical care
Here are some more facts about how anesthesiologists
function in the critical care setting:
- For nearly 50 years anesthesiologists have been
working in a critical care setting.
- Critical care anesthesiologists go through additional
training for one or more years. A certificate
of special qualifications in critical care medicine
is awarded by the American Board of Anesthesiology
to those who pass the examination process.
- Critical care is part of the anesthesiology
residency. Currently 2 months are required and
this soon may increase to 6 months.
- There are 50 anesthesiology programs in the
U.S. that offer fellowship training in critical
care.
- Although all anesthesiologists are trained to
treat critically ill patients, some make this
their practice exclusively.
- Formally trained critical care anesthesiologists
provide intensive diagnostic and therapeutic interventions
within the Intensive Care Unit.
- The breadth and depth of critical care services
vary considerably but some of the functions include:
- Despite the wide spectrum of clinical problems
for which a patient might require ICU care, studies
have consistently documented improved care, reduced
length of stay, reduced cost, and improved morbidity
and mortality and better patient safety.
Watch ASA's recent
video news release on over-the-counter
drug abuse.
Web resources:
Web site of the Substance Abuse and Mental Health
Administration:
www.samhsa.gov
Article on over-the-counter medicine from the National
Clearinghouse for Alcohol and Drug Information (NCADI):
http://samhsa_search.samhsa.gov/cgi-bin/MsmGo.exe?grab_id=7&EXTRA_
ARG=&CFGNAME=MssFind%2Ecfg&host_id=42&page_id=70656&query=
Robotripping&hiword=Robotripping
"Give 'Em the Facts: Prescription and Over-the-Counter
Drug Abuse" (NCADI)
http://www.health.org/nongovpubs/prescription/