Not reading the directions for prescription medications may come with serious consequences.
Research presented in September at a National Safety Council meeting reported an increase in deaths from accidental drug overdoses and pointed to prescription painkillers as the leading cause for the problem.
Bob Howell, a licensed chemical dependency counselor and the clinical director at The Ranch at Dove Tree, a Lubbock rehabilitation clinic, said people who take pain relievers such as codeine or morphine for a prolonged period of time will have to take more of the drugs to achieve the same effect.
"Of all the drug classes on the planet, the highest rate of tolerance is in mind-altering drugs, which include painkillers," he said. "What if you had a broken leg or a disc problem in your back? You'd have to take more of the drug to relieve the pain. Therein lies the problem."
In a follow-up statement about the meeting, National Safety Council President Janet Froetscher said an estimated 24,000 deaths in the United States resulted from unintentional drug overdoses in 2006, a rate that doubled since 2000.
According to the U.S. Centers for Disease Control and Prevention, prescription opioids were to blame for more than 38 percent of accidental overdose fatalities in 2005.
Melanie Bixler, chief pharmacist at the Texas Tech Student Health Pharmacy, said opioids such as oxycodone and hydrocodone are synthetically derived from opium, the naturally occurring chemical in morphine and heroin.
Both the synthetic and natural variations of the medicine are prescribed to relieve pain.
George Comiskey, associate director of community programs for Texas Tech's Center for the Study of Addiction and Recovery, said it is not uncommon for patients to overdose as a result of a "if one is good, maybe two is better" mindset.
For the same reason, he said, non-medical users of prescription painkillers sometimes find themselves needing more and more of the drugs to achieve the same "buzz."
"Your body builds up a tolerance," he said, "and by the point you're at a lethal dose, your body shuts down to protect itself."
The use of prescription pain relievers among young adults between the ages of 18 and 25 years old increased from 4.1 percent in 2002 to 4.6 percent in 2007, according to a survey conducted last year by the U.S. Department of Health and Human Services.
"I think prescription drugs have been the way for students struggling to keep up to cope," Comiskey said. "There is a message out there that if you aren't doing it all and doing it 100 percent, you'll be behind."
Students taking the drugs may find themselves caught up in a roller-coaster effect of taking a pill to get "up," Comiskey said, only to then seek something to get "down."
Over the years, Howell said, the prevalence of certain classes of abused prescription drugs has changed.
He said the popular prescription drug moved from barbiturates like Nembutal in the 1950s to benzodiazepines like Valium in the 1990s. Today the use of opioids and opiates such as hydrocodone and morphine is on the rise.
"I have seen slightly more abuse of opioids in the last three to four years," Howell said. "They are coming on strong."
Howell said accidental overdose with prescription drugs - whether taken for medical or non-medical purposes - often occurs when a user combines multiple drugs.
"When you've got a combination of drugs," he said, "the potential for side effects dramatically increases."
He said taking painkillers in combination with other stimulant medications or alcohol increases the likelihood of respiratory arrest, which often leads to cardiac arrest and death.
As your body begins to gag, Howell said, the vomit does not come all the way up the esophagus.
"People at this point will vomit and inhale it back into their lungs," he said, "which is called aspirating."
Another danger, he said, comes with mixing pain-relieving prescription medications with over-the-counter pain medications such as aspirin.
"The liver is particularly hammered really hard by this," he said, "and it can lead to liver failure."
Kelly Bennett, medical director of Tech's Student Health Services, said non-medical users of prescription drugs also run into trouble when they buy the drugs from an unreliable source.
"They may be buying a drug with more narcotics than they thought," she said.
But obtaining prescription medications from a known source can be risky, too, she said, because users may not know how it will interact with their body or other medications in their system.
In both 2006 and 2007, according to the HHS survey, more than half of non-medical users of prescription pain relievers and other stimulant medications 12 years old and older said they obtained the drugs from a friend or relative at no charge. The majority of the respondents said their supplier obtained the drugs legally from a doctor.
Doctors, however, have little in the way of alternatives to the habit-forming medications.
"Unfortunately," Howell said, "the opiates are still the most effective at treating pain."
When it comes to abuse of these drugs, he said, the real tragedy is not always in death.
Howell said a pain-medicaiton overdose may result in brain damage, leaving the victim breathing through a ventilator in a "vegetable" state.
"When anyone's life is cut short," he said, "it is a tragic occurrence that spills out to the family and friends of that individual."
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