Drug Abuse in Teens- from YOUR Medicine Cabinet

Prescription drug abuse is at an all time high- no pun intended. Sadly, studies have found that 1 in 5 high school students say they have taken a prescription drug without a prescription. What are they taking? Pain killers, stimulants, and anxiety medications. Specifically, the most common drugs are OxyContin & Percocet (narcotic pain pills), Ritalin & Adderall (ADD stimulant drugs), and Xanax (an anti-anxiety sedative like valium.)

It frankly terrifies me to hear of kids swapping prescription medications, particularly ones as potent as these. Add in that the pain and anxiety pills are usually combined with alcohol, and you now have a recipe to take your breath away- literally. Both narcotics and alcohol can suppress your drive to breathe, and they are additive when taken together. Accidental overdose is the second leading cause of death for teenagers, and inappropriately used prescription drugs are believed to be major culprit. There is often a false feeling of security with getting a buzz from a prescription drug. Surely, if a doctor prescribed it for her, then it is safe for me, right? Wrong.

What can parents do about this alarming trend? Number one, TALK to your teen and ask (in a non-threatening, conversational tone) if they are aware of anyone borrowing prescription medications from friends. Let them know this is dangerous, even when someone else is using the drug for the same reason it was prescribed in the first place (like friends sharing ADD meds to be able to focus better in class.) The reality is that although there is plenty of "altruistic" sharing of medications, most "sharing" is for side effects- the buzz of the narcotic or sedative, or the appetite suppressant effects of the ADD drugs. At any rate, talking with your teen lets them know you are aware of this risky behavior in general. Next step? Take a close look at your medication cabinet. Throw away expired drugs, and keep close inventory of any potentially abused medications. Finally, if you realize that you are using prescription drugs inappropriately, it's time for a difficult conversation with your physician. You can't abuse it if we don't prescribe it, so this is a problem we need to tackle together, and there are solutions beyond simply cutting you off.

BOTTOM LINE: Prescription drug abuse is out of control. Learn the facts and protect and educate your teens. Get more info at the National Institute on Drug Abuse.

New Treatment Approved for Head Lice

Nothing makes your head itch like hearing someone has head lice! Immediately, we all cringe and reach up for a quick scratch. Who gets lice? Primarily grade school aged girls (5-11 years old). Girls that age live with their heads tightly paired up with their best friends, sharing hairbrushes, pillows, headbands and hats. Certainly boys get lice, too, and people of all ages are susceptible. In the United States alone, we have between 6-12 million cases per year!

Lice come in two flavors- head lice and pubic lice- and they do not jump from one body part to another. Head lice stick to scalps, and pubic lice attach to the coarse pubic hair, or possibly coarse underarm, mustache, or eyebrow hairs. Lice are obligate parasites, requiring humans for their life cycle. The adults are 1-3mm long (so they are visible to the naked eye.) Most often, lice are recognized by seeing nits, which are the eggs that attach to hair near the base of the shaft. They look like tiny clear or white ovals stuck on the hair, and they will not be easily detached (as opposed to flakes of dandruff, which you can flick off easily.)

Lice can be treated with a couple different over-the-counter products- Rid and Nix. These products kill the adult lice, but not the eggs, so typically treatment is repeated one week after the initial treatment. There are also special combs that help to physically remove the nits from the hair. The FDA has recently approved another lotion called Sklice, with that active ingredient being ivermectin. (You might recognize this medication from your pet, as ivermectin is used to prevent heartworm.) The apparent advantage is that only one ten minute application resolves most lice infestations without the need to remove the nits.


Is Sklice better than the products we already have? Maybe, but we don't have any head-to-head comparison studies yet (pardon the pun.) Certainly, if it reduces or eliminates the need to "nit-pick", this will represent a very significant advantage over our existing treatments.

BOTTOM LINE: If you or your child get head lice, talk to your doctor about the treatment options, including the newly approved Sklice. (Note that Sklice will not be available in pharmacies for another couple of months.)

Having Trouble Taking All Your Medications?

Today I'd like to say a few words about medications. Often physicians need to prescribe multiple medications for the same patient. One is each morning, another twice a day, a couple are "as needed" and yet another is recommended at bedtime. One must be taken with food, and another is restricted to an "empty stomach". Before you know it, our patient is supposed to take a half a dozen pills per day- at different times, and with different restrictions- and then we wonder why they are "noncompliant"!

In a perfect world, pills would not interact with each other or with meals, and they could be given once per day. In reality, many medications do not play well in the stomach together, and must be separated. What can we all do? Well, the basic pill box that has a separate compartment for each day is lovely. Don't feel you need to qualify for Medicare before you purchase one! I tell all my patients that there is a good reason "the pill" comes in a dispenser that is labeled by day. How many times have you wondered, "gee, did I take my pill today?" Well, the same is true for vitamins, calcium supplements, and prescription medications of all sorts.

Find a pill dispenser that works for you! If you have multiple medications, consider one that actually reminds YOU! There are wonderful contraptions that you can set up with a week or more of pills, and then an alarm will go off up to four times per day, letting you know that your pills are ready for you!

The picture above is the one I used for my memory-challenged father for several years with great success.

BOTTOM LINE: Don't rely on your memory- find a pill dispenser that works for you to simplify and increase your success with medication compliance!

You can find this pill dispenser at the online Alzheimer Store ; I have no financial ties to them, just really appreciate how this tool simplified MY life and improved my Dad's consistency with medications!

ADD- Is Zinc the answer?

We are always looking for more and better solutions to Attention Deficit Disorder, so I was pleased to read a study published last month in the Journal of Child and Adolescent Psychopharmacology, entitled Zinc for attention-deficit/hyperactivity disorder: placebo-controlled double-blind pilot trial alone and combined with amphetamine, that looked at the role of ZINC in treating ADD. There have been some studies published in other countries that suggest supplemental dietary zinc may improve symptoms of ADD. This pilot study was small (as pilot studies should be) including just over 50 children.

The kids received zinc or placebo alone for the first two months, and there was no consistent, statistically significant advantage to taking zinc alone (vs. placebo). Then, the children were randomized to receive either zinc plus amphetamine (such as Ritalin) or a placebo plus the amphetamine for the next five weeks. Here is where the results are encouraging. Although the symptoms of inattention were not better for the kids who received the zinc plus amphetamine, the good news is that those receiving the zinc supplement required 37% less amphetamine to receive the same results compared with those taking amphetamine plus placebo.

Simply restated, the zinc seemed to help the amphetamine work more efficiently, so that a LOWER DOSE of the amphetamine achieved the desired results. Why is this important? Because lower effective doses mean LESS SIDE EFFECTS. So, should you rush out and buy zinc to supplement your child's ADD medications? No, I wouldn't do that based on a study with only 50 kids. However, while we're waiting for future studies with more significant numbers, why not be sure your child is meeting the recommended daily allowance for zinc? (~10mg per day for teens) What foods contain the most zinc? Seeds (pumpkin, sesame, watermelon), wheat germ, chocolate and peanuts. Hmm...maybe Snickers had the right idea! Or a healthier choice would be to head for the hummus (made with tahini- sesame seed paste.)

BOTTOM LINE: Zinc may help reduce the amount of amphetamine medication needed to improve symptoms of ADD.

Mixing Drinks & Medications?

People have become increasingly cavalier about mixing medications. In our age of polypharmacy, we think nothing of taking this pill for our heartburn, plus this one for ADD, and that one for anxiety and depression. In fact, our doctors prescribe these combinations all the time, usually with good reasons and positive effects.

Why am I writing about this? Because there are (at least) two major problems that result from this mindset.

1. People like to SHARE. We want to help our friends, and often people share their PRESCRIPTION medications-from saved up antibiotics, to cough suppressants, pain pills and anxiety medications. When you remove the medical professionals (both providers and the pharmacy team) from the equation, there are no checks and balances to watch out for drug interactions.

2. People forget ALCOHOL is a drug. Especially this time of year, alcohol is offered and consumed without a second thought to whether or not it might interact with prescription medications. The most DANGEROUS combinations are ALCOHOL, NARCOTICS (pain pills and cough suppressants) and ANXIETY MEDICATIONS (like Xanax/Valium, etc.) Please note- your SLEEPING PILL falls into this category as well!
In this case, 1 +1= 3 or more, as the additive effects are much greater than the individual effects simply combined. In particular, you can STOP BREATHING when you combine these drugs. And BREATHING is good, right?

PLEASE, before you toast the season, picture your prescription bottles sitting in your drink. Is this MIXED DRINK safe?

BOTTOM LINE: PLEASE, do NOT share prescription medications, and do not COMBINE alcohol, narcotics, and/or other sedatives!

Dangers of Internet Drugs

The FDA recently issued a warning about a flu medication- Tamiflu- that was being sold online. It was marketed as "generic Tamiflu", but really had a PENICILLIN derivative (cloxacillin) instead of the anti-viral drug. Can you imagine what would happen if you are severely allergic to penicillin and took this drug to combat flu symptoms? You could potentially send yourself to the emergency room (or die on the way there from anaphylaxis) because you were trying to save money and time by self-diagnosing and ordering medications on line.
While this is an extreme example, it points out yet another danger of the internet. Many drugs are available online at discounted rates, but there is less supervision about the content and quality of these drugs. In addition, self-diagnosing frequently leads to incorrect treatment. I'm not saying every medical issue is challenging, by the way. A simple cold, strep throat or a sprained ankle are typically straight-forward. However, few medical challenges occur in isolation, and with the poly-pharmacy that most Americans choose these days, a few years of medical education come in handy to sort out interactions.
BOTTOM LINE: Buyer beware! Internet "specials" on drugs may not be such a great deal.