www.drugcocktails.ca Facts about mixing medicine, booze and

street drugs

Sandy Whitehouse MD Sabrina Gill, RN

Dean Elbe, PhD Pharmacy We have nothing to disclose

April 6-8, 2014 San Francisco, CA

Annual Conference on Youth + Tech + Health

www.DrugCocktails.ca

Medication Misuse & Overdose

Many celebrities have died after combining medications with substances of abuse While we are fascinated by celebrities… MANY, MANY more average citizens and youth suffer harm due to adverse reactions from prescription medication & substance cocktails

http://en.wikipedia.org/wiki/List_of_drug-related_deaths

Teens & Substance Use

DEAN (age 19)

Substance Experimentation in Youth

Youth with chronic illness are as, or more likely to use substances than those in good health Substances taken may interact with medications prescribed for chronic conditions These questions come up all the time during medication counseling sessions with youth

Adolescent health survey: chronic illness & disability among youth in BC. Burnaby, BC, The McCreary Centre Society, 1994 Suris JC, Parera N. Sex, drugs and chronic illness: health behaviours among chronically ill youth. Eur J Public Health 2005; 15: 484-8.

Harm Reduction

Harm Reduction

One pillar of the “Four Pillars” approach One of 4 defined mental health priorities for all British Columbians Reduce harm to individuals and communities from problematic substance use (legal or illegal) Accept that abstinence may not be a reasonable goal for some users DrugCocktails.ca supports harm reduction http://vancouver.ca/people-programs/four-pillars-drug-strategy.aspx

BC Ministry of Health Services & Ministry of Family Development. (2010). Healthy Minds, Healthy People: A 10-Year Plan to Address Mental Health and Substance Use. Victoria: Government of British Columbia

JF: 20-year old Female Formerly dependent on heroin, now taking methadone maintenance Ongoing marijuana use Admitted with Dx: psychosis, Rx: quetiapine During discharge counselling, she asks if there are any problems with taking quetiapine together with methadone or marijuana?

Where would you look?

Methadone interactions in the CPS and drug databases… but what about cannabis?

Pubmed & Journal search: time consuming, not all info is in primary literature

Vaults of Erowid (erowid.org): info often promotes substance use: if you’re looking to grow bigger plants, or for pot brownie recipes; no consistent interaction information

Original Cocktails Handbook (2002)

Original Cocktails Handbook (2002)

DrugCocktails.ca – Youth Warnings

DrugCocktails.ca – Youth Warnings

DrugCocktails.ca – Youth Warnings

DrugCocktails.ca – Pro Site

DrugCocktails.ca – Pro Site

DrugCocktails.ca – Pro Site

DrugCocktails.ca – Pro Site

DrugCocktails.ca – Pro Site

DrugCocktails.ca – Substance Info

Substance Information Courtesy of Here To Help – www.heretohelp.bc.ca

Design Considerations: Youth Friendly

Consulted BCCH Youth Advisory Council Visually pleasing Works on smartphones Plain language warnings Hide the indication/purpose ‘Hide This Page’ button No personal information collected

DrugCocktails.net version 1.0 The Research Site

www.DrugCocktails.ca

DrugCocktails.ca Warnings

Keep it Simple Harm-Reduction approach Followed youth-friendly style used in original 2002 Handbook Clinical pharmacist made final determination (and standardization) of warning levels

DrugCocktails.ca Warning Icons

Does any particular colour seem to be missing?

DrugCocktails.ca Warning Icons

Key Point: There are no ‘green lights’ in DrugCocktails.ca

There is risk with taking any substance into your body. Often, there is no information. Everyone reacts differently.

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Research Survey Results

Research Survey Ease of Use Satisfaction

Use Site again Recommend

Need Changes

Youth (n=45) Professionals (n=45)

85% 87%

85% 91%

82% 100%

82% 98%

27% 56%

Analytics Data

Websites Now Available

Youth Professionals

drugcocktails.ca drugcocktails.ca/pro