Stop Over-the-Counter (OTC) and Prescription Drug Abuse

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Over-the-Counter (OTC) and prescription drug abuse are a growing and dangerous problem, as a retailer you can play a role in reducing and preventing it.

After viewing this presentation, you will better understand:

Following this online presentation, please take the brief quiz to receive your certificate of completion.

Thank you for taking this training and helping to prevent and reduce over-the-counter and prescription drug abuse.

• Types of abused OTC and prescription drugs

• Potential side effects of misuse• Best practices to set up and

monitor medication sales in your store

• How to reduce consumer theft• Right to refuse a sale• Responsibility to report suspicious

activity

Training Overview

• What’s the problem?• Why is OTC and prescription drug abuse becoming more common?• What are the impacts of misuse?• Which drugs are abused?• How can I reduce access and abuse?

What’s the problem?

Source: Centers for Disease Control and Prevention

The problem

The consequences of abuse of Over the Counter and Prescription drugs include:

• Unprotected, unplanned, unwanted sexual activity• Impaired motor vehicle driving/passengers resulting

in accidents, injuries, and death• Poor academic and athletic performance in youth• Impacted work performance and attendance• Experimentation and mixing of other drugs• Serious injury or death

Why is OTC and Prescription Drug Abuse Becoming More Common?

AvailabilityAccessAwarenessAttitude

Availability

Many over-the-counter (OTC) and prescription drugs are readily available.

Photo source: www.fdalawyersblog.com

Access

• Internet• Friends and family• Medicine cabinet• Legally purchase• Stolen from retailers

OTC medications are easy to get.

Awareness

Media highlights illegal drug use more than OTC and prescription misuse.

All have the potential to be dangerous and lethal when abused.

PBS Frontline Episode

Attitude

1 in 5 youth said that there was “no risk” or only “slight risk” to using OTC meds differently than directed.

Source: Iowa Youth Survey

OTC and prescription drugs are

increasingly abusedbecause of the current availability, access,

awareness, and attitude.

General Short Term Impacts of OTC Misuse

• Nausea / vomiting• Anxiety• Poor memory• Poor coordination• Numbness• Dizziness• Hallucinations

• Heart palpitations/failure

• Depression• Seizures• Blurry vision• Nightmares• Sleep disturbances• Fainting

General Long Term Impacts of OTC Misuse

• Ruptured blood vessels• Stroke• Paranoia• Seizures• GI bleeding• Brain damage

• Kidney complications• Liver complications• Heart complications• High blood pressure• Cancer• Death

Cough Suppressants Cold Medicines

Inhalants Stimulants

Sleep Aids, Allergy Medicines and Motion Sickness Pills

Commonly Abused Over-the-Counter Drugs

Cough Suppressant - DXM

• Contain Dextromethorphan (DXM) found in over 120 common OTC drugs for colds and the flu.

• Products such as Actifed, Comtrex, Coricidin, Robitussin, Vicks, Pediacare, Theraflu, and others.

• DXM is a dissociative anesthetic, meaning it can cause hallucinations. At high doses, may cause loss of muscle control, nausea, loss of consciousness, seizures, stroke and death.

Some OTC elixirs (liquid medications) have a very high alcohol content, some times as high as 50% (100 Proof), which is just as potent as straight whiskey.

Cold Medicine

• Contain Pseudoephedrine, an ingredient used to make “meth”

• Found in non-prescription cold medicines such as Sudafed, Aleve, Claritin-D

• In Iowa: Need a valid ID, sold behind the counter where quantities are limited.

• Side effects at high doses include: low blood pressure, chest tightness, vision changes, seizures, irregular heartbeat and difficulty breathing.

Sleep Aids, Allergy Medicines and Motion Sickness Pills

• Contain Dimenhydrinate• Found in Benadryl, sleep

aids, common cold products.• Large doses may cause

euphoria, hallucinations, heart palpitations, extreme drowsiness, severe dizziness, abnormal speech, flushed skin, temporary amnesia, coma and death

Stimulants

• Contains caffeine • Energy drinks –(Monster,

RedBull, Blast), diet pills and stay awake products

• Make the heart beat faster and may cause stroke

Inhalants

• Chemical fumes /nitrous oxide• Found in products such as

Reddi-wip, Dust Off and other aerosols. Metalic spray paints are preferred.

• Inhaling from a paper or plastic bag “bagging”, and huffing (inhaling) from a soaked rag.

• Causes hypoxia, can result in death from the very first use

Misusing over-the-counter products and prescription

drugs can be just as dangerous as using

illegal drugs.

Commonly Abused Prescription Drugs

Stimulants

Central Nervous System Depressants

Opioids

Stimulants

• Use: treat asthma, attention deficit/hyperactivity disorder (ADHD) and severe obesity

• Drug names: Ritalin, Adderall, and Dexedrine

• Side effects: – Increases blood pressure

and heart rate, constricts blood vessels, increases blood glucose and breathing

– May cause heart attack or lethal seizures

Central Nervous System Depressants

• Use: sedative and tranquilizer to treat anxiety and sleep disorders.

• Drug names: Xanax, Valium

• Sided effects include: Suicidal thoughts, depressed heart rate and breathing, may even result in death

Opioids

• Use: Narcotic painkillers• Drug names: Codeine,

morphine, methadone, hydrocodone, fentanyl

• Side effects: Affects the brain and spinal cord, respiratory failure, nausea and vomiting

Prescription drugs can be dangerous when

taken for non-medical reasons, by a person

other than it is prescribed for, or in extreme amounts.

What can we do?

Prepare

Be Aware

Look for Signs

1. 2. 3.

Prepare: Set Up Store• Train employees to recognize/report

suspicious behavior.• Install security cameras.• Place products in sight of counter or near

register.• Find out your store’s policies on sale of OTC

and prescription drugs and your right to refuse a sale.

• Make policies known to staff and customers.Don’t have a policy? Contact Helping Services info@helpingservices.org for assistance in policy creation or for additional training.

Be Aware: At Point of Sale

Watch for suspicious behavior.• Persons trying to steal or consume in

the store.• Persons who are under the influence.• Persons buying multiple products.

You have the right to refuse the sale.

Look for Signs

Quantity Frequency Combinations

Buying large quantities, multiple packs of cold pills or several bottles of cough medicine, at one time.

Coming in often to purchase similar items (Ex: purchasing cold medicine several times each week).

Buying cold or cough medicine with pop or alcohol. (This masks the taste to be able to ingest large quantities.)

What else can you do?

• Keep track of inventory and notice trends or areas of concern.

• Monitor restrooms for signs that products are being used or consumed in the store.

Report suspicious activity to management and law enforcement.

Reduce OTC and Prescription Drug Misuse

Educate yourself and others about this issue• Four A’s: Availability, Access, Awareness, and Attitude• Long and short term consequences and behaviors• Variety of products to watch for

Prepare your store and employees • Know the signs: Consumers buying quantity, frequency,

combination• Be aware of consumers • Prepare: Set up store, at point of sale, after the customer

leaves• Make sure all employees are knowledgeable about policies

around these issues.

Use this information to take action to eliminate

OTC and prescription drug misuse.

You can help prevent risky behaviors,

health issues, and even death.

Take the quiz and get your certificate of completion.

Thank YouSpecial thanks to Corporal Steve Eastvedt, from the Dubuque Police Department, for his contribution to this training.

This training was created with funding from the Iowa Department of Public Health through the Comprehensive Substance Abuse Prevention grant.

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Help promote proper disposal of unused medications. Click to find the next local Drug Take Back events and drop-off sites.

Photo: www.medicaresolutions.com/blog

References• DrugFacts: Prescription and Over-The-Counter Medications. (Revised 2013, May). National Institute on Drug

Abuse. Retrieved January 16, 2014, from http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications

• Drug Facts: Prescription Drugs. NIDA For Teens. Retrieved January 16, 2014, from http://teens.drugabuse.gov/drug-facts/prescription-drugs

• Most Commonly Used OTC Drugs. Teen Drug Abuse. Retrieved January 16, 2014, from http://www.teen-drug-abuse.org/teenoverthecounterdrugabuse/ commonly-used-otc-drugs.htm

• Dextromethorphan. Teen Drug Abuse. Retrieved January 16, 2014, from http://www.teen-drug-abuse.org/teenoverthecounterdrugabuse/ dextroamphetamine.htm

• Shoplifiting. Reference for Business. Retrieved January 16, 2014, from http://www.referenceforbusiness.com/small/Qu-Sm/Shoplifting.html

• ShineWideOpen. Inhalants- The Legal Killer. (2013, June 12). Bubbleews. Retrieved January 16, 2014 from http://www.bubblews.com/news/651340-inhalants-the-legal-killer

• Over the Counter Pain Medication Problems. Doctor Saupto.com. Retrieved January 19, 2014, from www.doctorsaputo.com/a/over-the-counter-pain-medication-problems

• Dimenhydrinate. MedlinePlus a service of the US National Library of Medicine NIH National Institutes of Health. Retrieved January 19, 2014, from www.nlm.nih.gov/medlineplus/druginfo/meds/a607046.html

• Over-The-Counter Drugs.(2001). Encyclopedia.com. Retrieved on January 19, 2014 from http://www.encyclopedia.com/doc/1G2-3437000061.html

• Talking About Prescription Drug Misuse [Pamphlet]. Iowa Governor’s Office of Drug Control Policy. www.iowa.gov/odcp

• Over The Counter Drug Abuse: More Dangerous Than You Think [Pamphlet]. In the Know, Prevention and Treatment Resource Press. www.ptrpress.com

• Talking To Kids About Prescription Drug Abuse [Pamphlet]. Iowa Governor’s Office of Drug Control Policy. www.iowa.gov/odcp

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Additional Resources• Helping Services for Northeast Iowa

www.helpingservices.org• Iowa Department of Public Health Bureau of Substance Abuse

www.idph.state.ia.us/bh/substance_abuse.asp •Iowa Governor’s Office of Drug Control Policy

www.iow.gov/odcp • Iowa Substance Abuse Information Center

www.drugfreeinfo.org • Substance Abuse and Mental Health Services Administration

www.samhsa.gov • The Partnership At DrugFree.Org

www.drugfree.org or 1-855-DRUGFREEwww.helpingservices.org

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