Week 4 – Assignment: Compare and Contrast the Use and Abuse of Prescribed and OTC Analgesics Essay

Week 4 – Assignment: Compare and Contrast the Use and Abuse of Prescribed and OTC Analgesics Essay

Compare and Contrast the Use and Abuse of Prescribed and OTC Analgesics

Drug misuse is not limited to illicit substances. The most often misused substances in the United States are, except marijuana, prescription medications. Drugs on prescription and over the counter can be used to help and heal us. Yet, some can be hazardous and addicting if used improperly. Prescription pharmaceuticals as well as over-the-counter (OTC) analgesic treatments are frequently used to manage pain and discomfort in daily living. Although some medications are very safe, they can have negative side effects. In Western nations, analgesics are frequently used by up to 70% of the population, mostly to treat headaches, other particular symptoms, and febrile illnesses (Algarni et al., 2022). Thus, misuse and abuse of prescription drugs among young people is a serious issue.

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Prescription Pain Medication

Although every prescription medicine has the potential to be abused, analgesics, usually referred to as narcotics, opiates, or opioids, are one of the most frequently misused. The opium poppy plant naturally contains members of the opioid chemical family. While some prescription opioids are made by scientists in labs using the same chemical formula, others are made directly from plants (Sánchez-Sánchez et al., 2021). Opioids are often used as drugs because they include chemicals that can soothe the body and lessen pain. Prescription opioids are often used to treat moderate to severe pain, even though certain opioids can also be used to manage coughing and diarrhea. Opioids may also make users feel very relaxed and “high,” which is the reason they are occasionally taken for non-medical reasons. Given that opioids have a significant potential for dependence and that overdoses and deaths are common, this might be dangerous. Examples include meperidine, codeine, morphine, oxycodone, and hydrocodone.

The Risks Associated

Opioids may cause unpleasant side effects including constipation, motion sickness, drowsiness, and mental fog. They could also make breathing difficult, which raises the possibility of lethal overdoses. Using prescribed opioids has additional hazards, such as dependency and addiction. If you abuse medications, you run a higher chance of developing dependency and addiction (Squeglia et al., 2019). Opioid misuse, addiction, and overdose are serious public health concerns in the US. Another problem is the prevalence of opiate abuse among pregnant mothers. Neonatal abstinence syndrome, which produces withdrawal symptoms in neonates who are addicted, can develop from this. Occasional opioid usage can also lead to heroin addiction since some people switch from prescription opioids to heroin.

Routes of Administration

Opioid analgesics are administered via a variety of methods, in contrast to nonopioid analgesics, which are often taken orally. Among the most significant recent advancements in opioid analgesia therapy are the availability of more concentrated dose forms, controlled-release oral opioid formulations, and transdermal opioid preparations. These medications frequently allow the patient to sleep through the night because of their prolonged duration of action, which lessens the intensity of pain that may be felt at the end of the effective dosage. For instance, several methods may be employed to deliver morphine. The following delivery methods are most often used: oral (PO), intravenous (IV), epidural, and intrathecal (Sofuoglu et al., 2019). Oral formulations in immediate-release and extended-release forms are readily accessible for the management of both acute and long-term pain.

Absorption

The mucosa of the duodenum as well as the stomach absorb all oral opioids before they are transferred to the liver via the portal venous system. Some drugs go through “first-pass metabolism” in the liver before being distributed throughout the body. This significantly affects the systemic plasma concentrations of medications (Squeglia et al., 2019). Morphine is absorbed, for example, under the alkaline conditions of the upper gastrointestinal and rectal mucosa. Morphin is bioavailable in 80 to 100% of cases (Sofuoglu et al., 2019). Because of the significant first-pass metabolism, oral intake must be six times larger than parenteral doses to provide the same effect.

Site of Action

Opioids have actions at both the presynaptic nerve terminals and postsynaptic neurons. Post-synaptic opioid actions are frequently inhibitory. Opioids are hypothesized to inhibit neurotransmitter release by presynaptic action, which is their principal neurological function. For instance, morphine is a drug that binds to mu, kappa, and delta opioid receptors (Sofuoglu et al., 2019). The majority of this medication’s analgesic effects are achieved through binding to mu-opioid receptors located in the CNS and PNS.

Pharmacological Effects

The main afferent terminals in the spinal cord, where the opioid medicines work, are inhibited from releasing neurotransmitters, and the midbrain’s descending inhibitory controls are activated. These activities take place at several levels of the neurological system to generate analgesia. Sedation and dizziness are additional central nervous system side effects that can cause falls, injuries, and respiratory depression in patients on long-term opioid treatment. Some typical side effects of morphine include euphoria. respite from discomfort. Unusual tiredness or sleepiness (Abuse, 2020). Respiratory depression, apnea, and, to a lesser extent, cardiovascular depression, respiratory distress, shock, and cardiac arrest are serious adverse events related to morphine sulfate injection USP.

OTC Pain Relievers

Some of the top over-the-counter (OTC) painkillers include ibuprofen, aspirin, naproxen, acetaminophen, and aspirin/citric acid/sodium bicarbonate. The most potent anti-inflammatory painkiller without a prescription is naproxen (SAMHSA, 2020). It works particularly well for ailments including arthritis, sunburns, and sprains. Naproxen tends to have a longer half-life than other over-the-counter painkillers at comparable dosages. The most frequent adverse effects of naproxen include rashes, fatigue, headaches, buzzing in the ears, alterations in eyesight, and disorientation.

Risks and Mechanism of Developing a Substance Use Disorder

What particularly causes drug use problems is uncertain. Other contributory variables include genes, side effects of medications, peer pressure, emotional distress, anxiety, grief, and environmental stress. Drug users frequently experience depression, attention deficit hyperactivity disorder, PTSD, and other psychological disorders (Abuse, 2020). Also common is low self-esteem and an active or chaotic lifestyle. Children who saw their parents using drugs when they were growing up may be more likely to develop substance use disorder in the future due to environmental and genetic variables. When a patient has a drug use disorder, they exhibit a pathologic behavioral pattern in which they continue to use the substance in question while having serious issues with it. The categories for manifestations include social impairment, risky use, and biological symptoms (Sofuoglu et al., 2019).

Age Groups

The greatest opioid overdose fatalities occur in the 35 to 44-year-old age group, with 20,137, a 73% rise from 2019 and a 20% increase from 2020 (Sánchez-Sánchez et al., 2021). Currently, 71% of opioid-related deaths that might have been prevented happen to adults between the ages of 25 and 54, and the mortality rate for people over the age of 55 is increasing significantly. Analgesic usage rises with age, and 20–30% of older persons take analgesics on any given day. Although older persons (65-79 years) and smokers use OTC analgesics less frequently, women and smokers use them more frequently (SAMHSA, 2020).

Professional Recommendations

Dose reduction, symptom management, opioid rotation, and modifying the route of administration are methods to reduce the negative effects of opioids. The misuse of OTC drugs can be decreased with pharmacist attention (Algarni et al., 2022). There are two sorts of interventions for preventing drug use disorders. The first category includes measures designed to prevent drug misuses and abuse, such as the adoption of PDMP programs and their required usage, legislation banning doctor shopping and mandating medical provider education, and physical exam requirements. The second set of initiatives is to increase access to and support substance abuse services (Coombes & Cooper, 2019). Some of these techniques include the adoption of good Samaritan legislation, regulations that make it easier to get rescue medications, and other overdose harm reduction programs. This group also recommends devoting resources to the development and continuous support of drug misuse programs.

Summary

Opioid-related government policies and regulations come in a variety of shapes and sizes, including Medicare/Medicaid rules, opioid prescription practices regulation, and medication scheduling through the Drug Enforcement Administration. Data show the potential benefits of several regulations, including Good Samaritan laws, naloxone access laws, and PDMP standards, in lowering drug usage (Coombes & Cooper, 2019). Legislative action is still needed on several issues, including the regulation of pain control clinics, the requirement of tamper-resistant prescription forms, physical and psychological status examination laws, laws against physician shopping, laws regarding prescription monitoring, and laws regarding access to naloxone. Healthcare practitioners and the general public must get an education. Community education programs might focus on prescription medicine storage, usage, and disposal. Prescribers of pain medications must be trained in pain diagnosis and treatment, alternative modalities, drug misuse screening, psychiatric illness evaluations, and therapeutic interventions for vulnerable groups.

References

Abuse, N. I. on D. (2020, June). Summary of Misuse of Prescription Drugs. National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/misuse-prescription-drugs/overview

Algarni, M., Jalal, Z., Hadi, M. A., & Alghamdi, S. (2022). Community pharmacists’ views and experiences toward over-the-counter medicines misuse and abuse in Saudi Arabia: A qualitative study. Frontiers in Pharmacology, 13. https://doi.org/10.3389/fphar.2022.997342

Coombes, H., & Cooper, R. J. (2019). Staff perceptions of prescription and over-the-counter drug dependence services in England: a qualitative study. Addiction Science & Clinical Practice, 14(1). https://doi.org/10.1186/s13722-019-0170-4

SAMHSA. (2020, December 17). Rise in Prescription Drug Misuse and Abuse Impacting Teens. Www.samhsa.gov. https://www.samhsa.gov/homelessness-programs-resources/hpr-resources/rise-prescription-drug-misuse-abuse-impacting-teens

Sánchez-Sánchez, E., Fernández-Cerezo, F. L., Díaz-Jimenez, J., Rosety-Rodriguez, M., Díaz, A. J., Ordonez, F. J., Rosety, M. Á., & Rosety, I. (2021). Consumption of over-the-Counter Drugs: Prevalence and Type of Drugs. International Journal of Environmental Research and Public Health, 18(11), 5530. https://doi.org/10.3390/ijerph18115530

Sofuoglu, M., DeVito, E. E., & Carroll, K. M. (2019). Pharmacological and Behavioral Treatment of Opioid Use Disorder. Psychiatric Research and Clinical Practice, 1(1), 4–15. https://doi.org/10.1176/appi.prcp.20180006

Squeglia, L. M., Fadus, M. C., McClure, E. A., Tomko, R. L., & Gray, K. M. (2019). Pharmacological Treatment of Youth Substance Use Disorders. Journal of Child and Adolescent Psychopharmacology, 29(7), 559–572. https://doi.org/10.1089/cap.2019.0009

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Preparing a CANVA Infographic

CANVA is a free platform to create documents that are used to illustrate and present concepts and information. You can use words and images to convey ideas to create the desired information piece. This link will take you to the website with instructions on how to develop your document: https://www.canva.com

For this task, explore the use and abuse of drugs taken for chronic pain (known as analgesics) and compare narcotic analgesics (those prescribed by a physician) with OTC analgesics. You will create an infographic that includes the following:

• The category of the prescription pain medication
• The risks associated with the specific medication
• The routes of administration for these particular drugs
• The manner of absorption
• The site of action
• The prime effects including effective on mood and emotion as well as side effects of these drugs
• The effects of OTC pain relievers
• The risks of developing a substance use disorder and description of how it typically occurs
• The age groups most likely to abuse this substance
• The recommendations that would be made to professional groups including the medical profession

After you have created your infographic, write a summary that uses your critical thinking skills to discuss whether these drugs are sufficiently controlled by current law and what can be done to prevent or minimize addiction to prescription drugs.

Length: The infographic should be 3-5 pages, including the summary.

Resources: Your infographic should be supported by reference to at least 3 articles published in peer-reviewed journals in the past 5 years. You may also find additional information at the NIDA InfoFacts website. In addition to these specified resources, other appropriate scholarly resources, including older articles, may be included.

Your infographic should demonstrate thoughtful consideration of the ideas and concepts presented in the course by providing new thoughts and insights relating directly to this topic. Your response should reflect scholarly writing and current APA standards. Be sure to adhere to Northcentral University’s Academic Integrity Policy.