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Rx Abuse. Ready or Not?

Rx Abuse. Ready or Not? That's what we in emergency medical services should be asking ourselves.

Rx Abuse: Accident or Intentional
According to this story from Reuters found at, prescription medication abuse is rising faster than methamphetamine and marijuana abuse. According to the Substance Abuse and Mental Health Services Administration, treatment and those seeking treatment for addiction to prescription medication has increased 400 percent. This rate was more than meth abuse, which has doubled, and marijuana abuse, which has gone up by nearly one-half.

They go on to claim that nearly ten percent of hospital admissions in 2008 were for prescription drug abuse; this is up from 2.2% in 1998. Pain killers were overwhelmingly the medication of choice; with hydrocodone, oxycodone and morphine are the medications of choice. Interestingly, the abuse included all levels of education, employment, race, and geography.

EVERY responder needs a guide!
A take-home note for EMS responders is that a majority of the people abusing these medications are in the 18-24 year age group. The rationale seems to be an [incorrect] belief that the prescription medications are "safer" than the street drugs. This translates into the need for responders to search out and document all medications found on a scene...not just those actually prescribed to the patient. Yes, I'm profiling and suggesting that the potential for abuse is there with all patients...keep in mind, it could be accidental, but the potential for prescription medication use/abuse; accidental or intentional, exists in all cases. Bottom line - include all medications on the scene in your medication history - make doing so a habit (no pun intended).

A good medication history may make the difference in your working field diagnosis. I also recommend that each responder have access to some kind of field references to identify prescription medications. My choice is the EMS Field Guides from Informed Publishing. A hard-copy pocket guide or the app for iPod/iPhone of the BLS or ALS version is the way to go (I have both on my iPod). Either way, every responder should have one...keeping a copy will help you identify medications by name and provide the insight that might just save a life. Read my review of the BLS/ILS iPod app

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