Prescription Drugs
Famalies shouldn't share everything. Talk with your kids about prescriptions.

One in two Canadian homes have prescription medications that are potentially dangerous and most do not store them in a secure place.

There is a misperception among some young people that prescription medications are safe to use – even non-medically. Kids may have easy access to prescription or over-the-counter medications in their homes that could pose a serious risk to their health.

Learn more about common prescription and over-the-counter medications and their effects. Becoming familiar with the types of medications that are most frequently prescribed will help you identify the ones that pose a potential risk of being used improperly.

Below are the details of the three most commonly prescribed medications.

Opioid Painkillers

Sedatives

Stimulants

Be mindful of your meds

The opioid crisis continues to be of great concern, with increased instances of overdoses and accidental poisonings reported across the country.

Why it’s important :

  • 1 in 10 or 11% of high school students in Ontario admitted to having used prescription painkillers like Percocet, Tylenol 3, Demerol, Dilaudid, codeine, etc.) without a prescription 1 and 49% say they got them from home. That represents an estimated 231, 000 Canadian teens. 2
  • Hospitalization rates due to opioid poisoning have increased across all age groups – but mostly among youth aged 15 to 24 years of age. 3
The Family Toothbrush – Radio spot

This year, our National Drug Drop-off campaign during the month of August focuses on the importance of using prescription and OTC medications only for their intended purpose. 

Entitled “Families shouldn’t share everything” the messaging reminds parents that prescription and over-the-counter medications should only be taken by the person they are prescribed to, and to engage in conversations with their kids about medication safety.  The campaign also parents to return all unused and expired medications to their pharmacy for disposal as a simple way to keep their kids safe and protect the environment.

Parents are encouraged to always:

• Secure all the medications in their homes.

Model positive coping strategies in times of anxiety or stress.

Talk openly with their kids about the health risks of taking any form of medication without a prescription that is intended for them and prescribed by a health care provider.

*It’s important to remember there are several pain management options available that do not include opioids. Ask your health care provider for alternatives to opioids.

“Let’s Talk Opioids, including fentanyl”

This resource will provide you with the knowledge and strategies to help you prevent your child from using opioids problematically, spot problematic use by recognizing the signs and symptoms, and take action effectively to prevent an accidental overdose.

If your son or daughter is already using opioids problematically, this resource suggests several important steps you can take to help protect them from harm.

Do you or someone in your family need to take a medical prescription?

Some easy ways to keep your medications safe:

1. Install a medicine cabinet with a lock and key – that’s a simple solution.

2. Store prescription and over-the-counter drugs in a lockbox, a locked drawer, or a filing cabinet.

3. Don’t flush your drugs away when you’re done with them – it’s harmful to the environment.

4. Collect and securely store any expired or unused prescription and OTC medications until you return them to the pharmacy for safe disposal.

Let’s drop the stigma

Check your tone when you talk about substance use – do you sound judgmental? Using condescending or disparaging language can be counterproductive, and can have an extremely negative impact on people who use opioids or other substances, people with substance use disorders, people who are in recovery, as well as their families. This negative stigma often leads people to use drugs on their own, which can, in turn, lead to accidentally overdosing and dying alone.

ANYONE who uses drugs can be at risk of an accidental overdose, including those who:

• Are already struggling with problematic substance use

• Use drugs occasionally in a recreational context

• Are trying a street drug for the first time

• Are not strictly following their health care professional’s instructions

Opening up the conversation about stigma and its negative effects on people will engage all of us to think about how we treat others who may be suffering from some form of problematic substance use and encourage people to get the help they need.

Protect your kids – Talk with them about the importance of using medications as prescribed.

Teens say that when it comes to making choices about whether to use substances, their parents are the most important influencers.

Ready to begin that conversation? Here are a few tips that might help you:

Use open-ended questions – They can help start a dialogue and avoid a lecture. For example; “What do you think motivates kids to take prescription pills recreationally?”

Use Active Listening – Be curious as to what your teen or young adult has to say about substance use. “What have you heard about using cough syrup to get high?” Reflect back on what you hear – Let your child know you heard what was said. For example: “It seems like you’re concerned that some kids you know are taking pain pills.” Reflections do not mean that you necessarily agree, but that you understand what your child is trying to convey.

Choose a good time and place – Look for opportunities to talk when both you and your child are most receptive. Occasions when you are doing something together, like taking a walk, going for a drive, or working on chores are often good times for conversations.

Give them the information – Explain how taking anyone else’s medications can be dangerous. Ask your child if they are aware of the consequences of experimenting with opioids, and explain the risks to them. Talk about the effects drug use can have on their mental and physical health.

Talk about their future plans – Encourage your child to think about what they want for their future, and help them understand the benefits of making healthy choices.

Offer empathy and support – Let your child know you understand the teen years can be tough. Acknowledge that everyone struggles sometimes, and it may be tempting to use substances as a way to cope with problems. Talk about the importance of finding healthy coping strategies and offer to explore those alternatives together.

Above all, always come from a place of love – Remind your children that you are always there to guide and support them and that it’s important to you that they are healthy, happy, and making safe choices for themselves.

1. CAMH 2019 OSDUHS, 2. DFK estimate from CAMH 2019 OSDUHS, 3. Canadian Institute for Health Information

Opioids/ Painkillers

Opioid drugs act by effectively changing the way a person experiences pain.

Commonly referred to as painkillers, Opioids are drugs that contain opium or are derived from and imitate opium. They are prescribed for pain relief and are only available by prescription.

Most opioid or painkilling drug prescriptions are non-refillable and, when used properly under a medical doctor’s supervision, are safe and effective.

Morphine derivatives, or narcotics, come from opioids and are used to therapeutically treat pain, suppress coughing, alleviate diarrhea, and induce anesthesia. When using these narcotics, abusers experience a general sense of well-being by reduced tension, anxiety, and aggression.

Although painkillers have different potencies and are taken in different ways, when they are used they all pose a risk for addiction and other serious effects.

Examples of Opioid Painkillers

Some of the most well known painkillers are listed below with the names you might find on a prescription label.

Opioid table2
  • Codeine: like morphine, this is found in opium, is weaker in action than morphine, and is used especially as a painkiller.
  • Fentanyl (and fentanyl analogs): a man-made opioid painkiller similar to morphine that is administered as a skin patch or orally.
  • Morphine: the powerful, active ingredient of opium is used as a painkiller and sedative.
  • Opium: from the opium poppy, formerly used in medicine to soothe pain but is now often replaced by derivative alkaloids (as morphine or codeine) or man-made substitutes (opioids).
  • Hydrocodone: often combined with acetaminophen for use as a painkiller. Vicodin (which is not available in Canada, but can be found in the USA) is an example.
  • Oxycodone: a narcotic painkiller, for example Percocet and Percodan.
Street or Slang Terms for Painkillers

Oxies, OC, oxycotton, 80s, percs, vikes, and vikings are commonly used slang terms to refer to painkillers.

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Opioid painkillers are the prescription drugs most often used non-medically by young people.

According to the 2019 CAMH OSDUHS study, one in ten high school students (Grade 7 – 12) reported using a prescription opioid pain reliever at least once during the past 12 months. In Ontario alone that represents 95,000 students.

In Canada as a whole, it’s estimated that approximately 310,000 Canadian students have taken prescription drugs not prescribed to them. (DFKC estimate based on 2019 CAMH OSDUHS study)

There are several ways painkillers can be taken. Most teens report swallowing pills, but they can also be crushed and snorted for an intensified effect.

Signs and Symptoms of problematic painkiller use
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Short-term effects
Painkillers can cause drowsiness, inability to concentrate, apathy, lack of energy, constriction of the pupils, flushing of the face and neck, constipation, nausea, vomiting, and most significantly, respiratory depression.

Long-term effects
If a person uses painkillers for a period of time, they can become addicted to the drug and experience withdrawal symptoms when they stop taking the drug. Associated with addiction is increased tolerance, which means more and more of the drug or a combination of drugs is needed to produce the same high or euphoric feeling, possibly leading to an accidental overdose.

Withdrawal
Due to the physical dependence produced by chronic use of opioid painkillers, people who are prescribed opioid medications need to be monitored not just when they are appropriately taking the medicine, but also when they stop using the drug to reduce or avoid withdrawal symptoms. Symptoms of withdrawal can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes, and involuntary leg movements.

Potentially dangerous Drug Interactions

Painkillers should never be used with alcohol, antihistamines, barbiturates, or benzodiazepines.


Since these substances slow breathing, their combined effects could lead to life-threatening respiratory depression.

If you or your teen is already taking a prescribed painkiller, always consult with your physician before taking any other medicine.

Signs of an Opioid Overdose

Physical signs of painkiller overdose include pinpoint pupils, cold and clammy skin, confusion, convulsions, severe drowsiness, and slow or troubled breathing.

If you see a teen or anyone else in this state, call 911 immediately.

DFK offers links to resources in your region to help you and your family find the right kind of help for opioid or painkiller dependency or addiction.


Fentanyl

Fentanyl is a highly potent prescription painkiller that is linked to an increasing number of accidental deaths in Canada.

Many of these overdoses are linked to pharmaceutical-grade fentanyl that is diverted onto the streets and consumed unknowingly by those with addictions and recreational users alike.  However, illicit fentanyl produced in clandestine labs is also responsible for causing overdose deaths. 

Click here for more on illicit fentanyl

Fentanyl is 40 times more powerful than Heroin and 50 to 100 times potent than morphine.

Fentanyl is an extremely powerful synthetic opiate analgesic similar to but more potent than morphine. It is typically used to treat patients with severe pain, or to manage pain after surgery. It is also sometimes used to treat people with chronic pain who are physically tolerant to opiates.

When prescribed by a physician, Fentanyl is often administered via injection, transdermal patch, or in lozenge form.

In its prescription form, Fentanyl is known as Actiq, Duragesic, and Sublimaze.

Like heroin, morphine, and other opioid drugs, Fentanyl works by binding to the body’s opiate receptors, highly concentrated in areas of the brain that control pain and emotions. When opiate drugs bind to these receptors, they can drive up dopamine levels in the brain’s reward areas, producing a state of euphoria and relaxation.

The Opioid Crisis in Canada

The number of deaths involving opioids ( including Fentanyl) continues to rise in Canada. There were 19,355 apparent opioid toxicity deaths between January 2016 and September 2020.

According to Health Canada, Fentanyl and fentanyl analogues are the major drivers of the crisis:

  • 82% of accidental apparent opioid toxicity deaths involved fentanyl in 2020 (January to September).
  • The majority of fentanyl detected in opioid toxicity deaths was non-pharmaceutical (99%)
  • 86% of accidental apparent opioid toxicity deaths from January to September 2020 involved a non-pharmaceutical opioid.

Source: Health Canada

street fentanyl
Fentanyl on the Street

Street names for the drug include Apache, China girl, China white, dance fever, friend, goodfella, jackpot, murder 8, TNT, as well as Tango and Cash.

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Mixing fentanyl with street-sold heroin or cocaine markedly amplifies the drugs’ potency and potential dangers. 

Signs of Fentanyl overdose

Physical signs of fentanyl overdose include:

Drowsiness/respiratory depression, respiratory arrest, nausea, confusion, constipation, sedation, unconsciousness, coma, and death.


Accidental overdoses of fentanyl should be treated immediately with an opiate antagonist.

Naloxone is one kind of medication called opiate receptor antagonists which acts by blocking the effects of opiate drugs. If someone in your family is problematically using opioids or has a substance use disorder to opioids, be sure to keep Naloxone in the home.

If you see anyone in this state, call 911 immediately.

DFK offers links to resources in your region to help you and your family find the right kind of help for fentanyl abuse.


Sedatives/Central Nervous System (CNS) Depressants

Prescription sedatives are central nervous system (CNS) depressants, meaning that they depress or slow down the body’s functions.

These medications are mainly used to relieve anxiety and assist with sleep problems. Other medical uses include inducing sedation for surgical and other medical procedures, treatment of alcohol withdrawal, seizure control and relaxation of skeletal muscles.

Often referred to as sedatives and tranquilizers, CNS depressants are substances that can slow normal brain function. Most CNS depressants reduce brain function through a neurotransmitter called gammaaminobutyric acid (GABA), a chemical that enables communication between brain cells.

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Prescription sedatives and CNS depressants are usually taken in pill form; however, some are available as suppositories or prepared as a solution for injection.

Sedatives are often prescribed by doctors to treat a variety of health conditions including anxiety and panic attacks, tension, acute stress reactions, and sleep disorders. When given in high doses, sedatives may act as anesthesia. Sedatives have the potential for problematic use and should be used only as prescribed.

Examples of Depressants

There are three different classes of sedatives: benzodiazepines, non-benzodiazepine sleep medications and barbiturates.

Barbiturates are a type of depressant often prescribed to promote sleep.

Benzodiazepines are a type of depressant prescribed to relieve anxiety.

Some of the most well known sedatives and CNS depressants are listed below with the names you might find on a prescription label.

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  • Estazolam (ProSom)
  • Zolpidem (Ambien)
  • Zaleplon (Sonata)
  • Eszopiclone (Lunesta)
  • Mephobarbital (Mebaral)
  • Sodium pentobarbital (Nembutal)
  • Secobarbital (Seconal)
  • Chlordiazepoxide (Librium)
  • Chlorazepate (Tranxene)
  • Meprobamate (Miltown)
  • Chloral hydrate (Noctec)
  • Ethchlorvynol (Placidyl)
  • Methaqualone (Quaalude)
  • Oxazepam (Serax)
Street or Slang Terms for Sedatives
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Benzos, xanies, xani-bars, xani-bombs, and roofies are commonly used terms to refer to sedatives.

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Problematic use of Sedatives

While different sedatives work in unique ways, they produce a drowsy or calming effect that can help those suffering from anxiety or sleep disorders. Because they can produce a state of intoxication, they have a high potential for problematic use.

Some people tamper with the medication to use it for the drug’s euphoric effects. Tampering involves changing the form of the medication or the route by which it is taken or both.

Signs and Symptoms of Sedative Abuse

Sedatives and CNS Depressants should be used only as prescribed.

Be on the lookout for these side effects:

  • Physical side effects: include dilated pupils and slurred speech; relaxed muscles; intoxication; loss of motor coordination; fatigue, respiratory depression; sensory alteration; and lowered blood pressure. Teens taking barbiturates may exhibit side effects such as slurred speech, dizziness, sedation, drowsiness, and fever.
  • Psychological side effects: include poor concentration or feelings of confusion; impaired judgment; and lowered inhibitions. Teens on barbiturates may experience depression, fatigue, confusion, and irritability.
     
Side_effects_of_Vicodin

If you have observed any of the symptoms or side effects listed above, contact a medical professional immediately.

Withdrawal from Sedatives

Because all CNS depressants work by slowing the brain’s activity, when someone stops taking them, the brain’s activity can rebound and race out of control, possibly leading to seizures and other serious consequences.

Withdrawal symptoms: include anxiety, insomnia, muscle tremors, and loss of appetite. Going “cold-turkey” off of some depressants can have life-threatening complications, cause convulsions, delirium, and in rare instances, death.

If you have observed any of the symptoms or side effects listed above, contact a medical professional immediately.

Potentially dangerous Drug and Alcohol interactions with Sedatives
Woman taking painkillers and alcohol

Sedative use can be combined with the use of other drugs like alcohol, other prescription or over-the-counter drugs, and street drugs.

Combining these substances can be highly dangerous:

  • Alcohol – Using sedatives with alcohol can slow both the heart and breathing and may lead to death. When combined with alcohol, the effects and risks of depressants are seriously increased.
  • Prescription drugs – Some interactions with other drugs can be risky. Sedatives should be used in combination with other medications only under a physician’s close supervision.
  • Over-the-counter drugs –  Sedatives should not be combined with any other medication or substance that causes central nervous system depression, including some over-the-counter cold and allergy medications. Doing so may slow the heart and breathing, a serious health risk.
Signs of Sedative overdose

Symptoms including shallow breathing, clammy skin, dilated pupils, weak and rapid pulse, coma, or death.

If you see anyone in this state, call 911 immediately.

DFK offers links to resources in your area to help you and your family find the right kind of help for sedative dependency or addiction.


Stimulants

Stimulants are a broad category of substances that act to increase the level of activity of the central nervous system. Stimulants increase alertness, attention, and energy, as well as elevate blood pressure, heart rate, and respiration.

The category includes commonly used substances such as caffeine and nicotine, over-the-counter decongestants, (e.g., pseudoephedrines like Sudafed TM), illegal drugs (e.g., cocaine, methamphetamine), and prescription medications.

The most common use of prescription stimulants is to treat individuals diagnosed with attention deficit hyperactivity disorder (ADHD). Prescription stimulants are also prescribed by doctors to treat conditions such as asthma, respiratory problems, obesity, and the treatment of narcolepsy and other sleep disorders.

Examples of Stimulants
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Amphetamines and dextroamphetamine  –  are stimulant drugs whose effects are similar to cocaine.
Methamphetamine is a highly addictive stimulant drug that is part of a larger family of amphetamines.
Methylphenidate is a central nervous system stimulant. It has effects similar to, but stronger than, caffeine and less potent than amphetamines.

Street or Slang Terms for Stimulants

Ritz, rippers, dexies, and bennies are commonly used terms to refer to stimulants.

pills and hands(1)
Problematic stimulant use by teens

This class of drug is often used for its ability to produce euphoric effects or to counteract sluggish feelings induced by tranquilizers or alcohol.

Stimulants are used to stay awake, increase alertness and concentration, boost energy, and get high. Teens and university students report saving and selling their own ADHD drugs around exam time. Sometimes teens go beyond swallowing these pills, they also crush and snort them, or mix pills with alcohol.

Signs and Symptoms of Stimulant Abuse
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There are a number of symptoms and side effects to look for:

  • Physical side effects – include dilated pupils; decreased appetite; loss of coordination; collapse; increased heart and respiratory rates; elevated blood pressure;dizziness; tremors; headache; flushed skin; chest pain with palpitations; excessive sweating; vomiting; and abdominal cramps.
  • Psychological side effects  – include feelings of restlessness, anxiety, and delusions;hostility and aggression; and panic, suicidal, or homicidal tendencies. Paranoia, often accompanied by auditory and visual hallucinations, may also occur.

If you have observed any of the symptoms or side effects listed above, be mindful of the possibility of withdrawal or accidental overdoses.

Withdrawal from Stimulants

Withdrawal symptoms associated with discontinuing stimulant use may include depression, disturbance of sleep patterns, fatigue, and apathy.

Potentially dangerous Drug and Alcohol Interactions with Stimulants

Stimulant use often goes along with the use of other substances like alcohol, other prescription drugs, over-the-counter drugs, and street drugs.

Alcohol: People who use alcohol and stimulants together are likely to drink more before feeling the effects of alcohol because of the stimulant effects; The result? When the stimulant effects wear off, the alcohol kicks in.

Prescription drugs:  Stimulants should only be used in combination with other medications under a physician’s careful supervision.

Over-the-counter drugs:  There are dangers associated with mixing stimulants and over the counter drugs that contain decongestants. Blood pressure can become dangerously high or lead to irregular heart rhythms.

Signs of Stimulant overdose

The symptoms of a sublethal stimulant overdose may include dizziness, tremor, irritability, confusion, hostility, hallucinations, panic, headache, skin flushing, chest pain, palpitations, cardiac arrhythmias, hypertension, vomiting, cramps, and excessive sweating.
Overdose or death is preceded by high fever, convulsions, and heart failure.

Since death in these cases is partially due to strain on the heart, physical exercise increases the risks of stimulant use.

If you see anyone in this state, call 911 immediately.

DFK offers links to resources in your region to help you and your family find the right kind of help for sedative or depressant dependency or addiction.