In this episode of the Ask Nurse Alice podcast, host Alice Benjamin discusses the alarming increase in drug overdose deaths in the United States. With over 105,000 deaths reported in 2022 alone, the issue of counterfeit pill use is becoming a major concern. Alice highlights that these deaths are often a result of drugs being abused and sold illegally on the black market, such as opioids and benzodiazepines. She stresses the importance of distinguishing these fake prescription pills from legitimate medications used for conditions like high blood pressure and diabetes. It is crucial to address this issue and take action to prevent further harm.
Jump ahead to listen:
[00:03:48] Counterfeit drugs and their dangers.
[00:10:06] Fake medications and leftovers.
[00:11:16] Medication abuse and misuse.
[00:14:48] Prescription medication and addiction.
[00:19:13] Substance use and managing pain.
[00:21:44] Higher drug overdose death rate.
[00:26:45] How to protect from counterfeit pills.
[00:33:23] Prescribing intranasal Narcan.
[00:36:14] Helping people manage pain.
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[00:00:29] You're listening to Ask Nurse Alice presented by Nurse.org where Alice Benjamin combines
[00:00:44] no nonsense advice with thought-provoking interviews.
[00:00:49] Welcome to the Ask Nurse Alice podcast.
[00:00:51] The show will talk about anything and everything nursing and healthcare related.
[00:00:55] And her host, Alice Benjamin, clinical nurse specialist, family nurse practitioner
[00:01:00] and chief nursing officer at Nurse.org.
[00:01:02] And on today's episode, I wanted to talk about a recent report from the CDC that is highlighting
[00:01:10] and trying to sound the alarm on drug overdose deaths with evidence of counterfeit pill use.
[00:01:17] Now let me just share that drug overdose deaths are at a historical high in the United
[00:01:23] States with an estimate of more than 105,000 deaths in 2022 alone.
[00:01:30] That is significant increase in that type of thing.
[00:01:33] And when we're talking about overdose, drug overdose deaths,
[00:01:37] typically these are drugs that are being taken in recreational use.
[00:01:43] They're drugs that have been abused are being sold on the streets, the black market
[00:01:50] and things like that illegally.
[00:01:52] And these can be your opioids, your benzodiazepines and things like that.
[00:01:56] So let's just be very clear.
[00:01:58] Drug overdose deaths all time high.
[00:02:00] But now what they're even more concerned about, as if that weren't already a problem,
[00:02:04] is that an increase of those deaths are related to fake prescription pills.
[00:02:11] Now when we talk about this, we're not talking about your blood pressure medication.
[00:02:15] We're not talking about the diabetes medication.
[00:02:17] We're talking about medications like oxycodone, hydrocodone, Xanax, Adderall.
[00:02:25] Now as a healthcare provider, I'm very familiar with those drugs with the proper diagnosis.
[00:02:29] I may prescribe those again very strictly and diligent about that for certain medical
[00:02:35] diagnoses after a thorough evaluation and assessment.
[00:02:40] But what's happening here is these are not healthcare providers that are prescribing
[00:02:44] these and then they're kind of just being sold around.
[00:02:46] What we're talking about when we say fake prescription pills or counterfeit pills
[00:02:50] is that we have street pharmacists, drug dealers, people in their makeshift black market labs
[00:02:56] concocting some type of something and they're creating these pills that look like guys,
[00:03:03] they look like.
[00:03:04] They're down to the shape, the color, the letters and numbers that are on the pill
[00:03:08] and they are making pills that look like the medication that we prescribe and they're
[00:03:14] selling those.
[00:03:15] And those drugs, those synthetic drugs are what the CDC believes is responsible for the
[00:03:23] increasing number of deaths, drug overdose deaths.
[00:03:27] Now that's dangerous.
[00:03:28] So, you know, like, so what are in these counterfeit pills?
[00:03:32] Right?
[00:03:33] Well, we don't really know.
[00:03:34] That's the crazy thing about it.
[00:03:36] These counterfeit pills are fake medications that have different ingredients than the actual
[00:03:41] medications.
[00:03:42] So when we think of oxacodone, like you can go to, you know, a pharmaceutical resource,
[00:03:49] drug library and kind of look to see what the ingredients are.
[00:03:52] No, these street pharmacists, these drug dealers, they don't care about that.
[00:03:56] They're just making something to put a product on the street themselves.
[00:04:00] For them, it's in business.
[00:04:02] It has nothing to do with the benefits of these medications and how they can manage
[00:04:06] someone's pain and this is not assessing, they're not diagnosed.
[00:04:09] And they're just making these drugs and they're selling them.
[00:04:10] So the concern is that we don't know what's in these pills, actually.
[00:04:14] And so for all we know there is no active ingredient.
[00:04:18] It could be the wrong active ingredient or it could have the right ingredient but the
[00:04:23] wrong quantity.
[00:04:24] But what's even more and more and more concerning is that these counterfeit pills
[00:04:28] are containing as some of the research and evidence has shown from them testing
[00:04:33] these drugs, they're containing lethal amounts, lethal, lethal amounts of fentanyl,
[00:04:38] methamphetamine, cocaine and benzodiazepines.
[00:04:42] Now that is extremely scary.
[00:04:45] Now I need to draw this, draw a line in the sand.
[00:04:49] When we talk, when I talk about prescription medications that are prescribed by a healthcare
[00:04:56] provider after a proper assessment and interview for the proper diagnosis, for the proper reason
[00:05:03] and even when we prescribe these control substances, it's usually for a defined amount of time.
[00:05:09] Right? We're not going to give you oxycodone indefinitely for a headache or something like
[00:05:13] that. Like no, that's just not appropriate.
[00:05:15] So there's more planning to this because we don't necessarily want to keep
[00:05:20] someone on these types of control substances because we know that they can be highly addictive.
[00:05:24] So that's one thing.
[00:05:25] But again now back to these counterfeit drugs.
[00:05:28] These are being, you know, if someone said like where are they coming from?
[00:05:30] Well the DEA said that a vast majority of the counterfeit pills that are being brought to the
[00:05:35] United States are actually produced in Mexico and made by gangs and drug rings.
[00:05:40] And in some cases they're actually even being sold on the internet
[00:05:44] or by unsafe websites who are opposing to be online pharmacies.
[00:05:49] Now this is scary because this makes drugs a lot more accessible and like this,
[00:05:54] it's getting sophisticated.
[00:05:55] So like if I could just say funny not funny but when we think of drug deals,
[00:06:01] we're thinking of the street corner in the dark in the alley where no one can see you.
[00:06:05] You know, but now these street drugs are getting a lot more sophisticated to mimic and
[00:06:12] copycat actual prescription medications that are being sold on the internet.
[00:06:15] Like they're optimizing technology.
[00:06:18] I'm actually very scared of that because it's like drugs are being sold right under our noses
[00:06:24] and we wouldn't even know.
[00:06:26] When we talk about prescription drugs, let me just be also very clear.
[00:06:32] Oxycodone, potent opioid medication used to relieve severe pain.
[00:06:36] Hydrocodone, same thing.
[00:06:38] Another potent opioid medication used to treat and relieve pain.
[00:06:43] Adderall.
[00:06:44] This is a brand name medication but it's a combination of amphetamine and dextroamphetamine.
[00:06:51] It's used to treat like attention deficit hyperactivity disorder and narcolepsy and things
[00:06:56] like that.
[00:06:56] So there's actually a place for it.
[00:06:58] That's a stimulant right?
[00:07:00] And young Xanax which is also a brand name medication.
[00:07:03] And it's part of the benzodiazepine family and it's a central nervous system depressant
[00:07:09] and it's usually used to treat anxiety and panic disorders.
[00:07:12] So we got some very powerful addicting drugs here guys that are being copied,
[00:07:20] copied to be sold on the black market.
[00:07:22] And I also want to throw this out there because we have some healthcare providers
[00:07:26] who are more responsible than others and I'm going to share a personal story.
[00:07:29] So I went out to some dental work done.
[00:07:33] And it was very painful and the dentist gave me some pain medication afterwards.
[00:07:40] So here's the thing, he gave me a whole bunch of Vicodins.
[00:07:42] He gave me a bottle of Sturdy Vicodins.
[00:07:44] I don't need that and the low dose Vicodins by the way.
[00:07:47] I don't need that and I had never really taken the medication.
[00:07:49] So what I did is I took one for my toothache and I took it at night because it was pretty painful.
[00:07:56] My face was a little swollen so I was like oh shoot this really hurts and I want to be able
[00:07:59] to sleep through the night.
[00:08:00] So I took one at nighttime.
[00:08:02] I went through the whole day with you know with Motrin and Tylenol but I was like I'm not,
[00:08:06] I don't want to wake up in my sleep from the pain so I want to have a peaceful night.
[00:08:10] I was out like a light, out like a light.
[00:08:13] Believe me when I tell you when I got up the next morning I was so groggy
[00:08:16] like I was like what is this?
[00:08:18] Like I don't know what that is that the year 4th of the people won because I like it.
[00:08:23] I didn't like it not one bit but what I realized is in like the next time, the next night
[00:08:29] it did help with the pain but I was like this is too much so I just took half of one.
[00:08:33] Very very important drug.
[00:08:35] So if you think of this we do this in a very controlled way.
[00:08:38] They're made by pharmaceutical companies.
[00:08:39] They're you know FDA approved.
[00:08:42] We know exactly what's in it and also we know how to reverse
[00:08:46] some of the effects of these medications like if we have our opioids we know that Narcan is a
[00:08:52] reversal agent.
[00:08:53] For your Xanax we know that Flemazenil is a reversal agent.
[00:08:59] As a healthcare provider we get we know all these things right?
[00:09:01] We got it but when it comes to street drugs and people don't know they don't know what
[00:09:05] they're getting.
[00:09:06] They think they're buying Adderall.
[00:09:08] They think they're buying Xanax.
[00:09:09] They think they're buying hydrocodone or Perkis heads but they don't have no idea what
[00:09:13] they're getting and it actually can be even more dangerous because again it's been said to have
[00:09:18] other lethal substances in these medications.
[00:09:22] Things like fentanyl, methamphetamines, cocaine.
[00:09:28] That's those things are extremely dangerous and let me just talk about fentanyl.
[00:09:32] Fentanyl is a synthetic opioid that's up to 50 times stronger than heroin
[00:09:36] and 100 times stronger than morphine.
[00:09:39] I think we've seen enough on social media where like usually it's like police officers
[00:09:43] they're at a stop, they touch something and the officer is down
[00:09:47] and immediate Narcan or something is needed to help basically bring them back to life because
[00:09:52] they're on the way out because these are type of drugs that are so powerful they can suppress
[00:09:56] your breathing, suppress your heart but basically shut down your body with even the slightest amount.
[00:10:02] So this is something that's extremely dangerous.
[00:10:04] People need to be very on alert for these type of things and so actually did an NBC medical
[00:10:12] segment on this talking about it and I think people were just so fascinated by this.
[00:10:17] I don't think people really understand when we talk about drugs.
[00:10:21] I think cocaine, methamphetamines, those type of things are really kind of
[00:10:28] viewed but we don't really talk about prescription medications and now while
[00:10:31] we're talking about fake medications let me just flip real quick to the
[00:10:34] prescription medications.
[00:10:36] When it comes to prescription medications as point in case with my dentist who gave me
[00:10:40] 30 pills I don't need all of that.
[00:10:43] So what happens to the leftover medications?
[00:10:46] So let's say maybe I took like three.
[00:10:48] First off I paid you know healthcare since it's a misogynistic
[00:10:52] of cost or subject of medication costs a lot and some people kind of even get
[00:10:56] access to this so but anyway that's a whole nother episode but I paid for
[00:11:00] and my insurance paid for medication that I did not need then here I am left with
[00:11:06] this bottle of medication.
[00:11:09] Now what most people do whether you want to admit it or not they keep that bottle
[00:11:15] of Vicodin's and then the next time they're having a ache or a pain or something else
[00:11:22] they just go to that medication so like oh my gosh I got a really bad really bad migraine.
[00:11:27] Oh instead of going to their regular over the countertolino or Motrin or maybe
[00:11:31] have a prescription medication for their their migraines they're gonna take
[00:11:35] Vicodin Vicodin's in the house and here's the thing so that's medication abuse
[00:11:40] because even if it's my medication I'm taking it it was prescribed to me for a
[00:11:44] particular reason for a particular occasion.
[00:11:47] When I use it for something else I am not following the provider's orders
[00:11:53] so I'm abusing the medication I'm misusing the medication taking it for a different rationale
[00:11:58] let's say because I got prescribed for my dental issue now if I'm taking oh my me hurts
[00:12:03] yes it's for pain but that Vicodin wasn't prescribed to me for my knee pain so that's
[00:12:08] misuse but here's another thing sometimes it'll be the family member like oh granddaddy's ankle
[00:12:15] he tripped in his ankle swollen it hurts give him one of them Vicodin's that you have
[00:12:19] Alan so he can you know not be in pain he don't need to go emergency room it's a little
[00:12:22] swollen we're gonna raise it up put some ice and just give him a Vicodin.
[00:12:26] Now I'm giving the whole narcotic to somebody else who is not even prescribed for
[00:12:31] right and so I think that happens a lot also oh and I hate this one although bottles are
[00:12:38] meant to be child-proof we know that you can crack that bottle open if you really wanted to you
[00:12:45] don't need to really fiddle with the top so you have people in the home perhaps minors
[00:12:51] who could possibly get into that bottle and inadvertently take it and get sick and die
[00:12:58] and or you might have someone else in the home who's like hmm I bet you I can get a pretty penny
[00:13:04] for those and then take the leftover grandma's leftover Vicodin and sell it to their classmates
[00:13:10] to their friends too and so you can see prescription medications in addition to the
[00:13:16] individual popularly getting addicted to them and developing a tolerance to them which is
[00:13:21] not good you have all those other things of misuse and abuse that could happen
[00:13:26] in the home which some people just like oh they don't think a big thing about it's like oh
[00:13:31] you know ask me uh let me let me have one of those Vicodin that you had for your your tooth
[00:13:36] because my ankle is killing me we think we're doing our friend a favor we do but what we're
[00:13:41] doing is we're contributing to the big opioid problem that we have now I'm talking about
[00:13:46] oxycodone, hydrocodone, Parkinson's and things like that now the other medication that is being
[00:13:54] you know sold out there on the black market at least counterfeit pills are the Xanax and the Adderalls
[00:13:59] Adderalls, uppers people take them to be more attentive more alert that's actually a big problem
[00:14:05] on college campuses as they're being sold people get prescriptions for them and then they sell them
[00:14:10] guys this this is I mean and that's that's actually a prescription medication that was probably
[00:14:13] received from a pharmacy now you now you fold into the mix you have people who are selling
[00:14:19] quote unquote Adderall how do you know what that is how do you know what that is and I actually
[00:14:24] know some instances of when this has happened and it really can lead to some other problems
[00:14:29] because you don't know what you're getting you really don't and same with Xanax and these are
[00:14:35] medications that can be highly addictive so maybe someone starts off on a prescription medication
[00:14:40] and they're asking for it but their provider's like you know what no we reached our cap here
[00:14:45] we need to try alternative things to try to manage your condition because you're developing
[00:14:51] a tolerance the long-term use could lead to addiction and it's probably teeter tottering
[00:14:56] on the line of addiction because your medical indication that you're telling me really doesn't
[00:15:00] warrant this strong of a medication so when they're denied from their healthcare provider
[00:15:06] then they'll go shopping around to different doctors nurse practitioners see where they can get
[00:15:10] when all else fails they can't get it then this is where enter the street pharmacists
[00:15:14] and how they're able to be successful and that's a really really dangerous thing and as healthcare
[00:15:19] providers I know not every listening to healthcare provider but as healthcare providers it's very
[00:15:23] important that we understand this because the best offense is a better it's an even better defense
[00:15:29] so even when it comes to prescribing medications to our patients talking to them about this
[00:15:35] and making sure that we're prescribing the appropriate medications in appropriate quantity
[00:15:41] and providing the appropriate surveillance and we've done the education with our patients
[00:15:45] to let them know that hey this could happen before we even start these medications okay
[00:15:51] and develop some type of contract and with how you're going to manage this and monitor this
[00:15:56] that way if they keep coming back coming back like I need you know I need more
[00:16:01] percocets it's like I gave you 14 day prescription it's only day 10 why are you
[00:16:08] asking me for more already what's happening is your condition getting worse so it's
[00:16:11] healthcare provider we have to be very diligent about that and let's not just let's
[00:16:14] leave be a little more alert so when we're like we I know you give these medications all the time
[00:16:18] it's like oh patient in room 504 needs a vikin m patient in 501 needs viking and patient in 507
[00:16:24] wants viking everybody want viking and then like we go into the pixus machine we get it and we
[00:16:30] give the medication like just be mindful that like what's happening like it's it's not candy
[00:16:36] guys we almost give it away like it's candy it's not and so as a healthcare provider if you
[00:16:40] are anywhere involved in the prescriptive side of it the administration side of it or the delivery of
[00:16:48] it be mindful that when people get to the point of when they're buying fake prescription medications
[00:16:54] I really think it's real but it's really fake at the end of the road we're actually part of that
[00:16:58] stream we are we are not for every single person right but a majority of people who
[00:17:06] start on these medications get highly addicted to them they're keep giving access and they're finally
[00:17:10] denied and then they look for alternatives and then they land there so let's be a little more diligent
[00:17:15] about how we use these medications when it comes to our patients let's look a little
[00:17:19] some more holistic things some non-medicinal things let's look at more therapy and not even just
[00:17:25] therapy like physical therapy occupational therapy but mental health therapy counseling
[00:17:30] because there is definitely indeed a connection between pain and our mental health
[00:17:34] depression and things like that so I think that's a very underutilized service and I know
[00:17:39] people like oh my god what are you saying Alice that we need a a site consult for everybody who
[00:17:44] wants an narcotic maybe have you done at least the depression screening anxiety screening and
[00:17:50] we've done any of that have we explored their mental health first have we explored their
[00:17:56] social history um their substance use in the past I don't know that we do
[00:18:02] I don't know we do and I say that because I found myself in situations where
[00:18:06] and I'll say that someone is indeed pain they got a broken ankle I see the fracture I see the
[00:18:10] break okay I get it I need to give them that but I think it's very important the question that
[00:18:15] doesn't get asked enough I didn't initially but now I do I ask them before I give them a
[00:18:20] pain medicaid because it's warranted I ask them about their social history and any type of
[00:18:26] substance use beforehand because some people may have had a substance issue and they've
[00:18:32] breaking away from that because actually had some lady who um had a history of like almost every
[00:18:38] type of street drug she's using and then she had a fracture and it was very painful her swollen red
[00:18:44] all of the type of things and she was going to get an ortho consult I said I'd like to
[00:18:48] manage her pain have you ever taken anything like morphine or this and that she said
[00:18:52] and she's kind of said morphine she said she was so out of it because she was in pain she's like
[00:18:57] I don't think so he said is it a narcotic because I don't want those I've recovered I'm
[00:19:01] like recovering addict and I don't want to use that type of drugs there you go
[00:19:05] when she said that I thought to myself I don't know that I really asked people that
[00:19:08] I asked them have they ever had a medication but that interaction let me know that that is
[00:19:14] a question that I probably should be asking now some people are like oh I'm that's
[00:19:18] offensive question no it's not it's not it's actually doing the patient uh doing your due
[00:19:25] diligence to make sure that you're not reversing something that a patient had to work so hard
[00:19:29] to get out of so what she actually she just actually I think we gave her a motrin she opted
[00:19:35] for motrin which by the way is very helpful it can be very helpful especially in that situation
[00:19:40] if inflammation is anywhere involved in it but we gave her motrin ice elevated it until
[00:19:46] she had an ortho-contal engine she you know moved for but she also did a lot of deep breathing
[00:19:51] meditation and other things which for her according to her was enough now I'm not going to say that's
[00:19:57] going to work for everybody but what I'm saying is I think we need to exercise other avenues of
[00:20:03] treatment before we go to any type of prescription medication or drug to manage a treatment because
[00:20:10] not saying that we as healthcare providers are the responsible completely for those things but
[00:20:15] we are somewhere along the line we need to take some type of accountability for it because most
[00:20:19] people wouldn't even have exposure to any of these medications drug users wouldn't even know that
[00:20:24] these medications are popular or people want them if people had never taken them and
[00:20:29] you know felt what they felt that euphoric feeling so not saying we take on all the burden
[00:20:35] of responsibility but we do have some responsibility for public safety educating
[00:20:41] and being diligent about the use of opioids and controlled substances with our patients
[00:20:45] because it had to start somewhere it did and now here we are with a rapid high higher than ever
[00:20:54] drug overdose death rate for people who are trying to now buy knockoff prescription medications
[00:21:04] I think that's an interesting spin on it because when we see these titles that say you
[00:21:08] know CDC reports this and counterfeit pills and I think immediately healthcare providers kind of look
[00:21:12] at it like oh my gosh like there's a problem not understanding that we kind of what do you call
[00:21:19] those bend diagrams where they have one circle and other circle overlaps we're part of it we're
[00:21:25] part of it not saying that we are the problem but we have contributed to that we've fanned the
[00:21:32] flames with the medications especially very willy-nilly prescribing now I have my I can prescribe
[00:21:39] these medications I don't want to I'll say well let me take that back because you're like nurse
[00:21:44] house you don't treat your patients right when they have pain I do I do but I'm definitely now
[00:21:48] provider that whenever a controlled substance is needed I'm having a very personal conversation
[00:21:55] with the patient about the potential addiction that comes with these drugs other alternatives
[00:22:02] for pain management and then also some non-medicinal interventions as well because that's also very
[00:22:08] important I think this generation of people you got people who do legit just want their drugs
[00:22:14] but then you have some like I want to do natural I want to be you know I don't want to put
[00:22:17] these chemicals in my body and like so I'm going to push more for that I'm going to push more
[00:22:22] for that now I'm going to tell you this if somebody's bone sticking out their leg I'm like
[00:22:27] you probably going to need some more fiend or some dilated probably but we can agree to do low dose
[00:22:33] amount for a short period of time and really set the patient up for success so they're not set up
[00:22:38] to become addicted on these medications because once I go home with that prescription as the
[00:22:43] health care provider have I prescribed it they're going as the nurse you may be someone who's
[00:22:47] administering it but they're calling you you have to sign it out out of the pixas or
[00:22:51] whatever and then you have to administer it you're there to observe and you know that
[00:22:54] it was taken in for the reason and that's this now when they go home who's to say that they're
[00:22:58] going to take one Vicodin every six to eight hours they may pop four at one time or they may not
[00:23:05] take it for that knee surgery now they're they're taking it four months later because
[00:23:10] they got a headache like so there's just so much variables that happen and I'm not saying
[00:23:13] that patients aren't intelligent um and that they don't know how to manage themselves at home
[00:23:18] they do with the proper education surveillance and support team system but after we send someone
[00:23:24] home with narcotics where is the support where's the follow-up because some hospitals might do a
[00:23:29] two three day discharge follow-up like how's it going is your prescription this is that okay I get
[00:23:33] it but who's following up with the patient one month out how's your pain doing what things have
[00:23:38] you tried are you trying stretching are you trying meditation um how's your diet exercise
[00:23:44] what else are we doing to help manage this pain before you take your Vicodin like that I wish that
[00:23:50] type of service existed I really do you know there actually might be listen entrepreneurs
[00:23:54] I'm just saying there might be a room a space for that type of service whatever there are people
[00:24:00] there are problems wherever the problems we can long as you have a solution you can
[00:24:04] create a business um but I think that's actually the missing piece of it and it doesn't necessarily
[00:24:09] have to be a home health nurse that comes into the home to visualize it but I think even phone
[00:24:13] calls can be very helpful even with telehealth a telehealth visit could be very helpful but who's
[00:24:18] doing that and then people say well how's that visit compensated well you know I don't know
[00:24:24] I know it's needed I know if we have 105,000 people die from overdose deaths although you know
[00:24:30] those may be from people who are buying on the streets for people before they get to that point
[00:24:34] what services and systems of processes have we put in place to prevent them from getting there
[00:24:38] so anyway there's that I think that's very helpful but now let me swing it back to the people who are
[00:24:44] buying these counterfeit pills on the street and as healthcare providers and even if you're not
[00:24:50] healthcare provider you're listening to this everybody needs to know this and also let me
[00:24:54] also say that just because I am a healthcare provider I'm also a patient I'm also a consumer
[00:24:59] so just as much as I'm educating other people on this this is stuff that I am taking in for
[00:25:04] myself that I am applying to myself my family my friends and my circle of people very very important
[00:25:12] question so we can prevent the overdose deaths or people wanting to buy these drugs on on the
[00:25:18] streets how can we protect people from the dangers of counterfeit pills well one only use
[00:25:26] pharmaceutical pills that are prescribed to you and received directly from a licensed
[00:25:32] pharmacy or healthcare provider I'm gonna add to that take the medication for what it's intended to
[00:25:39] and also don't share those two so only use medication that are prescribed to you and that
[00:25:44] are given to a licensed pharmacy and healthcare provider that way you know the the place in
[00:25:49] which it's coming from is legitimate it's coming from a licensed healthcare provider a licensed
[00:25:53] pharmacy so you know exactly that you're getting the right medication for the right reason and
[00:25:57] from the right place okay two do not take any unlabeled pills because you can't rely on the
[00:26:04] appearance of the pill anymore because again these street pharmacists are copycatting medications
[00:26:09] to look like the real thing everything from the same right shape color number and letter
[00:26:14] do you know how many and I've seen this a lot a lot of seniors will come in or they're
[00:26:20] about these seniors they're like I got this pill I think this is or they'll have a group
[00:26:25] of pills and they'll look at them like oh well that's my blood pressure pill and that's my diabetes
[00:26:29] pill and this is this because they remember the shape and color and the numbers on them
[00:26:33] can't do that anymore can't do that anymore and I'll say this as a nurse who is actually
[00:26:37] delivering the medication to someone you're not supposed to do this you're not supposed
[00:26:41] to come in with just the peel cup you should actually have the packaging for the medications
[00:26:47] because really if you did it the real way you're supposed to do it you're supposed to come
[00:26:51] to the patient's bedside scan or verify their identity right and then also scan the medication
[00:26:57] do your five rights at the bedside with the patient and then open it that's what you're supposed to do
[00:27:02] so when some people come in with a pill a couple of a cup of pills I'm like what is that
[00:27:06] I'm not taking that shit I don't know what it is I would never take it so if you're ever
[00:27:10] going to be my nurse don't ever think you're gonna come in with a cup of pills and just
[00:27:13] give it to me I want to see the package okay we've got a waste of going to get some more
[00:27:16] I want to see the package and you should you want to make sure that you're
[00:27:20] seeing a label package so you know exactly what it is that it's the right drug of the right
[00:27:24] strength and all of that stuff um and not that I would hope not that in a hospital healthcare
[00:27:31] setting that a nurse would do a switcheroo with a fake pill I would hope not but still
[00:27:36] applies to hospital applies to outside a hospital it could be like one of your friends is like oh
[00:27:40] here I have a a viking in that you could take for such and such for your headache first off
[00:27:46] you are not my friend trying to push a drug on me that you know that I'm not supposed to be taken
[00:27:50] you know do you know who I am I'm nurse Alice why would you even do that to me but yeah that's
[00:27:54] that's what I say don't take any uh unlabeled pills three for those who still going to do it even though
[00:28:01] as a healthcare provider I've advised you not to do it because it's not safe
[00:28:04] because there will be some people who are still saying you know what I can't get a prescription
[00:28:08] for I'm still going to do it there are people who are still going to go against the grant and
[00:28:11] against your medical advice those are the AMA people for those who are still going to try to
[00:28:16] buy their drugs on the street first advise you not to do it but if you want to do it there are
[00:28:24] you can buy fentanyl test strips and other drug checking products and there's some services that
[00:28:30] can help you identify the content of the pills just like when a patient comes in with their
[00:28:34] medications and they're supposed to take their home medication because we don't have it on
[00:28:37] formula area hospital the medication's supposed to go to the pharmacy and they verify it and
[00:28:41] this is an extended back tube for the patient to use they think there are ways to verify
[00:28:45] that this is indeed the medication it says to do some people would be say like well why would we even
[00:28:50] do that we don't want them to take we don't want them to use these type of medications
[00:28:54] well similar to IV drug use we don't want people to do it but there are safe needle programs
[00:29:00] so if you are going to do it at least try to be as safe as possible because we understand
[00:29:04] that not everybody is just going to do the right thing unfortunately and then also anyone who uses
[00:29:10] medications whether prescribed or not prescribed please please make sure that you have a reversal
[00:29:17] agent available to you so here's the thing when we talk about a reversal agents we know like for
[00:29:24] your hydrocodone, percocet, oxycodone those type of things there's a reversal agent even with
[00:29:31] morphine and delirious reversal agent is Narcan. Narcan can be given IV can be given IM it
[00:29:38] can be given subq it can be given intranasally it's an opioid antagonist and it only all works on
[00:29:45] overdoses by opioids what are some other drugs oxycontin fentanyl methadone bichidine and even
[00:29:53] street drugs like heroin Narcan can reverse those types of things for reverse those drugs
[00:30:00] but what it will not do is we'll will not reverse overdose effects from non-opioid drugs
[00:30:05] like cocaine and benzodiazepines so when we talk about benzodiazepines like adavan, xanax,
[00:30:13] valium that's flumazanil. Flumazanil is a reversal agent we don't talk about that one as much
[00:30:19] we should talk about that more but it's usually flumazanil is given IV I don't know that there's
[00:30:24] any type of over-the-counter or an intramasal flumazanil I hope there is soon if there isn't
[00:30:29] already I'm not familiar with it I've not seen it I wish it was because those are medications
[00:30:34] that should accompany prescription and I'll say this the last time I had some dental work done
[00:30:41] I had to tell my dentist don't be giving don't be prescribing me all that stuff I don't even want to
[00:30:44] in the system that you that I was even prescribed this who like what first house what you doing with
[00:30:48] all this Vicodin I don't need all that just give me three three Vicodins and anyways I'm gonna
[00:30:53] take split them in half but anyways last time I got a prescription it came with a
[00:30:58] intranasal Narcan I don't know how many providers are doing that but that is definitely
[00:31:02] what I do now when I prescribe any type of opioid I'm also prescribing an intranasal Narcan
[00:31:08] I am there's nothing wrong with it it's better to have it and not need it than needed and not have it
[00:31:13] because although mom might get her prescription medication use them responsibly if her son
[00:31:19] gets into her drugs thinking it's candy and takes them and he's down mom has the Narcan
[00:31:25] to use and I think that's really really important and I think that's a safety net
[00:31:29] that we need to make sure that happens so if you're listening in your healthcare provider
[00:31:32] or your whether you're prescriber or whether you're the nurse is going to mention the medication
[00:31:37] or discharge a patient please please please changes in your practice if someone's going
[00:31:41] to get a prescription for some type of opioid make sure that they also get a prescription
[00:31:45] for Narcan that can be extremely helpful people can also buy this over the counter
[00:31:49] but I think people are feel like they're going to be judged when they buy this and they shouldn't
[00:31:53] but then also I want to say that there are federal programs that have given
[00:31:58] been uh monies to emergency rooms in many places not all unfortunately in many places
[00:32:04] where you can actually go to an emergency room and say hey I'm here to pick up some Narcan
[00:32:10] no questions asked no uh don't don't even need your name this is I think you have to sign
[00:32:16] you know what maybe they do need your name uh do they do they not I don't I can't recall
[00:32:21] but my point is you will get Narcan they will give you an intranasal Narcan without asking
[00:32:27] why you need it they won't if you have to come back every day because you know someone
[00:32:31] who's using it every day that's fine it's meant to save lives we're not there to judge you we
[00:32:36] were there to help you provide you the tools to save someone's life because we know unfortunately
[00:32:42] against advice people are still going to do these things and we don't want that to happen
[00:32:46] so that is another way to make sure that you have a reversal agent available to you so
[00:32:52] those are some things that I want to talk about those are really interesting topic
[00:32:55] and even as a healthcare provider and I'll say this I think people assume that we as
[00:32:59] healthcare providers know everything we don't necessarily know everything which is why I
[00:33:04] took the time to talk about this topic for this episode because I'm hopeful that something
[00:33:08] that I've shared here has resonated with you if you are a healthcare provider to
[00:33:15] realize that you know what although you may not maybe the person who is selling the fake
[00:33:20] prescription medications somewhere along the line with the work that you do although well
[00:33:25] intended could inadvertently cause some people to develop an addiction develop a problem and
[00:33:31] they need help and the best way that you as a provider can help them is to help them upstream
[00:33:36] help them to with the education the resources alternative ways in which to manage your pain
[00:33:40] help them with support systems if they find themselves in this situation where can they
[00:33:43] go we need to develop a system in which we can check on people to make sure that they're
[00:33:47] using these medications properly without being judgmental and then also if we find people who are
[00:33:54] still going to do this provide them with the information which they can do so
[00:33:57] safely so that no one is dying from these fake prescription pills so thanks so much guys for
[00:34:04] tuning in I hope this was helpful whether your health professional or not I thought this
[00:34:08] was some great information I know that I found it very valuable and that I'm going to take this
[00:34:12] and hopefully share with a tons of other people which by the way you can share as well
[00:34:16] make sure to share this with your friends your classmates your co-workers
[00:34:20] anyone you think would benefit from this information and getting the word out really helps me
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[00:34:34] ever you're listening to this let me know what do you think give me five stars I'd love it
[00:34:39] and you know this is five star material anyway so I would appreciate that I don't ask for much
[00:34:43] but I would ask for do appreciate your support shout out to nurse.org thank you so much for
[00:34:47] helping to host the podcast appreciate them make sure to check out nurse.org and guys I'm Alice
[00:34:53] love chat with y'all you can follow me on social media at Ask Nurse Alice
[00:34:57] and hey until next time please make good choices be kind to one another and look
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