Trisha's policy paper

Policy on People Self-Medicating Themselves with Prescriptions and Over the Counter Drugs
When a person thinks they have a cold, which is a viral infection, they go to the pharmacy and buy over-the-counter medications and expect these products to help the cold symptoms they are experiencing (2). After taking the medication for a few days they think it has worked because the symptoms are going away, but really it is because the virus has run its course. When some people are prescribed a medication from the doctor they do not finish it because they are feeling better, so they stop taking the drug. A lot of these people get similar symptoms of what they had before so they think it is okay to start taking the same prescription. When people do that, it makes the bacteria or virus resistant to more types of antibiotics and it is harder to find an antibiotic that will be able to fight the bacteria or viral infection.
A major reason for people to self-medicate with prescriptions is due to unfinished prescriptions from family, friends, and themselves. A study done by HealthStyle Surveys during the years of 2001-2006 described how adults borrow prescription medications and share them among other adults. A particular study was done with women in their years, which is 18-44. (3) After the data was collected the results were “28.8% women and 26.5% men. The women that were 18-44 reported “prescription medication borrowing or sharing" more than women older than 45. The common medications that were borrowed or shared were “allergy medications (43.8%) and pain medications (42.6%).” By the end of the study, the results showed that “prescription medication borrowing or sharing” is common with adults, but more common among women that are between the ages 18 and 44. (3)
This isn’t just the adults self-medicating themselves with leftover prescriptions or with over the counter drugs, it is also evident in adolescents. They might not be taking the antibiotic for an infection, but to get high, increase alertness, to sleep, and to help for pain (1). Also the data showed that the adolescents that reported self-medicating were more at risk of using illegal drugs and drinking. (1) A common prescription that is used for self-medicating is a prescription for ADHD. The most common people to self-medicate with that kind of drug were the family, and friends. They also had reported taking the prescription several different times. The reason for the nonmedical use of the prescription was for productivity. (4)
I. Policy at Mercy Medical Center of Sioux City
A. All clients will be educated about bacterial vs. viral infection before they are discharged. They will be educated about the differences between the two. Viral and bacterial infections have different ways to be treated. Viral infections can only be treated with certain antibiotics.
B. All clients will be educated on how cultures have to be done to see what type of infection they have and what the bacteria or virus is susceptible to. Then the physician has to decide what type of antibiotic is the best.
C. All clients will be educated on what happens when they do not finish their prescription and what could happen by taking it later.
D. All clients will be educated on the effects of taking over the counter drugs for an infection, they might not have. They will learn what it does to the virus or the bacteria and how they can become resistant to the medication.
E. All clients will be educated on how it can harm their bodies when they take a prescription medicine that is not theirs.
F. All clients will be educated on why it is important for them to take the right dosage of the medication. They will also learn the effects their body can receive from not having the right dose, or prescription.
The consequences for the physicians and nurses that do not follow this protocol will be seen as a staff member that does not know the correct way to discharge a patient. The nurse or physician would be put on probation and if it would happen again they would have a three day suspension.
An argument against this policy would be that when a person goes home you are not able to control how they take their medicine. That is true but, when they learn what happens to their body when medication is taken incorrectly, it might change their habits on how they take their medications. Also when they learn that there is a difference between a virus and bacteria that might also make them realize how both of them cannot be treated the same. Another argument that could be made against this policy is, you cannot stop anyone from sharing their prescriptions, and making sure they are getting the correct over-the-counter medication from the pharmacy. You might not be able to stop anyone from sharing their prescription, but by hearing the effects of what the prescription abuse do to their bodies would make them rethink sharing medications. Also, something that could be done for example in the Wal-Mart pharmacies in Iowa, would be to make it mandatory that the person buying some over-the-counter medications would have to buy it in the pharmacy where the pharmacist would have the right to ask the person why they are buying that and the symptoms. If the pharmacist thinks they are buying incorrect medications he or she could direct the person to the right medication or tell them they need to go see a physician.
The FDA has eight rules that promote using prescription drugs safely. “1. Always follow the medication directions carefully.” “2. Don’t increase or decrease doses without talking to your doctor.” “3. Don’t stop taking medication on your own.” “4. Don’t crush or break pills.” “5. Be clear about the drug’s effects on driving and other daily tasks.” “6. Learn about the drug’s potential interactions with alcohol, other prescription medicines, and over-the-counter medicines.” “7. Inform your doctor about your past history of substance abuse.” “8. Don’t use other people’s prescription medications and don’t share yours. –M.M” (5)
Antibiotic resistant is becoming more popular among all ages. It isn’t just with prescriptions, but also with over-the-counter medications too. The nurses and physicians at Mercy Medical Center of Sioux City will have to attend an education meeting that goes over this policy. In the meeting they will learn what they have to do before their patient leaves the facility when the patient has a prescription. Also the nurse and physician will be responsible to let their patients know what happens when they take over-the-counter drugs when they don’t really need them.

References
1. Boyd, C., McCabe, S., Cranford, J., Young A. “Adolescent’s Motivations to Abuse Prescription Medications.” PubMed Central. Pediatrics. 2006 December; 118(6): 2472–2480. Retrieved on September 25, 2008.
2. Grigoryan, L. “Self-medication with Antimicrobial Drugs in Europe.” CDC. http://www.cdc.gov/ncidod/eid/vol12no03/pdfs/05-0992.pdf retrieved on September 26,2008
3. Peterson, E., Rasmussen, Sonja., Daniel, K., Yazdy, Mahsa., Honein, M. “Prescription Medication Borrowing and Sharing among Women of Reproductive Age.” Journal of Women’s Health, Vol. 17, November 7, 2008. http://www.liebertonline.com/doi/pdfplus/10.1089/jwh.2007.0769?cookieSet=1 retrieved on September 30, 2008.
4. Novak, S., Kroutil, L., Williams, R., and Van Brunt, D. “The nonmedical use of prescription ADHD medications: results from a national Internet panel.” http://www.substanceabusepolicy.com/content/2/1/32. Retrieved on October 1, 2008.
5. Meadows, M. “Prescription Drug Use and Abuse.” U.S Food and Drug Administration, FDA Consumer Magazine, September-October 2001. http://www.fda.gov/fdac/features/2001/501_drug.html Retrieved on October 5, 2008.

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