A Question of Influence

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Classification
The most commonly prescribed drugs that affect mood and behaviour fall into the categories of stimulants, opiates, and CNS depressants.


Stimulants

• At one time, prescription stimulants were more commonly available. However, the risk that they can produce serious problems linked to dependence has led to a change in prescribing practice.
  
• Stimulants are now prescribed for treating only a few health conditions, including narcolepsy (a sleeping disorder where a person cannot help suddenly falling asleep), and attention-deficit hyperactivity disorder (ADHD).
  
• Methylphenidate (Ritalin) is commonly prescribed in these cases. For people with these disorders, this drug has a calming rather than stimulating effect. However, others seeking a stimulant effect sometimes abuse them.

Opiates

• Drugs from the opiate family (sometimes referred to as narcotics) are quite useful in treating pain (e.g., codeine, morphine).
  
• Because drugs in this family can also produce feelings of pleasure, they are used non-medically as well. Effects include drowsiness, constipation, and, with larger doses, slowed breathing.
  
• Taking a large single dose (such as through injection with a needle) can stop breathing and cause death.
  
• Because tolerance develops with long-term use and because withdrawal is difficult, dependence on these drugs happens easily.
  
• OxyContin, an opiate-like substance that is very effective in managing severe pain, deserves special mention:
  
  • Its form can be altered, making a substance that some are using non-medically because of effects similar to heroin. It is highly addictive when used this way.
    
  • Hundreds of deaths have occurred in the US as a result of overdose, and a growing number of deaths have been reported in Atlantic and Eastern Canada in the past five years.

CNS depressants

• These substances slow down normal brain function.
  
• Barbiturates, also called “downers,” were developed to treat sleep problems, anxiety, tension, high blood pressure, and seizures. Some are used as anesthetics.
  
• Benzodiazepines have replaced barbiturates in the treatment of many disorders. They are usually prescribed to treat anxiety and nervousness, to relax muscles, to control certain types of muscle spasm, and to treat sleep problems. Although they are safer and have fewer side effects than barbiturates, they can also produce dependence and are generally recommended for short-term use only.
  
• CNS depressants should not be combined with any medication or substance that causes drowsiness, including alcohol, opiate pain medicines, or certain over-the-counter cold and allergy medications. If combined, they can multiply each other’s effects and slow breathing and the heart to the point of death.

Control of pharmaceutical products
The pharmaceutical industry produces hundreds of drugs that can affect a person’s mood and behaviour. These all have medical uses that can provide real benefits when used responsibly. Several groups play a role in controlling these drugs and making sure they are used responsibly:

• Governments need to make sure that scientific proof of safety and effectiveness of new drugs is available, keep an eye on the production, sale, and distribution of these products, and make sure there is a balance between public health and the business interests of the pharmaceutical companies.
  
• Pharmaceutical companies must provide full, accurate information on the benefits and problems that may result from use.
  
• Physicians and pharmacists need to have a strong understanding of the product and the patient, communicate this information to the patient, and watch for signs of dependency.
  
• The patient needs to be honest about their condition and their use of the drug. Because it is possible for a person to become dependent on most of these substances, sometimes being responsible might mean looking for alternatives to pharmaceutical drugs, for example, by improving relaxation and stress-management skills.

Use of pharmaceutical products in Nova Scotia

• There is no information available on how common pharmaceutical medicine use is in Nova Scotia.
  
• In 2007, about 6.6 percent of students in grades 7–12 in Nova Scotia reported having used amphetamines or Ritalin without a prescription in the past year. Like with most other substances, use increases through the grades (from 2.5 percent of grade 7s reporting using the drugs in the past year to 8.2 percent of grade 12s).
  
• In 2007, 3.0 percent of students reported non-medical use of tranquillizers.