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FTA Drug & Alcohol Regulation Updates Issue 37, page 6 |
RX & OTC MEDICATIONS |
| Prescription Sedatives and Tranquilizers |
Barbiturates and Benzodiazepines are both central nervous system depressants
that have effects similar to the effects of alcohol. Barbiturates are
prescription sedatives that are prescribed for acute anxiety, tension, and
sleep disorders. Commonly prescribed barbiturates are mephobarbital (Mebaral)
and pentobarbitalsodium (Nembutal). Benzodiazepines such as alprazolam (Xanax), diazepam (Valium), and chlordiazepoxide HCl (Librium) are prescribed to treat anxiety, acute stress reactions, and panic attacks. ProSom is a benzodiazepine that has a more sedating effect and can be prescribed for short-term treatments of sleep disorders. These medications are most commonly found in multi-colored tablets and capsules. Prescription sedatives and tranquilizers can cause euphoria. They slow normal brain function, which may result in slurred speech, shallow breathing, sluggishness, fatigue, disorientation and lack of coordination, or dilated pupils. Upon initial use, a person usually feels sleepy and uncoordinated. Tolerance to the drug’s effects can occur over time resulting in a need for larger doses to achieve similar effects as those experienced initially. Higher doses cause impairment of memory, judgment and coordination, irritability, paranoia, and increased thoughts of suicide.  Barbiturates
and Benzodiazepines should not be used with other medications unless
specifically ordered by a physician. This includes other central nervous
system depressants including prescription pain medications, some
over-the-counter cold and allergy medications, or alcohol. Using these
medications in combination with other substances, including alcohol, can be
fatal.Prescription depressants can be addictive resulting in withdrawal when the drug use is discontinued. Discontinuing use can result in seizures and other harmful consequences and should be done only under a physician’s supervision. Transit employers should make sure their safety-sensitive employees are aware of the short-term and long-term effects of barbiturate and benzodiazepine use. Employees should be instructed to consult with their prescribing physician and explain the safety-sensitive nature of their job when discussing treatment options involving central nervous system depressants. |
| Prescription Pain Relievers |
Prescription pain relievers are also known as prescription narcotics,
narcotic analygesics, or opioids and are the most used and abused
medications in use today. Commonly prescribed pain relievers include
codeine, morphine, oxycodone, Percocet, hydrocodone and Vicodin. Morphine is
one of the most effective drugs known for the relief of severe pain and is
the standard against which new analgesics are measured. The use of morphine
has increased significantly in recent years. Oxycodone is a pain reliever
that is twice as potent as morphine. The most common oxycodone products are
OxyContin®, Percocet, and Percodan. Hydrocodone is a legal opiate that is
similar to morphine. There are over 200 medications that contain hydrocodone,
but Vicodin (hydrocodone with acetomenaphen) is one of the most commonly
used and abused. Codeine and morphine in large enough concentrations will
show up as chemical positives for opiates in DOT drug tests. The MRO may
downgrade those positive results with a proof of a valid prescription but
should issue a safety warning to the DER as per Part 40.327 as use of these
substances certainly poses a risk to public safety. When used as directed, these medications can relieve pain. They also cause drowsiness, constipation, and slowed breath. In some people, pain relievers also cause euphoria or feelings of well being by affecting the brain regions that mediate pain. When taken as prescribed, pain relievers can safely manage pain effectively. Long-term use can result in an increased tolerance to the drug and requires higher doses to achieve the desired effects. But, ongoing use can also result in physical addiction as the body adapts to the presence of the drug. Withdrawal symptoms include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, and cold flashes. Prescription pain relievers should not be used with other substances that depress the central nervous system such as alcohol, antihistamines, barbiturates, benzodiazepines, or general anesthetics as the interaction may result in severe respiratory depression and death. Many transit professionals think that prescription pain relievers are safe because they have legitimate uses, however, they can be just as dangerous and addictive as illegal drugs. Other prescription painkillers such as Tramadol and Flexeril have been responsible for several high profile accidents in the transit industry including the Staten Island Ferry accident of 2003 and the Maryland MTA light rail accidents at BWI airport in 2000. Source: Partnership for a Drug-Free America |
