Up to 48% percent of homes contain common medications – yet only 11% of those store prescriptions securely.

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

• 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.

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

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.

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.

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.

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.

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

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

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.

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.

• 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)

Benzos, xanies, xani-bars, xani-bombs, and roofies are commonly used terms to refer to 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.

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.
   

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

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.

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.

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.

• 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.

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

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.

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

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.

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.