Size Matters-Dose Size That Is… Prescription Drugs
Legal cases involving the use of the compound zolpidem, a drug used to induce and/or maintain sleep, have made the news with the rare “sleep driving” scenario-where an individual unknowingly operates a car while they should be asleep in bed. Nevertheless a more common situation exits and just over a year ago the Federal Drug Administration (FDA) announced a recommendation to lower the dose of sleep drugs that contained zolpidem (aka Ambien®).1 In the announcement the FDA states: “New data show that zolpidem blood levels in some patients may be high enough the morning after use to impair activities that require alertness, including driving.”1 What does that mean? It means that after you have taken the drug appropriately you may still be impaired when you wake up. With zolpidem, the pharmacokinetic differences between males and females were found to be a factor in some of the cases, since women may eliminate the drug more slowly than men. The FDA recommended that the dose be evaluated and possibly lowered for both males and females. Regardless of sex, patient self-perception is not an adequate gauge of impairment and can result in an individual operating a car when they should not.2
Zolpidem is not the only drug that can have serious negative effects when the dosage is not correct. For example, in patients with opiate addiction the compound methadone has been used successfully to decrease the dangers of opiate withdrawal while going through the detoxification process and also in the treatment of chronic pain. However, too much methadone and the individual can have unwanted feelings of sedation and euphoria. Drugs such as zolpidem and methadone should be taken via a health care provider who [hopefully] would council a patient on the proper use of the drug. Unfortunately, per the Centers for Disease Control and Prevention, prescription drug abuse has reached epidemic status.3 “Data from the National Survey on Drug Use and Health show that nearly one-third of people aged 12 and over who used drugs for the first time in 2009 began by using a prescription drug non-medically.”2 Sleep and pain medication are just two examples of the numerous prescription drugs that are abused.
Prescription drug abuse campaigns have been initiated to deter individuals (teens and adults) and operate on platforms of education, monitoring, enforcement, proper use and disposal. From community-based campaigns to the White House, sites exist that promote education of the public on appropriate use and risks of abuse of prescription medication. Stay aware and stay informed about what your taking and housing. Understand the dose of what you are taking and communicate any concerns to a health care provider. Prevention is far better than dealing with the aftermath of impaired driving, accidental ingestion or overdose.
“Per the Substance Abuse and Mental Health Services Administration (SAMHSA) 3 out of 10 people between the ages of 57 to 85 use 5 prescription medications or more.”-Want to read more? Check out post Prescription Medication Use in the Elderly
- Federal Drug Administration. “FDA requiring lower recommended dose for certain sleep drugs containing zolpidem.” Jan. 10, 2013. Accessed Jan. 10, 2014 http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm334798.htm
- Farkas, R., Unger, E., Temple, R. “Zolpidem and Driving Impairment-Identifying Persons at Risk”. N Engl J Med 2013; 369:689-691 Accessed January 13, 2014 http://www.nejm.org/doi/full/10.1056/NEJMp1307972#t=article
- Prescription Drug Abuse. Office of National Drug Control Policy. Accessed Jan. 10, 2014 http://www.whitehouse.gov/ondcp/prescription-drug-abuse