The Four Pillars to Recovery

Opioid Addiction in the United States (Part 1)

Why Naloxone is Important and How to Use It (Part 2)

How Your Prescription Medication Could Lead to Addiction (Part 3)

Welcome to the Community Education Series, hosted by The Recovery Village and Advanced Recovery Systems.

Okay, everybody. Welcome back. It is our fourth webinar with Miss America. Welcome to Mind Your Meds with Miss America and Advanced Recovery Systems. I’m Alison Walsh. I am a proud member of the ARS team, and if this is your first time joining us welcome. We’re thrilled that you’re here. This has been such a wonderful experience for us and an opportunity to continue to raise awareness for mental health, substance abuse and addiction, especially during the month of May, which is Mental Health Awareness Month.

We wanted to do something really special, and so we joined forces with the Miss America organization to be able to increase awareness and have really meaningful conversations around topics pertaining to substance abuse and addiction. It has been an honor and a privilege to be able to collaborate with Camille, and I’m looking forward to her presentation today as always.

So a little bit more about Advanced Recovery Systems. We are a national behavioral health care company. We started about seven years ago in the Central Florida area, but we saw a real need to increase our presence in other communities as well. We have expanded across the nation and have programs in Colorado, Washington, Ohio, Maryland, of course, Florida.

We have several programs, both inpatient, outpatient, and telehealth for adults and adolescents, and we are getting ready to open up in New Jersey this summer. So, really exciting. I have just enjoyed being able to not only work with providers and healthcare professionals, but also in the community as well. When we get to do types of collaborations like this, I am a very happy camper. So without further ado, I’m going to turn it over to Camille, she is the star of the show today and always, and so I’m going to let her jump into her presentation

Today my presentation is a little bit different. For the past three presentations, I’ve been talking a lot about opioids and substance abuse disorders, but this is a Mind Your Meds kind of webinars series. I feel like Mind Your Meds, which is my own personal social impact initiative; I feel like it really has two different branches to it. We have the medication safety piece of it, which we’re going to talk about today, and then we focus a lot on that abuse prevention.

One of the most important things that I’ve learned both in my own personal experience, but also being a doctor or a pharmacy student is that medications, even though maybe they’re prescriptions or they’re over-the-counter, or they’re given to you by a doctor, they can be just as dangerous as using illicit drugs if they’re not used properly. So that is something that I’m really passionate about, and we’re going to talk a little bit about that today. This is less substance abuse, but more, how can you keep your kids especially safe around medications, whether or not it’s your medications or medications you’re giving them. Quite honestly, this is important information for everyone.

So, I love this picture. If you are maybe this mom or this parent who is in the grocery store, you’re that person that flips over maybe the nutritional label, you want to read the nutrition facts on your foods. Maybe you’re a parent that feeds your child only organic foods, or maybe you’re concerned about GMOs. Maybe you want to make sure that your children aren’t getting preservatives.

A lot of parents are really into this right now, I’ve seen a lot of that. There are special sections in our grocery stores that are kind of catered toward this. If you’re the parent that flips over cans and packages in the grocery store, why would you not be just as careful about what kind of medications and what you’re putting in your child’s body when it comes to medicine. It’s not any different. Just because it’s on the shelf or it’s given to you by a doctor or a healthcare provider doesn’t mean that you shouldn’t be conscious of what is in that.

In fact, it’s just as important as ever, if not more important than well, flipping over nutrition facts on food, to know that this is what you’re putting in your child’s body. From, you know, maybe over on the left here we have over-the-counter medications or maybe on the right, we have prescription medications that could be yours or it could be for your child. So these are one in the same, just a little reminder on that.

So, why do we care about this? It seems obvious, but this statistic is really shocking. So among young children, 95% of medication-related poisoning poisoning visits to emergency departments are caused by a child ingesting medication while unsupervised. Approximately 5% are due to dosing errors made by caregivers. So there is a huge issue in terms of children that are unsupervised around medications and also a smaller yet still important, 5% where the caregiver is making an error that is putting that child in a dangerous situation.

Here are some more of these statistics. Medications are the leading cause of child poisoning today. So when we think about poison control, this is why poison control gets a lot of calls. More than 500,000 children under the age of five experience a potential poisoning related to medications. Think about that, that’s 500,000 children. That’s so, so many.

660,000 children are treated in emergency departments due to accidental unsupervised ingestion. More children are brought to the emergency departments for medication poisoning than motor vehicle occupant injuries. This is a common thing that happens. This is not something that I mean, it is random, but it’s not something that’s a rare occurrence. This is happening often.

I want to share this story. This is something that literally happened to me last year. I was in between competing for my local competition to go to Miss Virginia and going there. So I just started my Mind Your Meds initiative, and I have this wonderful friend, she was helping me prepare for Miss Virginia. Her and her husband both own their own companies, they’re busy parents, they have a three-year-old and a one-year-old at this time.

The three year old little girl has what they think is a staph infection on her finger. And so the dad, who’s just a hoot is like, “You’re a doctor Camille, can you look at this?” Of course I am not a doctor and I’m like, “You need to take your daughter to a pediatrician.” Long story short, she had a potential infection on her finger and they gave her medicine.

A special medicine called Augment, and the generic of that is called amoxicillin and clavulanate potassium. It’s a suspension, it comes in that kind of brown bottle over here, or the orangy bottle on the right here. You’ve probably gotten something like this at the pharmacy at some point, whether for yourself or for your child. So the mom asks me, she’s like “Camille, they gave me this weird amoxicillin and it has something else in it.” It was because it was a different medication. She’s like, “something is, something looks weird with it.”

So I had just finished my community pharmacy rotation, and my preceptor had said, you know what’s a really frequent issue that parents have? When you’re busy, your kids are sick, you don’t read the label. A lot of parents forget to put medication in the refrigerator where they don’t realize that they’re supposed to, and it turns dark brown, and that’s when you know that the medication has gone bad and it’s no longer stable. Well, she hands me a dark brown bottle of medication and she picked it up off the counter.

It wasn’t in the fridge. So I immediately realized that it was supposed to be stored in the refrigerator and that she was giving it to her daughter and it wasn’t stored properly. This was a wonderful opportunity to teach her as a parent, but also to understand what parents go through. We taught this in pharmacy school, but until you get in that situation where you’re imagining this mom, with a three-year-old and a one-year-old. The three-year-old has an infection, she’s not paying attention to the bottle. She just wants to give her daughter the medicine.

This is where I get to my first piece of advice, which is read, read, read. What that mom missed was something called an auxiliary label. So if you look at the top right photo, there’s a bunch of little stickers up there. Sometimes they’re preprinted on your pharmacy prescription label. Sometimes a pharmacist actually sticks them on.

They will tell you what to do with the medication, whether or not it’s shaking it, putting it in the refrigerator, making sure that it only goes in your eye and maybe only in your ear. It will tell you the different things that you need to be conscious of when you are taking or giving that medication or how to store it. Really, really important.

So when you get medicine for you or your child, take a minute to breathe, especially if you have multiple children. Take that moment to talk to your child’s doctor. Maybe if you’re at an appointment or when you’re picking up, talk to that pharmacist and make sure that you are clear on how to give the medication, how to take the medication if it’s for yourself, and how to store it properly. All of those pieces are critically important so that that medication is the most effective and safe for whoever’s taking it.

Read the label. Some of us are those people that will put together a piece of furniture without reading the directions, and that doesn’t always go so well. It’s one thing if your furniture doesn’t stay together properly, but it’s another thing if you’ve hurt your child. So take a moment, read the label. If you look on the bottom there’s directions on every label. It says for this one, take one capsule by mouth in the morning and two capsules in the evening.

Make sure you’re clear on those directions and read them every time that you give that medication to make sure that you’re very accurate in understanding what you’re supposed to do. Ask questions if you are not sure what it means. It is always okay. You’re not going to sound silly, you’re not going to sound stupid. It’s always better to ask the question to ensure clarity. Then, every time that you give that medication, especially to a child, make sure that you look at the name.

Imagine you have three or four children, and a couple of them are sick. Think flu season, winter time, kids are sick. Check the name, check exactly what you’re giving that child. Check how much you’re supposed to measure out. Check again and check another time to make sure. Make sure that you are giving your child their medication and not yours.

These are easy things that can be mixed up in the home when it’s more than just you, and it’s really important just to take that extra second to ensure that they’re going to be safe.

So I have a couple of these, I love these. There are a couple of truths or myths and this one is a fun one, not necessarily fun, but you get the point. Here is the statement:

“It is possible to overdose on over the-counter medications like Tylenol.”

I want you each to guests and know you can’t necessarily tell me what you think, but take a minute. Do you think that this is true or do you think it’s a myth? It’s absolutely true. Especially something like Tylenol can be really dangerous if it’s taken in quantities that are larger than the medication label tells you what you should take. It can be dangerous to your liver and to a lot of your organ systems if you take too much of it.

I use this as an example because Tylenol seems really benign. We take Tylenol when we have a headache, take Tylenol maybe when we have a fever, but just because Tylenol is something that you can get over-the-counter does not mean that it cannot be dangerous. If you’re an adult taking Tylenol and drinking alcohol at the same time, that can be a really dangerous situation. So this is meant to show you that just because some things are over-the-counter, it does not mean that it is inherently not dangerous in any way.

Talking about kids again, pain medications like Tylenol or other prescription pain medications are the single most frequent cause of pediatric fatalities reported to poison control. Keep that in mind.

Another tip to keep this from happening, whether or not it’s giving your child too much medication or not giving them any at all, is it is so important to communicate with other caregivers. Maybe if you are a mom and you have a partner in your home, or you’re two parents trying to treat your child together. It’s really important that if there are two people helping to treat that child, that you guys are communicating, or it’s better to just designate one person to be the medication giver.

Imagine this: maybe you don’t know if the medication was given, so you give it to the child, but they’ve already taken it because the other caregiver gave it to them and you guys didn’t communicate that the child gets two doses of medication. Or the opposite happens. “Oh, they must have given it to them, so I’m not going to give it to them.” You both think the same thing. These can both be dangerous.

If a child needs the medication, they need to make sure that they got it effectively, but it’s very dangerous to have two of those doses. Definitely either keep a medication log, maybe even keep a tablet next to kiddos bed and just check off when you’ve given them that medication to make sure that everyone’s on the same page or again, just designate the primary person to give that medication so there is no confusion. Just a couple of little ways and just communicate, communicate, communicate.

Another truth or myth, love this one. The statement is “kitchen measuring devices like tablespoons and teaspoons are effective tools for measuring liquid medications.”

Do you think that you can use these? The answer is no. The answer is absolutely no. This is another huge risk to children in terms of taking medication. Not necessarily just with your soup spoons, but even the ones that you would use for baking that maybe say like one tablespoon, one and a half tablespoons, don’t use those.

They have a huge margin of error. It’s really easy to get confused which spoon you’re using, and they’re not always accurate. They’re not calibrated correctly. Don’t use these to measure medication for your children for any kind of liquid medication.

There’s this little picture up here in the top, right from the CDC, says “spoons are for soup, milliliters are for medicine.” So many times you will get a prescription and it will say, give your child three milliliters of medication in the morning, or it will say some kind of volume. Measure that accurately by using something like a dosing cup right here, which is above my little cross out spoons. Your pharmacist can give you a dosing cup. Even more accurately, you can use a syringe for liquid medication. I think the syringe is the easiest, you can just draw up the medicine, right to the line and give it right to your child.

Those are so important because if you’re not measuring the medicine correctly, that child could get a lot more than what they’re supposed to get, or they could get less than what they need. Dosing is so important for children, especially. Their bodies are not as large as us adults, and so a little too much, a little too less can be really impactful, especially to a child. Definitely make sure that you’re measuring properly. Make sure you’re measuring it all. That’s kind of a scary thing that I’ve seen occasionally. Measure and do it correctly. If you don’t have these things, you can always ask your pharmacist and they will happily give you a proper measuring device.

Here’s another statistic. Approximately 50,000 young children are brought to the emergency room each year because they got into medicines that were left within reach. We talked about this a little bit at the beginning– the unsupervised child, getting into medication and ending up in the hospital. This is a segue into the next most important thing to do with your medications or your child’s medications.

I’ve gotten to partner with the CDC this year in something called their Up and Away program. That pretty much does exactly what it’s named, which is encourages people to put medications up and away from children.

Lock up your medications, number one, to prevent little people or other people in your home from getting into them, especially with opioids or other drugs that could be abused. In general, even when we’re not talking about abuse, keeping them up and away from children can prevent those accidental poisonings that we’re talking about.

Every time you take a medication out, put it back up and away. Just because it’s something maybe that you’re using twice a day, make sure in between that time it goes back up and away from those kids, even if it’s their medication.

Kids are curious so prevent them from being able to get into that. You know, there’s this little picture down here and it says that they can reach it, they can eat it. They might be curious and maybe they like the taste of it, maybe they want more of it, and they don’t understand the danger of it. Putting those things away from those kids is really important. I also put down here these pill organizers, I’ve talked about this in a few of my webinars. These are not child-safe. So if these are being used, they are not exclusive of the Up and Away piece. They need to be stored properly away from children.

Here’s another piece. How many of us have extra medications laying around in our home and especially those within reach and access of our kids? So many patients after surgery have extra medication. Maybe we have extra medication for one reason or another. There are so many reasons that I could talk about why you should safely dispose of your medication, but today the real importance of this is to keep your children safe.

There should be safe disposal locations in your pharmacies, sometimes police stations will take them back. I have participated in national drug take-back day, which happens twice a year. A lot of other local places will take medicines back and dispose of them. There are also some safe disposal tricks that you can do at home like these Detero bags and Rx Destroyer that you can get on Amazon.

Make sure that you are getting rid of medications that you are not using. It is not helping you to keep them around. It could be potentially putting your children at risk. Definitely get them out of your house if you’re not using them. We’re here in quarantine time, you know, social distancing, take the time in your home to clean out your medicine cabinet. It’s really important.

Here’s another one that I talk about a lot with the little ones. You know, we talked to our kids about “don’t put anything in your mouth” and we’re usually talking about making sure that they don’t put dirt in their mouth. Take the time to talk to your little ones about nothing going in their mouth, nothing without asking first, even if they think it’s a treat or if they think it’s candy.

I’ve played this game with probably over 8,000 elementary schoolers and no one ever gets the answer. Not one group gets the answer 100% correct. One of these images is of a pill, the other one is of a piece of candy. This is to show you how incredibly similar candy and pills can look. Especially imagine in grandma and grandpa’s house where maybe those older adults are on more medications, then maybe that you are as a parent, and maybe they’re leaving them out cause they don’t have kids in the house often. How our little ones might find something and think that it is candy and get into a really dangerous situation.

I had a little boy tell me that when he was younger, he took all of his grandfather’s blood pressure medication pills, because he thought that they were tic-tacs because they looked like tic-tacs. He ended up in the hospital. So I want you guys, it’s a little easier when you’re an adult, but this is still kind of hard. Which one of these do you think is the medicine and which one do you think is the candy?

Take a minute and then I’m going to show you.

Okay, so the one on the left is aspirin-free, nighttime pain relief, and the other one is Smarties. Think, if you’re a two-year-old, three-year-old, four-year-old, how similar these can look. If you’re curious and you’re looking for smarties and you find something else, that can be a dangerous situation. So talk to your little ones, always tell them to ask a trusted adult, ask you before they put anything in their mouth, even if they think it’s candy.

This goes back to the education piece of this. It’s important to teach your children what medicine is. It’s not something that they should be afraid of, but it’s something that they should have kind of a respect for and know that it has its purpose, but it can be dangerous if not used correctly.

Never ever tell your kids that medicine is candy. Sometimes we get into this place where it’s hard to give children medications. If we convince them that it’s a piece of candy, it’s a little easier to get it in them. Think about the slide before and maybe how that could be misunderstood by that child, and it’s important that they know that this is not something that they can have. It’s not a treat. This is an important thing that can be potentially harmful for them, and so be honest with your kids and try to help them understand to the best of your ability.

Going into the drug piece of this. Kids are curious and especially teens may want to explore the medicine cabinet to see the effects of those medicines. Be open about drugs with young people in your life. Data shows that the earlier that kids are exposed to the idea that drugs are bad, even though sometimes it seems like we say that a lot, but the earlier they hear that, and the more they hear that the less likely they are to, to decide, to choose to do drugs at any point in their life. It will actually reduce their risk of becoming addicted.

So even if it’s with the really little ones, I’ve learned how to talk to preschoolers about what drugs are and why it’s important to, you know, just like we wash our hands and we drink a lot of water and we eat our vegetables. Just like that, we want to make sure that we don’t take drugs because we’re doing things that are healthy for our bodies. So making that a normal conversation, it makes it less taboo.

The more that they get that information, and maybe if there’s an environment where they feel like they can ask about those things in the home, that’s a really valuable place for them. When we think about why this is really important we think about things like opioids.

They could make one bad decision with a drug, like an opioid and they could risk her life, and so the earlier that they understand that maybe I always say, you know, you can upset your friend and you can say, sorry, or you can upset mom and dad, and you can say, sorry. If you make a mistake with something like that, you don’t necessarily have the opportunity to reverse that or change that.

My mission is really to help prevent the younger generation from becoming addicted to these medications. That’s, I think, the best thing that we can do to fight a lot of the drug abuse that we have in our country right now. We keep those little ones safe, and keep them out of those areas and from touching these substances, we can really combat this issue in a huge way.

So going back to the poison piece of this. If you’re a parent, if you’re a babysitter, if you are ever around young kids, if you’re a teacher, in fact, pretty much everyone, please take a minute and take your phone out. Save the poison control number in your phone. This poison help number can be something that will help to save your child. Understanding that if you’re in a situation where even you think that a child got into something and you’re not sure, make sure to call. You can ask, it’s always okay. If you are wrong, it’s better to be wrong, but it’s better to be safe than, sorry. Never be afraid.

There are wonderful people to work in poison control who will be there to help your child get you through those particular situations whether or not it’s taking your child to a hospital, they’ll help troubleshoot that issue for you. Really an important resource for anyone with little ones.

My last thing is this is a great resource for parents. I talked about this program that is put together by the CDC, it is called the Up and Away program. If you want to learn any more about what I talked about today and talking to your children, making sure that you’re storing your medication safely and keeping your kids safe with medications, go to upandaway.org.
It’s a really, really wonderful resource for parents and kids. So that is what I have today, I’m going to stop sharing my screen. I know we have a few minutes left.

Let me see if there’s any questions. With that, I hope that that was helpful. Alison, I know you have little kids at home, don’t you do?

I do and I was taking notes, you know, my oldest one is so responsible and methodical, whereas like the middle one they’re too little because both of them have to take like Zyrtec, right? For allergies. They’ll down both of them, if they’re right in front of her. So, you know, even thinking about where we’re placing things and you said if you can reach it, they can eat it. Yeah.

You know, it’s scary too, and we do the medication log with them, you know. We have so many different people. Like my mom’s here during the day, my husband and I are shifting, changing, rearranging. If we didn’t keep track of it, and we are busy, right? So you almost sometimes forget what you’ve already done. So really good advice, you know, I think it’s so important.

Then, from the opioid side of things too, and making sure that, or just any prescription drug, rather that we’re doing our part to prevent people from getting their hands on it. That could be a really dangerous situation and potentially lead to some type of a dependence, addiction, et cetera.

So we’re really focused on continuing to spread that message, but I want to thank you on behalf of Advanced Recovery Systems, Camille, it’s been wonderful, such an honor and privilege to be able to collaborate with you. I know you’re going to continue to do amazing things throughout your extended year of service, right?

We hope that we can continue to work together on additional projects, but thank you so much. Just to share a little bit more with the audience too, we have an educational program called Real Talk. We actually started it with the Miss Florida organization about four years ago, and since then we’ve been able to reach over 15,000 students and we’ve been in 60 schools.

It’s been an incredible initiative. Last week actually, we launched our 2020-2021 season and kicked off with another 30 ambassadors. We’re really excited to be able to continue to scale that message across the state of Florida. But if that’s something that you’re interested in bringing to your school, please reach out to us.

Of course, if you’d like to work with Camille, reach out to the Miss America organization. It’s been a true joy and honor. So anyways, thank you everybody again. Remember if you want to keep this conversation going, grab that social graphic that’s in the chat and share it on your social feeds and we will select a winner tomorrow at noon.

If there are any additional questions, feel free to leave them in the chat. We have Stacy Henson who’s one of our outreach coordinators. She’s a licensed clinical social worker, so if there’s a clinical question that you have, please leave it for us and we will make sure to follow up, but thank you again for joining us. It’s been a wonderful month and stay safe out there. Thanks everybody. Bye bye. Thank you.

Thank you for watching this video. We hope you enjoyed the presentation.