Transcript Powerful Partnership: The National Guard and Coalitions

Preventing Pharmaceutical Misuse and
Abuse is Everyone’s Business:
A Community Coalition Approach
June 20, 2006
Mary Elizabeth Larson
Vice President, Communications and
Membership, CADCA
CADCA’s Mission
To strengthen the capacity
of community coalitions
to create safe, healthy
and drug-free
communities.
What is a Coalition?
A formal arrangement for cooperation
and collaboration between groups or
sectors of the community, in which
each group retains its identity but all
agree to work together toward a
common goal of building a safe,
healthy and drug-free community.
What is CADCA?
• National, nonprofit, member-based
organization
• Founded in 1992; outgrowth of President
Bush’s Drug Advisory Council
• Core program areas:
– Training & technical assistance, research
& evaluation, communications, public
policy, and meetings
What is CADCA?
• CADCA is the national presence for
coalitions. We take the voice of
coalitions to Capitol Hill.
• CADCA is a strong advocate for
programs that support coalitions.
• CADCA is a leader in training and
technical assistance for coalitions.
CADCA’s Electronic Media:
• Website—www.cadca.org
• Coalitions Online—weekly e-news
– Subscribe at cadca.org
• Research Into Action—Coalition
Institute’s semi-monthly newsletter
– Subscribe at coalitioninstitute.org
Public Policy Issues: SDFSC
• Safe and Drug Free Schools and Communities Funding
in Jeopardy
– Primary source of federal funding for school- based prevention.
– FY 2006 budget request eliminates entire $441 million for the
State Grants portion of the SDFSC program
– Latest markup from House Appropriations Subcommittee
includes $400 million for the State Grants portion of the Safe and
Drug Free Schools and Communities (SDFSC) program
Effective Prevention is Critical
• According to the National Institute on Drug Abuse
(NIDA), addiction is a brain disease.
• Addiction can begin as a developmental disorder
in adolescence, sometimes as early as childhood.
• The younger a person first uses drugs, the higher
their chance of adult drug dependency and
addiction.
Substance Abuse Prevention is a
Good Investment
• Between 2000 and 2010, the youth population
will grow by 10 % adding 8.4 million youth.
• Even if drug use rates remain constant, there will
be a huge surge in drug-related problems
• According to the Journal of Primary Prevention,
the savings per dollar spent on substance abuse
prevention can be substantial and range from
$2.00 to $19.64.
Why Do We Need Drug Prevention
in Schools?
• Student substance use precedes, and is a risk
factor for, academic problems, such as lower
grades, absenteeism and high dropout rates.
• Those who begin using marijuana by age 13 are
more likely to report lower income and lower
level of schooling by age 29.
• School-based prevention programs provide
teachers, parents & students with information
and skills.
Past Month Use of Any Illicit
Drug Has Decreased
22
20
19.4
18.2
18
17.3
16.1
16
14
12
10
8th, 10th and 12th Combined
2001
2002
2003
2004
Percent of 12th Graders Reporting Nonmedical Use of
OxyContin and Vicodin in the Past Year Remained High
12.0
10.5
9.6
Percent
10.0
9.3
8.0
6.0
4.0
5.0
4.5
4.0
2.0
0.0
OxyContin
2002
Vicodin
2003
2004
No year-to-year differences are statistically significant.
Percent of 8th Graders Reporting Lifetime Use of
Inhalants Increased
Percent
25
20
*
15
10
5
0
91 92 93 94 95 96 97 98 99 00 01 02 03 04
8th Grade
* P < .05
10th Grade
12th Grade
NSDUH Highlights—PDA
• 6.3 million persons were current users of
psychotherapeutic drugs taken non-medically
(4.7 M using pain relievers, 1.8 M using
tranquilizers, 1.2 M using stimulants, and 0.3 M
using sedatives.)
• Significant increase in lifetime non-medical use
of pain relievers between 2002 and 2003 among
persons aged 12 or older, from 29.6 million to
31.2 million.
Commonly Abused Prescription
Drugs
• Stimulants, CNS depressants (some used to
treat anxiety and sleep disorders, barbiturates
and benzodiazepines), opioid analgesics.
• Brand names include, but are not limited to:
Lorcet®, OxyContin®, Percocet®, Ritalin®,
Soma®, Valium®, Vicodin®, and Xanax®.
PDA Trends--Youth
• Perception of risk is lower with prescription
drugs
• OTC abuse--DXM
• “Pharming”
– Raiding family medicine cabinets
– OD victims in emergency rooms
• Internet sales
• Real estate open houses
Legally produced drugs…
• Kill more people than all the illicit drugs
(cocaine, heroin, MDMA, GHB, et al) combined!
• Tobacco, the deadliest drug of all, contributes to
more than 400,000 deaths a year.
• Alcohol, contributes to over 100,000 deaths
each year.
Coalition Role in PDA Prevention
• Education and awareness of parents, youth,
coaches, teachers, the medical community, local
law enforcement, clergy, etc.
• Collaboration among all interested parties.
• Keep the issue before the media.
• Become the “firehouse” in your community on
alcohol, tobacco and other drugs.
Use Data to Inform Strategies
• Growing problem, and age of people abusing
prescription drugs is getting younger.
• Problem is much higher among white
Americans.
• Possible coalition actions:
– Q. Is this national data applicable to my community?
– Talk about prescription drug abuse with parents &
kids.
– Consider new places for messaging: professional,
social and civic clubs, workplaces, churches.
Coalition Building 101
•
•
•
•
•
•
•
Define the problem.
Identify the key stakeholders.
Convene a meeting.
Share perspectives.
Discuss the reality vs. the ideal.
Create a vision for your community.
Keep up the momentum!
Roadblocks to Success
• Lack of strong and consistent law enforcement
practices
• New drug monitoring in some states, but not in
others
• Ability to obtain medications via the Internet
• The “Medicating of America”—
commercialization, normalization
• Denial in the community
One Coalition’s Story
• Always lead with data!
– According to Catherine Brunson, Exec. Director of the
Metropolitan Drug Commission, prescription drug
abuse in TN is 4 times the national average.
– Prescription drug abuse represents the second most
common treatment admission, second only to alcohol.
Metropolitan Drug Commission,
Knoxville TN
• Helped to established a TN Prescription Drug
Abuse Task Force
• Used DEA Automated Reports and Consolidated
Orders System (ARCOS) database
• Pulled together TN Medical Foundation, Dept. of
Health and Human Services, law enforcement,
treatment
Coalitions Taking Action:
Knoxville, TN
• Pharmacies
– Local pharmacies agreed to include a brochure on abuse of
medications in every prescription filled
• Schools
– Middle school program--original drama event with group
discussion afterwards
– Called together all PTA presidents to talk about overall drug
strategy
– Added question about prescription drug abuse to local youth
surveys
Coalitions Taking Action:
Knoxville, TN
• Doctors
– Agreement with the medical college of Univ. of
TN to train doctors during their residency
– Must take 4 hours of drug-specific training
provided by the coalition to graduate
Coalitions Taking Action:
Knoxville, TN
• Media
– Coalition hosts a weekly radio broadcast on
Sunday mornings
– Pitches stories to local media; ABC affiliate is
doing a 5-part series
Coalition Advice
• Engage the treatment community as a valuable
resource of information and support.
• Find out what’s important to new partners to
draw them in.
• Reach out to the medical community: work with
local boards of health, doctors, dentists,
pharmacists, nurses.
Coalition Advice
• Get real about your local drug problem!
– Know your local medical examiner.
– Spend a weekend night from 12:00-4:00 am
in a local emergency room.
– Count your pills or lock your medicines up.
– Learn to recognize the signs of misuse and
abuse
Parents: What to Look For
• Changes in friends
• Negative changes in schoolwork, missing school, or
declining grades
• Increased secrecy about possessions or activities
• Use of incense, room deodorant, or perfume to hide
smoke or chemical odors
• Subtle changes in conversations with friends, e.g. more
secretive, using “coded” language
• Change in clothing choices: new fascination with clothes
that highlight drug use
• Increase in borrowing money
Parents: What to Look For
• Evidence of drug paraphernalia such as pipes, rolling
papers, etc.
• Evidence of use of inhalant products (such as hairspray,
nail polish, correction fluid, common household
products); Rags and paper bags are sometimes used as
accessories
• Bottles of eye drops, which may be used to mask
bloodshot eyes or dilated pupils
• New use of mouthwash or breath mints to cover up the
smell of alcohol
• Missing prescription drugs—especially narcotics and
mood stabilizers
CADCA is Here For You!
• For training and technical assistance, email
[email protected]
• For public policy, contact Kelly Lieupo at
[email protected]
• For membership, contact Jennifer Zimmermann
at [email protected]
• For “all things CADCA,” contact Mary Larson
[email protected]; 703-706-0560, Ext. 247
Summary
• Addiction is the #1 preventable public health
threat.
• Prevention works, early intervention saves lives
and treatment and recovery is possible for
everyone.
• Working through a coalition framework builds
local capacity, reduces duplication and connects
multiple sectors to work holistically.