Download “What You Need To Know About Prescription Drugs in York County!”

“What You Need To Know About
Prescription Drugs in York
County!”
January 11, 2012
York County Prevention Collaborative
Presentation
National Problem
 More than 2.5 million Americans 12 and
older began nonmedical use of prescription
drugs in 2008 -- outnumbering first-time
users of marijuana by 300,000.
 About 1 in 10 high school seniors used Vicodin for
nonmedical reasons in the past year.
 More than 1 million adolescents (12-17) and 2.7
million young adults (18-25) needed treatment
for an illicit drug problem in 2008.
 BUT, only about 11 percent of these received
treatment at a specialty facility.
(www.whitehousedrugpolicy.gov); National Survey on Drug Use and Health, 2009)
York County Youth
23% of 9-12th graders have
used Rx drugs without doctor’s
permission at least once.
13% 9-12th graders have used
Rx drugs without permission
in past 30 days.
20% 9-12th graders think there is
little or no risk to taking prescription
drugs that are not prescribed to them.
New data coming out by end of year
Maine Integrated Youth Health Survey, York County 9-12th graders 2009
25%
23%
23%
22%
20%
20%
18%
17%
16%
15%
15%
10%
5%
0%
York County High Schools
Maine High Schools
2004
2006
2008
2009
What is Misuse?
Misuse = “Non-medical use” or any use that
is outside of a medically prescribed regimen
Examples can include:
Taking for psychoactive “high” effects
Taking in extreme doses
Mixing pills
Using with alcohol or other illicit
substances
Obtaining from non-medical sources
Marijuana vs. Prescription RX’s
After marijuana, prescription drugs are the
second most common form of illicit drug abuse
among our nation's teens. Nearly 20 percent of
Maine's high school seniors say they have abused
prescription drugs, frequently taken from the
home of a parent or grandparent.
What drugs are being Misused?
Commonly Misused Rx Drugs
 Opiates: pain-killers:
Ex) Vicodin, Oxycontin, Tylenol Codeine
 CNS Depressants (Sedatives/Tranquilizers):
treat anxiety and sleep disorders
 Ex) Xanax, Ativan, Valium, Soma
 Stimulants: ADHD, weight loss
Ex) Aderall, Ritalin, Concerta, Dexedrine, Fastin
Rx Drug Misuse in the U.S.
6.4 million aged 12+ used a
Rx drug (non-medically) in the past year
4,700,000
1,800,000
S edativ es
1,100,000
272,000
S timulants
P ainkillers
T ranquiliz ers
SPLENDID FOR
Wind, Colic, Griping in the
Bowels, Diarrhea Cholera and
Teething Troubles
Generation Rx
•
•
•
•
•
Rx/OTC med abuse has penetrated teen culture
18% of teens have abused Vicodin
20% tried Ritalin or Adderall without Rx
9% abused OTC cough syrup to get high
Equal or greater abuse of OTC/Rx than cocaine, Ecstasy,
LSD, ketamine, heroin, GHB, ice
• Believe that Rx Meds safer (50%), less addictive (33%)
• Ease of access: medicine cabinets
• “Drugs are fun” vs. “Drugs help kids when they are
having a hard time”
April 21, 2005. Partnership for a Drug Free America. 17th annual study of teen drug abuse. N= 7,300,
error margin +/- 1.5%
Older Adults
An estimated one in five older adults are
negatively affected by combined difficulties with
alcohol and Rx medication abuse.
RX Drug Abuse in Older Adults
• Older Adults account for 1/3 of all medications prescribed in the U.S.
• 7.2 million (21.7%) receive at least 1 Rx annually.
• Older adults use Rx drugs 3 times more than the general population.
• On average, older persons take 4.5 medications per day.
• 2.8 million older adults abuse Rx drugs in the last year.
SAMHSA, 2006; NIDA, 2005
Older Adults Risks Factors
• Prescribed multiple medications.
• Long-term prescriptions can lead
to unintentional misuse - taking
different doses.
• Prescribed inappropriately high
doses.
Side Effects can be Lethal if…
•
•
•
•
Combining Rx & OTC medications.
Taking Rx and OTC meds with alcohol.
Using Rx and OTC with other illicit drugs.
Interactions: Rx & OTC meds with other
physical medications (i.e., HIV or Hepatitis)
Overview
• Three classes of commonly abused Rx drugs
– What are they?
• (opioids, sedatives, stimulants)
What are opioids?
• Opiate: derivative of opium poppy
– Morphine
– Codeine
• Opioid: any compound that binds to opiate receptors
– Semi synthetic (including heroin)
– Synthetic
– Oral, transdermal and intravenous formulations
• Narcotic: legal designation
Morphine
• Routes: oral, intramuscular, intravenous, rectal
• Sustained release preparations:
– MS Contin
– Oramorph
– Kadian
– Avinza
Codeine
•
•
•
•
Opiate (naturally occurring in poppy)
Low potency
Pain relief via 10% conversion to morphine
Most commonly prescribed opioid in the
world
• Probably the most widely used analgesic
– (Excluding aspirin)
Semi synthetic Opioids
• Hydrocodone with Tylenol:
–
–
–
–
•
•
•
•
•
Norco
Lortab
Vicodin
Lorcet
Hydrocodone with ibuprofen: Vicoprofen
Hydromorphone: Dilaudid
Oxycodone with Tylenol: Percocet
Oxycodone with aspirin: Percodan
OxyContin
OxyContin
• Used to treat pain associated with arthritis, lower
back injuries, and cancer
• Most commonly in tablet form: 10mg, 20mg, 40mg,
60mg, and 80mg tablets
• Dosed every 12 hours, half-life 4.5 hours
• Abuse: may be chewed, crushed, snorted or injected
– Eliminates time-release coating
– Enhances euphoria, “rush”
– Increases risk for serious medical consequences
Synthetic Opioids
•
•
•
•
•
Methadone
Demerol (meperidine)
Fentanyl
Suboxone/Subutex (buprenorphine)
Tramadol
– Complex mechanism of action
– Nonscheduled, less abuse potential
Dextromethorphan
• Over-the-counter cough suppressant
• Structurally related to morphine
• Also known as Robitussin
Sedative-Hypnotics
• Benzodiazepines
–
–
–
–
–
–
Librium (chlordiazepoxide HCL)
Valium (diazepam)
Restoril (temazepam)
Klonopin (clonazepam)
Ativan (lorazepam)
Xanax (alprazolam)
• Non-benzo hypnotics
– Ambien (zolpidem)
– Sonata (zaleplon)
– Lunesta (eszopiclone)
• Soma (Carisoprodol)
• Cross-tolerance with alcohol
Prescription Stimulants
• Stimulants (i.e., amphetamines) are often prescribed
to treat individuals diagnosed with attention-deficit
hyperactivity disorder (ADHD).
• Substantial amounts of pharmaceutical amphetamines
are diverted from medical use to non-prescription use.
• Amphetamines increase wakefulness and alertness
and have been used by:
– The military, pilots, truck drivers, and other workers to keep
functioning past their normal limits
Source: Erowid.org
Ritalin
• When used to treat ADHD, patients may report
increased attention, decreased impulsivity, and
decreased hyperactivity.
• Milder stimulant that works by affecting the
levels of chemicals (neurotransmitters) in the
nervous system.
• May also be used in the treatment of
depression in certain cases
• Long-acting form: Concerta
* WebMD
Adderall
• Adderall is used to treat attention deficit
hyperactivity disorder (ADHD).
• Adderall is a combination of stimulants
(amphetamine and dextroamphetamine).
• It increases the ability to pay attention, focus,
and control behavior problems.
• This drug may also be used to treat certain
sleeping disorders (narcolepsy).
Proper Disposal
of
Prescription Drugs
Unused Drugs
• It is estimated that 40 percent of prescription
drugs - particularly pain-killers, antibiotics,
and cardiovascular medicine - that are
prescribed outside of hospitals go unused
every year. Left in the home, they present a
serious health and safety hazard. Flushed
down the drain, they contaminate our waters
and harm wildlife.
Drug Take Back Day
•
•
•
•
April and 0ctober
In conjunction with National and Maine DEA
Disposal paid for by DEA
Coordinated and run by police with help from community
groups/HMPs
• Added evaluation component – survey results
• Maine collected more unused Rx drugs than any other state per
capita - 14,140 pounds on Oct 29th
• Next Drug Take Back Day is April 28, 2012 10:00 AM - 2:00 PM
•
Please go to the US DEA website this March for a Drug Take Back site near you .
• http://www.deadiversion.usdoj.gov/drug_disposal/takeback/index.html
Drug Take Back Day, October 29th Totals
April
Collection Site
Total
LTCFTotal
AGENCY
TOTAL
2011 Totals
16.9
0
16.9
23.5
145.9
20.4
166.3
_
Participant Name
City
Berwick Police Department
Berwick
Biddeford Police Department
Biddeford
Buxton Police Department
Buxton
54.5
0
54.5
78.6
Eliot Police Department
Eliot
79.5
0
79.5
81.3
Kennebunk Police Department
Kennebunk
86.4
11.1
97.5
114.1
Kennebunkport Police Department
Kennebunkport
51.2
0
51.2
46.7
Kittery Police Department
Kittery
38.4
38.2
76.6
50.1
North Berwick Police Department
North Berwick
54.8
0
54.8
62.9
Ogunquit Police Department
Ogunquit
15.9
0
15.9
7.8
Old Orchard Beach Police
Department
Old Orchard
Beach
150.3
0
150.3
106.2
Saco Police Department
Saco
110.4
0
110.4
123.7
Sanford Police Department
Sanford
100.9
0
100.9
73.3
South Berwick Police Department
South Berwick
29.4
11.9
41.3
39.6
Wells Police Department
Wells
74.1
0
74.1
108.7
York County Sheriff's Office
Alfred
61
0
61
101
York Police Department
York
250.8
39
289.8
152.6
1320.4
120.6
1441
1170.1
TOTAL Pounds
2611.1+
Evaluation Results
209 people
responded
(North Berwick and
Berwick not
included)
58 have 1 or
more children
under 21 in
home
“Reducing Prescription
Drug Abuse in York
County:
From Awareness to
Action”
A York County Grant funded by the Department of Public Safety
Project Update
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Facilitate 3 meetings of the
York County Rx Regional Group. 2
Provide ongoing oversight and support to 3 groups (Sanford
area, York Area, Saco area) as needed to insure each will be able
to successfully implement activities.
Develop and distribute information and press releases for local
and regional media outlets in York County that cover prescription
drug abuse issues and prevention efforts being undertaken by the
Rx Task Force Groups and stakeholders in York County.
Research, compile and provide materials to Rx Task Force groups
that will be used in community, parent and youth education and
awareness initiatives.
Project Update
• Design and print 3 regional community awareness campaign
posters in collaboration with the Rx Task Force groups. Rx Task
Force groups will develop concept, use fact-based content,
oversee final layout, print and distribute.
• Coordinate the fall DITEP Training. (Dec 8 and 9, 38 people
registered)
• Provide 4 trainings to a minimum of 100 healthcare providers on
prescription drug abuse and their role in prevention at York
Hospital, Goodall Hospital, Southern Maine Medical and
tentatively the medical students at UNE.
Project Activities ~ Not Begun or Need More Effort
1.
Community awareness campaign poster for your service area,
photographs and youth.
2.
Petition the town council or board of selectmen to adopt a prepared
resolution supporting prescription drug abuse prevention and declaring
a Prescription Drug Abuse Awareness Week.
3.
Provide a minimum of 2 parent education opportunities (PTA
presentation, adult ed., school parent nights, etc. web sites, emails,
phone, youth sports).
4.
Recruit up to 10 educators and law enforcement personnel in your
service area to participate in a York County Drug Impairment Training
for Education Professionals* (DITEP) in Fall 2011.
5.
Assist Project Leaders with disseminating an educational module for
middle and high school teachers in on the dangers of prescription drug
abuse.
Choose To Be Healthy Partnership at York Hospital
serves the Berwicks, Eliot, Kittery, Lebanon, Ogunquit, York and Wells
Coastal Healthy Communities Coalition at University of New England serves Kennebunk, Arundel,
Kennebunkport, Biddeford, Saco, Old Orchard Beach, Dayton, Buxton, Hollis
Partners for Healthier Communities at Goodall Hospital
serves Sanford, Alfred, Lyman, Action, Shapleigh, Waterboro, Springvale, Parsonsfield, Cornish,
Limington
•
Comprehensive community coalitions part of state wide system that promote health and
wellness through policy and environmental change.
•
HMP’s work to reduce the incidence of chronic diseases: cardiovascular disease, diabetes,
cancer, chronic lung disease and substance abuse.
•
Supported by the Fund for a Healthy Maine, Office of Substance Abuse, federal and local
grants.
Project Coordinators/ Contacts
William L. Paterson, M.Ed., C.P.E.
Project Director, Substance Abuse and Chronic Disease Prevention
Coastal Health Communities Coalition at
the University of New England
call 602-3589
email: [email protected]
Sally Manninen, M.A.
Substance Abuse Prevention Coordinator, Choose To Be Healthy Partnership
at York Hospital
call 439-2936
email : [email protected]
Connie Roux,
Prevention Coordinator, Partners for Healthier Communities at Goodall
Hospital
25 June Street, Sanford, Me 04073
Phone 207-490-7704, ext. 311
[email protected]