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Prescription Drug Misuse, Abuse, and Overdoses

Prescription Drug Misuse, Abuse, and Overdoses. Alcohol and Substance Abuse Council of Jefferson County, Inc. 167 Polk Street, Suite 320 Watertown, New York 13601 Voice: 315-788-4660; Fax: 315-788-4922; Web: www.jcasac.com ; Blog: www.jcasac.com/blog. What is Prescription Drug Abuse? .

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Prescription Drug Misuse, Abuse, and Overdoses

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  1. Prescription Drug Misuse, Abuse, and Overdoses Alcohol and Substance Abuse Council of Jefferson County, Inc. 167 Polk Street, Suite 320 Watertown, New York 13601 Voice: 315-788-4660; Fax: 315-788-4922; Web: www.jcasac.com; Blog: www.jcasac.com/blog

  2. What is Prescription Drug Abuse? • Use of a medication without a prescription • Use in ways other than as prescribed • Use for the experience or feelings elicited Source: http://www.drugabuse.gov/publications/research-reports/prescription-drugs/what-prescription-drug-abuse

  3. Prescription Drug OverdoseDefinition • Type of poisoning • Prescription drugs used in AMOUNTS or IN WAYS NOT recommended • No harm intended by user • Limited number of ingestions by young children or innocent mistakes by patients Source: Public Health Grand Rounds, February 17, 2011, Center for Disease Control and Prevention

  4. Types of Drugs and Reasons for Use • Types of Drugs • Drugs that depress breathing • Opioid pain medication • Sedative/hypnotics • Usually multiple drugs involved • Frequently combined with illicit drugs • Reasons for use • Original use: relief of pain and anxiety • Development of tolerance • Escalated use for “high” Source: Public Health Grand Rounds, February 2011, Center for Disease Control and Prevention

  5. Most Commonly Abused Prescription Drugs OPIOIDS – INDICATED FOR PAIN DEPRESSANTS – INDICATED FOR ANXIETY AND SLEEP DISORDERS Barbiturates Pentobartil sodium (Nembutal) Benzodiazepines Diazepam (Valium) Alprazolam (Xanax) Corvalolum • Hydrocodone (Vicodin) • Oxycontin • Propoxyphene (Darvon) • Diphenoxylate (Lomotil) • Fentanyl Source: www.oasas.ny.gov/StopRxMisuse/comRX.cfm

  6. Increase of Total Number of Opioid Prescriptions, 1991-2010 Source: http://www.drugabuse.gov/publications/research-reports/prescription-drugs/what-are-some-commonly-abused-prescription-drugs

  7. Because of the increase in the number of prescriptions drugs, more medications are available for misuse/abuse and diversion • Prescription drug misuse/abuse and diversion have tremendous impacts on the individual, the community, and the healthcare and judicial systems

  8. Prescription Drug Overdoses - A Public Health Epidemic • 2008 – 15,000 fatal overdoses • 1999 – 4,000 fatal overdoses • 2010 - 1 in 20 people age 12> reported using prescription painkiller for nonmedical reasons in the past year • 2009 – Approx. 500,000 ER visits due to misuse or abuse of prescription medication • 1 Month – Enough prescription painkillers were prescribed in 2010 to medicate every American adult 24/7 for a month • More men than women die of overdoses from prescription painkillers • People in rural counties are 2 times as likely to overdose on prescription painkillers Source: CDC Vital Signs, November 2011

  9. Implications of Pain Medication Deaths In 2008, 14,800 prescription pain medication deaths • For every 1 death there are • 10 treatment admissions for abuse • 32 emergency department visits for misuse or abuse • 130 people who abuse or are dependent • 825 nonmedical users Source: http://www.questdiagnostics.com/dms/Documents/health-trends/PDF-MI3040_PDM-Report_24638_FIN_Digital_4-20-12/PDF%20MI3040_PDM%20Report_24638_FIN_Digital_4-20-12.pdf

  10. Impact of Opioid Pain Medication Abuse Source: http://www.questdiagnostics.com/dms/Documents/health-trends/PDF-MI3040_PDM-Report_24638_FIN_Digital_4-20-12/PDF%20MI3040_PDM%20Report_24638_FIN_Digital_4-20-12.pdf

  11. Projected Impact of Opioid Pain Medication Abuse Using CDC 2008 Death Methodology

  12. Distribution of Narcotic Analgesics to Patients by Health Care Setting, National Percentages Source: Center for Disease Control, Public Health Grand Rounds, National Center for Health Statistics. Vital Health Stat 13 (163). 2006; www.cdc.gov/nchs/data/series/sr_13/sr_13163.pdf

  13. Opioid Pain Medication Use: Sources for nonmedical users, United States, 2009 Source: Public Health Grand Rounds, February 2011, National Survey on Drug Use and Health. Summary of national findings, 2008-2009, www.oas.samhsa.gov

  14. Total Numbers of Deaths from Overdoses, 2000-2012, Jefferson County (January – September 2012) Source: JEFFERSON COUNTY PUBLIC HEALTH SERVICE, MEDICAL EXAMINER PROGRAM, Numbers of Deaths from Total Overdoses; Opiates Overdoses, 2012:. Through September 2012, there have been 8 confirmed overdoses, with another 3 suspected (under review). Of the confirmed cases, 6 are opiates overdoses.

  15. Projected Impact of Opioid Abuse in Jefferson County Using CDC Death Methodology, Jefferson County

  16. Estimated Number (in thousands) of Past Year Users of Prescription Drugs Used Nonmedically, U.S. Residents Ages 12 and Older, 2002-2011 SOURCE: Adapted by CESAR from Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Detailed Tables, 2012. Available online at http://www.samhsa.gov/data/NSDUH/2011SummNatFindDetTables/Index.aspx.

  17. Beginning to Address Prescription Drug Use, Abuse, and Overdoses • Education • Increase Awareness • Safe medication use, storage, and disposal • Education for health care providers • Appropriate prescribing • Adverse events and drug interactions • Identifying those at risk for abuse • Counseling on proper storage and disposal • Screening, intervention, and referral for those misusing or abusing prescription drugs Source: Source: Public Health Grand Round, February 17, 2011, Center for Disease Control and Prevention;

  18. Prescription Drug Monitoring Program (PDMPs) • Tool to identify • Inappropriate prescribing, dispensing, and drug-seeking behavior • Drug interactions and therapeutic duplication • Goals • All states have operational PDMPs • Mechanisms in place for communication between states • High utilization among health care providers • Regular part of office visit like checking insurance coverage Source: Public Health Grand Rounds, February 2011, Center for Disease Control and Prevention

  19. Proper Medication Disposal • Goals • To be easily accessible and an environmentally friendly method of drug disposal • To be cost-effective and not a burden on consumers • To reduce the amount of prescription drugs available for diversion and abuse Source: Public Health Grand Round, February 17, 2011, Center for Disease Control and Prevention

  20. Enforcement • Assist in addressing doctor and pharmacy shopping • Support prescription drug abuse-related training programs for law enforcement Source: Public Health Grand Round, February 17, 2011, Center for Disease Control and Prevention

  21. 911 Good Samaritan Law • Signed into effect on September 18, 2011 • Rationale: To save lives; to grant limited shield from charge and prosecution • In 2008, 900 people died from accidental drug overdoses in New York State • www.drugpolicy.org • http://www.ithaca.edu/sacl/healthpromotion/docs/nysgoodsamaritan.pdf

  22. Next Steps • Discussions • Who needs to be at the table but is not? • Who will invite that person or entity? • Other

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