Preven&ng  Prescrip&on  Drug  Abuse  :  

A  Behavioral  Health  Perspec&ve  

Preven&on  and  Prosecu&on    April  3,  2013    

Frances  M.  Harding,  Director  SAMHSA’s  Center  for  Substance  Abuse  Preven&on  

SAMHSA’s  Vision  

•  Behavioral  health  is  essen.al  to  health.  

•  Preven.on  works.  •  Treatment  is  effec.ve.  •  People  recover.  

America  is  a  na.on  that  understands  and  acts  on  the  knowledge  that  …  

SAMHSA’s  Strategic  Ini&a&ves  

 AIM:  Improving  the  Na.on’s  Behavioral  Health  1  Preven.on  2  Trauma  and  Jus.ce  

3  Military  Families  4  Recovery  Support  

 AIM:  Transforming  Health  Care  in  America  5  Health  Reform  

6  Health  Informa.on  Technology  

 AIM:  Achieving  Excellence  in  Opera.ons  7  Data,  Outcomes  &  Quality  8  Public  Awareness  &  Support  

•  Promote  emo.onal  health  •  Reduce  the  likelihood  of  mental  

illness,  substance  abuse  including  tobacco,  and  suicide  

SAMHSA’s  Strategic  Ini&a&ve  #1:  Preven&on  of  Substance  Abuse  and  Mental  Illness  

Crea&ng  communi&es  where  individuals,  families,  schools,  faith-­‐based  organiza.ons,  and  workplaces  take  ac.on  to:  

SAMHSA’s  Strategic  Ini&a&ve  #1:  Preven&on  of  Substance  Abuse  and  Mental  Illness  

Top  Priori&es  •  Prevent  substance  abuse  and  improve  

well-­‐being  in  states,  territories,  tribes  

•  Establish  preven&on  of  underage  drinking  as  a  priority  issue  for  states,  territories,  tribal  en..es,  colleges  and  universi.es,  and  communi.es.  

•  Increase  public  knowledge  of  the  warning  signs  for  suicide  and  ac.ons  to  take  in  response.  –  Surgeon  General’s  Na.onal  Strategy  

on  Suicide  Preven.on  •  Reduce  prescrip&on  drug  misuse  and  

abuse.  

•  About  22  million  Americans  star.ng  nonmedical  pain  reliever  use  since  2002.  

•  Use  is  down  in  10  states  and  did  not  increase  in  any  state.  •  Rate  of  past  year  use  in  Americans  12  or  older  is  4.6  

percent,  but  there  is  geographic  varia.on:  –  3.6  percent  in  Iowa  –  6.4  percent  in  Oregon  

•  Of  10  states  with  highest  2010,  2011  use  rates:  –  7  are  in  the  West  region  

•  Of  the  10  States  with  lowest  rates:  –  4  are  in  the  Midwest  region  –  4  are  in  the  Southern  region  

Prescrip&on  Drug  Abuse  Affects  Everyone  •  Rx,  over-­‐the-­‐counter  medica.ons  

among  the  top  substances  abused  by  12th  graders  in  the  past  year.    

•  In  2011,  more  than  4,500  young  people  per  day  abused  a  prescrip.on  drug  for  the  first  .me.  

•  All  ages  are  affected.  

•  Older  Americans  

•  2009:  approximately  1  U.S.  infant  born  per  hour  with  signs  of  drug  withdrawal.  

•  55  to  94  percent  of  neonates  exposed  to  opioids  in  utero  experience  withdrawal  .  

“ … lukewarm support among parents for some policies that would discourage the abuse of narcotic pain medicines. Only 41 percent of parents said they favor a policy that would require a doctor's visit to obtain a refill on these medicines, and about half do not favor a requirement that unused pain medicine be returned to a doctor or pharmacy.”

Na&onal  Prescrip&on  Drug  Abuse    Preven&on  Strategy  

•  Prescriber  and  consumer  educa.on/awareness.  –  More  than  half,  55  percent,  of  

people  12  and  older  using  prescrip.on  pain  relievers  non-­‐medically  got  them  from  a  friend  or  rela&ve  for  free.  

•  Expanded  and  enhanced  use  of  prescrip.on  drug  monitoring  programs.  

•  Educa.on/awareness  about  safe  disposal  of  unused  medicines.  

SAMHSA’s  Efforts  to  Curb  Prescrip&on  Drug  Abuse  

•  Partnerships  for  Success  grants  •  Prescrip.on  Drug  Monitoring  

Program  grants  

•  Preven.on  of  Prescrip.on  Abuse  in  the  Workplace  (PPAW)  Technical  Assistance  Center  

•  Promo.on  of  DEA’s  na.onal  take-­‐back  day  (April  24,  2013)  

•  Not  Worth  the  Risk,  Even  If  It’s  Legal  series  

How  States  Address  Prescrip&on  Drug  Misuse,  Abuse  

•  34  states:  Rx  drugs  issue  “very  important  or  important”.  

•  11  states:  Rx  drugs  “most  important  issue  they  face”.  

•  29  states  currently  have  a  Rx  drugs  task  force.    

•  7  states  had  a  Rx  drugs  task  force  that  already  completed  its  work.  

•  32  states  passed  Rx  drugs  legisla.on  in  recent  years.  

•  39  states  have  undertaken  public  educa.on  efforts.  

•  Nearly  two-­‐thirds  of  states:  PDMP  data  “very  useful  or  useful”.  

Prescrip&on  Drug  Monitoring  Programs  By  State  

Source:  The  Na0onal  Alliance  for  Model  State  Drug  Laws,  January  2013    

Collabora&on  Is  Key!  Center  for  Substance  Abuse  Preven&on  

Center  for  Mental  Health  Services  

Center  for  Substance  Abuse  Treatment    

Center  for  Behavioral  Health  Sta&s&cs  and  Quality  

hSp://www.samhsa.gov