Prescription Drug Abuse Presentation

CARE Nevadain collaboration with

Nevada Community Prevention Coalitionpresent

PRESCRIPTION DRUG ABUSE

GET INSURED LIVE HEALTHYand

GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE

WHO WE ARE and WHAT WE DO | CARE Nevada

In the pursuit of building healthy communities, CARE is committed to:a) improve the health of Nevadans by helping them get insuredb) helping Nevadans receive resources to help live healthy lives

CARE’s commitment to our community is based on collaboration by working with the business community, agencies and groups to

systematically solve existing and emerging problems that as individuals we would not be able to solve.

A healthy community is a productive community.


WHO WE ARE and WHAT WE DO | NCPC

In the pursuit of building healthy communities, NCPC is committed to:a) promoting collaboration towards individual, family, and community wellnessb) providing funding for direct prevention services in rural Clark County

NCPC is a comprehensive community coalitionthat brings together every community sector

to support the development and implementationof multi-faceted plans that lead to

individual, family, and community health and wellness.


The Problem with Rx Abuse

Prescription drug abuse is the Nation’s fastest-growing drug problem.

While there has been a marked decrease in the use of some illegal drugslike cocaine, data from the National Survey on Drug Use and Health(NSDUH) show that nearly one-third of people aged 12 and over whoused drugs for the first time in 2009 began by using a prescription drugnon-medically.

The same survey found that over 70 percent of people who abusedprescription pain relievers got them from friends or relatives, whileapproximately 5 percent got them from a drug dealer or from the Internet.

Additionally, the latest Monitoring the Future study—the Nation’s largestsurvey of drug use among young people—showed that prescription drugsare the second most-abused category of drugs after marijuana.


What is Prescription (Rx) Drug Misuse and Abuse

Prescription (Rx) Drug Misuse is:

the use of a prescription medication in a way not intended by the original prescribing doctor.

the use of prescription medications originally prescribed for another person.

Prescription (Rx) Drug Abuse is:

the use of a prescription medications without a prescription

the use of prescription medications in a way other than was prescribed

the use of prescription medications to get high


Prescription (Rx) Medications are all around us . . .and youth notice

Patients leave a doctor’s office with a prescription in hand in 7 out of 10 visits.

Direct-to-consumer advertising on TV and in magazines is pervasive.

Many people don’t know how to safely use these medications or ignore their doctor’s instructions.


Did you know that Prescription (Rx) Drugs Can . . .

Increase blood pressure or heart rate.

Damage the brain and other organs.

Lead to accidental overdose / poisonings.

Cause physical dependency and / or addiction.

Disrupt breathing (respiratory depression).

Lead to risks associated with mixing multiple drugs or combining with alcohol.

Cause seizures and even death.


What is Medication Misuse, Abuse, and Dependence?

Misuse by Patient

Dose level more than prescribed

Longer duration than prescribed

Used for purposes other than prescribed

Used together with other meds/alcohol

Skipping/hoarding doses



Misuse by Practitioner

Prescription for inappropriate indication

Unnecessary high dosages

Failure to monitor all medications

Failure to fully explain appropriate use



Abuse by Patient

Use resulting in declining physical and social function

Use in risky situations

Continued use despite

adverse social or personal consequences



Dependence

Use resulting in tolerance or withdrawal symptoms

Unsuccessful attempts to stop or control use

Preoccupation with attaining or using the drug


Factors associated with prescription drug misuse/abuse in older adults

Female gender

Social isolation

History of a substance abuse

History of or mental health disorder – older adults with prescription drug dependence are more likely than younger adults to have a dual diagnosis

Medical exposure to prescription meds with abuse potential


Prescription Drug Abuse in Older Adults

Reduced ability to absorb & metabolize meds with age

Increased chance of toxicity or adverse effects

Med-related delirium or dementia wrongly labeled as Alzheimer’s disease


“Symptoms” of Medication-Related Problems Due to Misuse/Abuse

Confusion

Depression

Delirium

Insomnia

Parkinson’s-like symptoms

Incontinence

Weakness or lethargy

Loss of appetite

Falls

Changes in speech


“SIGNS” of Prescription Drug Misuse/Abuse

Loss of motivation

Memory loss

Family or marital discord

New difficulty with activities of daily living (ADL)

Difficulty sleeping

Drug seeking behavior

Doctor shopping


Identifying High Risk “Older” Adults

Use of certain medications (e.g., warfarin, digoxin, diuretics, psychoactive meds, analgesics)

4 or more medications

Certain chronic conditions (e.g., diabetes)

Evidence of medication misuse

Chronic alcohol use


Medications to Target in Substance Abuse Interventions

1. Central Nervous System (CNS) DepressantsAntianxiety Medications, Tranquilizers, Sedatives and Hypnoticsa) Benzodiazepinesb) Barbiturates

2. Opioids and Morphine DerivativesNarcotic Analgesics / Pain Relieversa) Codeineb) Hydrocodonec) Oxycodoned) Morphinee) Fentanylf) Meperidine


Sedative Misuse and Abuse

a) Self-medicating hurts and losses will lead to changes in lifestyle

b) Doctors prescribe benzodiazepines to seniors more than any other age group

c) Behavioral pharmacological profile of sedatives is similar to benzodiazepines

d) Prolonged use or self-medication will lead to Prescription Drug Addiction

e) Illegal street retail of RX meds has an alluring profit making component

f) Sedatives are recommended for short-term use but many take meds long-term

g) Sedatives can cause hazardous confusion & falls


Prescribing and Use Patterns for Benzodiazepines

Older primary care patients (aged >/= 60) who received new benzodiazepine prescriptions from primary care physicians for insomnia (42%) and anxiety (36%)

After 2 months, 30% used benzodiazepines at least daily

Both those continuing and those not continuing daily use reported significant improvements in sleep quality and depression, with no difference between groups in rates of improvement

A significant minority developed a pattern of long-term use


Opioid Misuse/Abuse

Use pain medicine to sleep, relax, soften negative affect of life Dose requirement reduced with age

Reduced GI absorption Reduced liver metabolism Change in receptor sensitivity

Short-acting are the most easily & widely available Defeat extended-release mechanism Problems

Sedation, confusion Respiratory depression


Alcohol and Medication Misuse

An estimated one in five older adults may be affected by combined difficulties with alcohol and medication misuse.

Alcohol-medication interactions may be a factor in at least 25% of ED admissions (NIAAA, 1995).


Our Challenge:

Nevada has the Fourth Highest Drug Overdose Mortality Rate in the United States

Nevada Scored Seven out of 10 on New Policy Report Card of Promising Strategies to Help Curb Prescription Drug Abuse


Our Solution:

Educate the public to understand the risks of prescription drug use to avoid misuse in the first place.

Ensure responsible prescribing practices, including increasing education of healthcare providers and prescribers to better understand how medications can be misused and to identify patients in need of treatment.

Increase understanding about safe storage of medication and proper disposal of unused medications, such as through "take back" programs.

Make sure patients do receive the pain and other medications they need, and that patients have access to safe and effective drugs.


Goals:

Expand prevention services into the most sparsely populated rural areas of Clark County.

Increase prescription drug and wellness education across all rural populations of Clark County.

Create community readiness through education and discussion for the adoption of a bill specific to administering rescue medications, such as Naloxone, to overdosing individuals. This does not include a cost factor.

Increase the voluntary use of the Prescription Medical Program (PMP) through promotion and education.


Game Plan

Provide group seminars about RX use and abuse

Provide support groups for users and family

Provide literature to local business and organizations

Provide referral to mental health providers and sources

Collaborate with community partners


Contact Information

Care [email protected]

702.836.9033https://www.facebook.com/CARENVORG

[email protected]

702.293.3313https://www.facebook.com/NCPCOrg

Prescription Drug Abuse Presentation

Health & Medicine

Transcript of Prescription Drug Abuse Presentation