Marijuana: The changing public opinion 5/12/2014. Mother s little helper: Prescription drug abuse in the 21 st century

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Leonard Butler
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1 Mother s little helper: Prescription drug abuse in the 21 st century Carol Falkowski CEO and Founder Drug Abuse Dialogues St. Paul, Minnesota More kids smoke marijuana than smoke cigarettes In 2013, 16.3%of 12th-graders reported current (past-month) cigarette smoking, compared with 22.9% who reported current MJ use. Marijuana: The changing public opinion 58% of Americans favor legalization 20 states medical MJ CO, WA and Portland, ME recreational MJ 1

2 Other trends: Synthetic drugs Online purchasing of drugs Rx opioid and heroin abuse Most commonly abused prescription medications: Opioids prescribed to treat pain Central nervous system (CNS) depressants prescribed to treat anxiety and sleep disorders Stimulants most often prescribed to treat attention deficit hyperactivity disorder (ADHD). Awash in pills 7 million currently use Rx drugs non-medically Pain relievers 5 million Tranquilizers million Stimulants million Sedatives million Every day in the US, an estimated 2,000 teenagers use prescription drugs without a doctor's guidance for the first time. 2

Are non-refillable and when used properly under a medical doctor's supervision, are safe and effective.

3 PRESCRIPTION OPIOIDS (PAINKILLERS) Opioids are drugs that contain opium, are derived from, or imitate opium: Are used for pain relief and are available only by prescription. Are non-refillable and when used properly under a medical doctor's supervision, are safe and effective. They effectively change the way a person experiences pain. These include: Hydrocodone (Vicodin ), Oxycodone (OxyContin ), Oxymorphone (Opana ), Propoxyphene (Darvon ), Hydromorphone (Dilaudid ), Meperidine (Demerol ), Diphenoxylate (Lomotil ) 219 in

4 12.6 = Florida 11.8 = Tennessee, Nevada 11.6 = Oregon 10.2 = Delaware 9.8 = Maine 9.7 = Alabama 9.2 = Washington, Oklahoma 9.0 = Kentucky 8.1 = Michigan 7.9 = Ohio 7.5 = Idaho 7.2 = Missouri 6.5 = Wisconsin 6.2 = California 5.5= South Dakota 5.0 = North Dakota 4.6 = Iowa 4.2 = Minnesota 3.9 = District of Columbia 3.7 = Illinois US overall = 7.1 Prescription painkillers sold by state per 10,000 population (2010) SOURCE: Automation of Reports and Consolidated Orders System (ARCOS), US Drug Enforcement Administration (DEA), 2010 Diversion Source of pain relievers for most recent nonmedical use among past year users SOURCE: 2011 and 2012 data from the 2012 National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration,

5 Past month nonmedical use of types of psychotherapeutic drugs: million people SOURCE: 2012 National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration, Among persons age 12 and older. Illicit drug use initiates age 12 or older by drug SOURCE: Past year illicit drug initiates, 2010 National Survey on Drug Use and Health, SAMHSA. 5

6 Rates of prescription painkiller sales, deaths and addiction treatment admissions SOURCES: National Vital Statistics System, ; Automation of Reports and Consolidated Orders System (ARCOS) of the Drug Enforcement Administration (DEA), ; Treatment Episode Data Set, Prescription Opioid Abuse. How d we get here? Prescription Opioid Abuse Can be a first step toward heroin use. Greatest increase in heroin use is among young adults aged

OPIOIDS: High abuse potential High addictive potential High overdose potential Plentiful heroin supply fuels nationwide abuse Heroin use among

7 OPIOIDS: High abuse potential High addictive potential High overdose potential Plentiful heroin supply fuels nationwide abuse Heroin use among people age 12 and older: SOURCE: 2012 National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration,

8 Abuse-resistant pills Crush resistant Liquify to gel 8

What everyone can do: Keep Rx medications out of harm s way Signs of opiate overdose: The person can't be awakened Breathing is very slow or not existent Lips

9 What everyone can do: Keep Rx medications out of harm s way Signs of opiate overdose: The person can't be awakened Breathing is very slow or not existent Lips or nails may seem blue, skin gray Gurgling or snoring sound If you encounter an opiate overdose: Call 911 immediately Say, I think someone may have overdosed 9

10 If you encounter an opiate overdose: NARCAN = Naloxone Since 1996: 53,000 people trained 10,000 overdose reversals. Providing opioid overdose education and naloxone to persons who use drugs and to persons who might be present at an opioid overdose can help reduce opioid overdose mortality, a rapidly growing public health concern. SOURCE: What allied professionals can do: Learn: SIGNS AND SYMPTOMS HOW TO ACCESS SERVICES HOW TO IDENTIFY RISK 10

Addressing a drug epidemic: Law enforcement/curtail supply Public, professional education and prevention Access to evidence-based addiction

11 Addressing a drug epidemic: Law enforcement/curtail supply Public, professional education and prevention Access to evidence-based addiction treatment services Medical practitioners: medical education screening pain management Rxing Rx monitoring programs 11

Prescription drug abuse trends. Minnesota s Prescription Monitoring Program. Minnesota Rural Health Conference June 25, 2013 Duluth

Prescription drug abuse trends Minnesota s Prescription Monitoring Program Carol Falkowski Drug Abuse Dialogues www.drugabusedialogues.com Barbara Carter, Manager MN Board of Pharmacy www.pmp.pharmacy.state.mn.us