Rx for Prevention

1. Rx for Prevention

2. Rx for Prevention Prescription Drug Abuse in Clark County a presentation by:

3. 2 3 4 What to Expect: 1 The Facts Commonly Abused Rx Drugs Impact of Rx Drugs and Why Teens Use What you can do

4. Rx Abuse in Clark County: Test your Rx IQ! How much is a bottle of 30, 80 mg tablets of Oxycontin worth on the street? • $50 • $300 • $1000 • $2400

5. Test Your Rx IQ! Answer: • $2400! An 80 mg tablet of Oxy retails for $6.00, but high demand on the street means one tablet can sell for as much as $80.* • Many crimes related to Rx abuse are on the rise, including DUI, Pharmacy robberies and assault.**

6. Test your Rx IQ! Between 1997 and 2005, the number of individual doses of Oxycodone sold in the state of Washington increased by: • 25% • 100% • 300% • 500%

7. Test your Rx IQ! Answer: A 500% increase; from 1,941,270 individual doses to 11,650,127 doses. The number of methadone doses increased by 1,042%, from 918,004 to 10,481,780

8. Test your Rx IQ! Scientists in the Pacific Northwest have found: • Hormones from medicines in lakes and streams in King County • Medicines in the Columbia River • Medicines in the treated wastewater being discharged to local waters of Olympia, Lacey, Puyallup and Tacoma • All the above

9. Test your Rx IQ! Answer: All the above! As you’ve learned from our quiz, Rx abuse affects things we all care about: • Protecting our environment • Safe community • Healthy individuals and families

10. One in 10 high school seniors has mis-used Vicodin in the the past year Rx drugs are the most commonly abused drug among 12-13 year-olds A Rising Concern There are just as many new abusers of Rx drugs as there are for marijuana. OxyContin use by 8th graders doubled in last 4 years

11. Rx Data: True or False? Every day 2500 kids in the U.S. abuse prescription drugs for the first time. 9 out of 10 people who have drug/alcohol problems started using as a teen In 2007, 454 people died of Rx opiate-related overdoses in WA Washington State is ranked #6 in the country for prescription drug abuse

12. “Available Everywhere” • Three in five teens say Rx pain relievers are easy to get from parents’ medicine cabinets • Half of teens say they’re easy to get through someone’s prescriptions • More than half say Rx pain relievers are “available everywhere.”

13. Quiz: Where do teens get Rx Drugs?

14. Access

15. Rx Abuse Kills Drug overdoses have surpassed car accidents as the leading cause of accidental deaths in Washington State – The majority of these overdoses are due to prescription drugs

16. Lifetime Use for Clark County Youth: Alcohol Marijuana Rates of Use Tobacco Rx drugs 73% 55% Cocaine 35% 21% Meth 8% 5% Meth Cocaine Rx Drugs Marijuana Alcohol Tobacco

17. Frequent use: 30 day use 4.6% 9.1% 10.8% Of 8th Graders in Clark County Of 10th graders in Clark County Of 12th graders in Clark County

18. Commonly Abused Drugs • Painkillers/Opiates • Sedatives/Depressants • Stimulants • DXM/Cough Syrup

19. Pain Relievers • Opioids similar to morphine and heroin – Vicodin and Oxycontin are two examples • Users get feeling of euphoria • Medicines can be misused by being crushed and snorted • Some users may transition to heroin • Heroin substitutes, such as methadone

20. Rx tranquilizers/sedatives • Prescription medications that act as central nervous system depressants. Sedatives are “sleeping pills” and benzodiazepines are "tranquilizers.“ • Can be prescribed for acute anxiety, tension and sleep disorders and panic attacks. • When abused, they are swallowed or injected.

21. Rx Stimulants • Stimulants such as Adderall and Ritalin are in same drug category as cocaine methamphetamine • Prescribed for attention deficit / hyperactivity disorder. When used as prescribed, can reduce risk of drug addiction. • Misused as a “study” drug. • Published reports of parents permitting / providing these drugs to kids.

22. Medicines with ‘DXM’ • Some over-the-counter cough and cold medicines contain “dextromethorphan,” or DXM • Medicines are widely available – significant potential for abuse. Abusers take extremely large doses (bottles at a time.)

23. Signs and Symptoms

24. Pain relievers: Symptoms • Drowsiness • Slurred speech • Constricted pupils • Shallow breathing • Nausea • Decreased heart rate, blood pressure and respiration rate • Constipation • Decreased sexual interest/activity • Dependence

25. Stimulants: Symptoms • Loss of appetite / weight loss • Inability to sleep / restlessness • Feelings of hostility, distorted thinking, or paranoia • Irregular heartbeat or heart failure • Increased heart rate/blood pressure • Dangerously High Body Temperature • Hallucinations • Seizures • Dependence and Tolerance

26. Sedatives: Symptoms • Drowsiness/Sleepiness • Slowed Breathing • Confusion/Disorientation • Reduced attention span • Resembles alcohol intoxication • Hallucinations • Seizures • Very Dangerous when mixed with Alcohol

27. Cough Medicine • Dilated pupils • Dizziness • Fever • Hallucinations • High blood pressure • Hot and cold flashes • Psychotic episodes • Rash • Sweating

28. Three Moms

29. Rx Abuse and Development

30. Brain Development • Besides infancy, puberty is a period of rapid growth and brain development. • Rx drug use can impair brain development with no chance of recovery of lost functions. • Drug use during development can decrease memory, school performance and test scores.

31. Brain development 95% of the brain develops by age 6, with completion of the final 5% by age Frontal lobe is last to develop. 25 Frontal Lobe is responsible for: impulse control, judgment, planning, goal setting and predicting consequences.

32. Why teens use: • Easy to get from friends or at home • Seen as safer than other drugs, less stigma • Friends are doing it • Escape problems or self-medicate • Parents less aware of dangers or less likely to disapprove

33. Rx Myths: • It’s safer to abuse Rx drugs than illicit drugs, even if they’re not prescribed by a doctor. • Rx drugs have fewer side effects and are not as addictive. • It’s okay to share

34. Pill Taking Society • Rx medications are all around us; teens notice. • Patients leave the doctor with a prescription in-hand 7 out of 10 visits. • Direct-to-consumer advertising on TV and in magazines.

35. Rx Abuse: “A Sticky Situation”

36. How to reduce Rx Abuse

37. When Talking about Rx Drugs: “Denormalize” the behavior • While 1 in 5 teens are abusing Rx drugs, 4 in 5 are not. Debunk common myths • Just as dangerous and addictive as other substances; even “occasional use” Determine rules and boundaries • Set safety guidelines and controls in your home. • Be aware of your own behaviors, attitudes, and language around Rx use.

38. Keeping Rx meds Safe: Monitor all prescription and OTC medicines. Safely Store and Secure medicines Out of children’s reach and sight. Consider locking them up. Safely Dispose of old or unused medicines.

39. Reduce Access: Safe Disposal Throwing Rx drugs in the garbage is not safe: • Crime around stealing, using, and selling Rx drugs has increased • Drugs can be obtained illegally from your trash • Drugs that go into the toilet end up in our drinking water

40. Safe Medicine Return You can take unwanted controlled meds to safe disposal sites at all Sherriff’s and many Police Precincts, including: Battle Ground Police DepartmentCamas Police DepartmentClark County Sheriff's Office West PrecinctClark County's Sheriff's Office Central PrecinctClark County Sheriff's HeadquartersLa Center Police DepartmentRidgefield Police DepartmentWashougal Police Department For details visit: http://www.clark.wa.gov/recycle/recyclingA-Z.html (Click on “M” for Medicine)

41. Who Can Make a Difference? Who Influenced You? • Parents • Grandparents, aunts/uncles, others • Teachers/Coaches • Friends/peers • School administrators • Guidance counselors • School nurses • School resource officers • Community-based healthcare professionals

42. Take Action Legislative & Policy Efforts • Federal Medicine Return Program • Statewide Medicine Return Program • Prescription Drug Monitoring Program • Education and support for MD’s and other prescribers • Treatment and prevention efforts

43. If you are concerned: If you are concerned that someone you care about might be abusing Rx drugs… • School Nurse, Prevention/Intervention Specialist or Counselor • Clark County Alcohol & Drug Program • WWW.SAMHSA.gov • www.PreventClarkCounty.org

44. Resources Online: Parents: www.theantidrug.com www.drugfree.com Youth: www.abovetheinfluence.org www.sadd.org

45. Sources Used: • Office on National Drug Control Policy, “Prescription for Danger: A report on the troubling trend of prescription and over-the-counter drug abuse among the nation’s teens”. January 2008. • Clark County Medical Examiner’s Office email correspondence. 2009. • Partnership for a Drug Free America. Partnership Attitude Tracking Survey (PATS). 2006. • Substance Abuse and Mental Health Services Administration (SAMHSA), “National Household Survey on Drug Use and Health” (NHSDUH). 2008. • SAMHSA , “Monitoring the Future Survey” (MTF). 2008 • Washington State Department of Health. “Washington State Healthy Youth Survey”. 2008 • Washington State Department Of Social and Health Services, Division of Alcohol and Substance Abuse. “Prescription Pain-Reliever Abuse Among Teens”. 2008. • Washington State Attorney General’s Office, “Prescription Drug Abuse is our new epidemic”. August, 2009.

46. Thank You!