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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.
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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.
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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.
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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.
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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.
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
What is Medication Misuse, Abuse, and Dependence?
Misuse by Practitioner
Prescription for inappropriate indication
Unnecessary high dosages
Failure to monitor all medications
Failure to fully explain appropriate use
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
What is Medication Misuse, Abuse, and Dependence?
Abuse by Patient
Use resulting in declining physical and social function
Use in risky situations
Continued use despite
adverse social or personal consequences
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
What is Medication Misuse, Abuse, and Dependence?
Dependence
Use resulting in tolerance or withdrawal symptoms
Unsuccessful attempts to stop or control use
Preoccupation with attaining or using the drug
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
“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
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
“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
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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).
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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
GET INSUREDLIVE HEALTHYPRESCRIPTION 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.
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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.
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
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
GET INSUREDLIVE HEALTHYPRESCRIPTION DRUG ABUSE
Contact Information
Care [email protected]
702.836.9033https://www.facebook.com/CARENVORG
702.293.3313https://www.facebook.com/NCPCOrg
