Wed vs cadca


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Vision Session: Community Anti-Drug Coalitions of America (CADCA): Using the 7 Strategies of Community Change - CADCA's Comprehensive Coalition Approach to Preventing Rx Abuse - Mary Elizabeth Elliott and Sue Thau

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Wed vs cadca

  1. 1. Coali&ons  At  Work:     Implemen&ng  the  Seven  Behavior   Change  Strategies  at  the  Community   Level   ________________________   Sue  Thau,  Public  Policy  Consultant   Mary  Elizabeth  Ellio9,  VP,  Communica<ons,  Membership  &  IT   CADCA   1  
  2. 2. Community  an<-­‐drug  coali<ons  play  a  unique  role  that  involves:   •  Reducing  access  and  availability;   •  Enforcing  consequences;     •  Changing  aMtudes  and  percep<ons;     •  Changing  social  norms;   •  Raising  awareness  about  costs  and  consequences;  and     •  Building  skills  in  youth,  parents  and  communi<es  to  deal  with   these  issues  effec<vely   2  
  3. 3. What  is  a  coali&on?    A  coali<on  is  a  formal  arrangement  for   coopera<on  and  collabora<on  between   groups  or  sectors  of  the  community,  in   which  each  group  retains  its  iden<ty  but   all  agree  to  work  together  towards  a   common  goal  of  building  a  safe,  healthy   and  drug-­‐free  community.   3  
  4. 4.  Coali<ons  convene  and  combine  talent  and   resources  to  address  local  substance  abuse   issues:            Key  Sectors     • Law  enforcement   • Youth   • Parents   • Businesses   • Media   • Schools   • Youth  serving  organiza<ons   • Faith  based  community   • Civic  and  volunteer  groups   • Health  care  professionals   • State,  local  or  tribal  agencies   • Other  organiza<ons  involved   in  reducing  substance  abuse   4  
  5. 5. Environmental  and  Popula&on  Level   Strategies  Are  Effec&ve   Effec<ve  substance  abuse  preven<on  is  comprehensive,   community-­‐wide  and  includes  environmental  and  popula<on   level  strategies  designed  to  change  or  strengthen  norms  against   alcohol  and  drug  use.       Environmental  strategies  involve  changes  in  legisla<on,  policy   and  enforcement  throughout  an  en<re  community.     5  
  6. 6. The  community  coali&on  model,  specifically  the   Drug  Free  Communi&es  program,  has  proven   successful  in  reducing  substance  use/abuse,   including  the  misuse  and  abuse  of  prescrip&on   drugs   6  
  7. 7. DFC  Program   •  Na<onal  program,  created  by  Congress  in  1997   •  Reauthorized  in  2001  and  again  in  2006   •  Recognizes  the  importance  of  mul<sector  comunity   coali<ons  in  reducing  substance  abuse   •  Establishes  funding  for  local  community  coali<ons  –   (local  coali<ons  can  apply  for  up  to  $125,000  dollars   per  year  for  a  period  of  up  to  five  years  -­‐  renewable)   7  
  8. 8. DFC  Program  Requirements   To  be  eligible  to  compete  for  a  DFC  grant,  a  coali&on  must:   •  Have  the  reduc<on  of  substance  abuse  among  youth  as  its   principal  mission,  and  must  target  mul<ple  drugs     •  Have  been  in  existence  for  at  least  6  months   •  Have  representa<on  from  the  each  of  the  12  sectors     •  Be  able  to  demonstrate  through  its  mee<ng  minutes  that  it   func<ons  as  a  unique  en<ty  and  is  more  than  a  group  of   agency  and  organiza<on  representa<ves  or  a  board  of   directors  of  a  direct  service  delivery  organiza<on   •  Coali<ons  are  only  eligible  to  receive  as  much  federal  funding   as  they  can  match,  dollar  for  dollar,  with  non-­‐  Federal  support,   up  to  $125,000     8  
  9. 9. Na&onal  Drug  Free  Communi&es  (DFC)  Program   Evalua&on  Findings   • Past  30-­‐day  use  of  alcohol,  tobacco,  and  marijuana   have  declined  significantly  and  in  all  grade  levels   between  DFC  coali<ons’  first  and  most  recent  data   report.   9  
  10. 10. 10  
  11. 11. These  results  are  being  mirrored  at  the  local   level  in  communi&es  throughout  the   country.     11  
  12. 12. In  this  DFC  community,  past  30  day  use  of  marijuana  use  among  10th   graders  decreased  to  10.6%  in  2010,  a  47.3%  decrease  since  2002.   During  this  same  <me  frame,  according  to  Monitoring  the  Future   (MTF),  the  na<onal  rate  decreased  to  16.7%,  a  6.2%  decrease  since   2002.   12  
  13. 13. • Partnering  with  schools  to  implement  zero  tolerance  policies   related  to  any  substance  that  is  illegal  or  the  abuse  of  legal  drugs   (over  the  counter  drug  or  prescrip<on  drugs);       • Providing  youth  leadership  training  and  parent  educa<on   workshops;  and   • Partnering  with  local  newspapers  to  raise  awareness  about  the   risks/harms  associated  with  illegal  drugs  and  alcohol   Strategies  Implemented  To  Achieve  Reduc&ons   13  
  14. 14. In  this  DFC  community,  past  30  day  use  of  marijuana  use  among  12th  graders   decreased  to  14%  in  2012,  a  36.4%  decrease  since  2004.  During  this  same  <me  frame,   according  to  Monitoring  the  Future  (MTF),  the  na<onal  rate  actually  increased  to   22.9%,  a  15.1%  increase  since  2004.                        2004    2012          Na<onal  MTF  Rate  (2004)  Na<onal  MTF  Rate  (2012)     19.9   22   14   0   5   10   15   20   25   30   35   40   2004    2012   Past  30  Day  Use  of  Marijuana  Among  12th  Graders   Carter  County  Drug  Task  Force   Ashland,  KY   22.9   14  
  15. 15. •  Developing  and  implemen<ng  public   awareness  and  media  campaigns;   •  Increasing  parent  training  and  educa<on;  and   •  Promo<ng  meaningful  opportuni<es  for   youth  par<cipa<on.   Strategies  Implemented  To  Achieve  Reduc&ons   15  
  16. 16. DFC  coali&ons  are  singularly  situated  to  deal   with  emerging  drug  trends,  such  as  the  misuse   and  abuse  of  prescrip&on  drugs  because  they   have  the  necessary  infrastructure  in  place   16  
  17. 17. Keys  To  Pushing  Back  Against  The  Misuse   and  Abuse  of  Rx  Drugs   •  Taking  a  comprehensive,  data  driven  approach   that  appropriately  mobilizes  each  of  the  key   sectors  and  actors  who  have  a  role  in  reducing   access  to  and  availability  of  prescrip<on  drugs   •  Changing  social  norms  about  the  harm  that   misuse  and  abuse  of  these  substances  can  cause   is  also  cri<cal     17  
  18. 18. Seven  Strategies  To  Affect   Community  Change:   Based  on  local  data  and  condi<ons,  coali<ons  implement   mutually  reinforcing  combina<ons  of  seven  strategies  to   achieve  popula<on  level  reduc<ons  in  the  misuse  and  abuse   of  prescrip<on  drugs   18  
  19. 19. Strategy  1:  Providing  informa&on     •  This  strategy  involves  raising  awareness  within  the  community-­‐at-­‐ large  -­‐    to  include  youth,  parents,  police  officers,  healthcare  providers   and  educators,  etc.  –  with  educa<onal  presenta<ons,  workshops  or   seminars  and  data  or  media  presenta<ons.     •  The  goal  is  to  increase  the  knowledge  base  of  the  community  and   raise  general  awareness  around  prescrip<on  drug  abuse.     19  
  20. 20. Strategy  1  In  Ac&on   •  The  Woonsocket  Preven<on  Coali<on  implemented  media  campaigns   to  raise  widespread  awareness  about  the  dangers  of  prescrip<on  drug   abuse  in  their  communi<es.     •  The  Carter  County  Drug  Task  Force  in  Ashland,  Kentucky  distributed   35,000  Push  Cards  on  “Preven<ng  Abuse  of  Prescrip<on  and  Over-­‐the-­‐ Counter  Medica<ons”  and  35,000  Push  cards  distributed  on   “Guidelines  for  Proper  Disposal  of  Prescrip<on  Drugs”.     •  Coali<ons  oren  launch  these  types  of  campaigns  during  Na<onal   Medicine  Abuse  Awareness  Month,  held  every  October.     20  
  21. 21. Strategy  2:  Enhancing  Skills   •  This  strategy  provides  workshops,  seminars   or  other  ac<vi<es  designed  to  increase  the   skills  of  those  who  can  prevent,  iden<fy  and   treat  prescrip<on  drug  abuse,  including:     •  Healthcare  and  dental   providers;     •  Pharmacists;     •  Parents  and  adult  care   givers;     •  Educators;     •  Law  enforcement;     •  Businesses;  and     •  Youth   21  
  22. 22. Strategy  2  In  Ac&on   •  NCADD  of  Middlesex  County  delivered  community  educa<on   presenta<ons  to  enhance  the  skills  of  community  members  who   can  prevent  and  iden<fy  prescrip<on  drug  abuse,  such  as  law   enforcement,  youth,  parents  and  the  medical  community   22  
  23. 23. Strategy  3:  Providing  Support   •  This  strategy  provides  reinforcement  and   encouragement  for  par<cipa<on  in  ac<vi<es   that  prevent  prescrip<on  drug  abuse     •  The  goal  is  to  stop  prescrip<on  drug  abuse   before  it  ever  starts   23  
  24. 24. Strategy  3  In  Ac&on   •  The  Shelby  County  Drug  Free  Coali<on  partnered  with  local   pharmacies  to  distribute  prescrip<on  drug  warnings  to  raise   awareness  about  the  dangers  of  abuse.     24  
  25. 25. Strategy  4:  Enhancing  or  Reducing   Access  and  Barriers   •  This  strategy  u<lizes  the  systems  and  services  that  reduce  illegal   access  to  prescrip<on  medica<ons  while  protec<ng  access  for   those  who  legi<mately  need  medica<ons  to  relieve  pain.     •  It  targets  healthcare  providers,  pharmacists,  law  enforcement   officials,  educators  and  public  health  officials  and  encourages   en<re  communi<es  to  take  ac<on.   25  
  26. 26. Strategy  4  In  Ac&on   •  The  Delaware  Coordina<ng  Council  to  Prevent  Alcohol  and  Other   Drug  Abuse  reduced  barriers  to  proper  medicine  disposal  by   partnering  with  the  Delaware  County  TRIAD  program,  a   community  based  organiza<on  sponsored  by  the  Delaware   County  Sheriff’s  office,  which  provides  proper  disposal  of  unused   and  expired  medica<on.   26  
  27. 27. Strategy  5:  Changing  Consequences   This  strategy  focuses  on  increasing  or   decreasing  the  probability  of  a  specific   behavior  by  changing  the  consequences   (e.g.,  increasing  public  recogni<on  for   deserved  behavior,  individual  and  business   rewards,  taxes,  cita<ons,  fines,  revoca<ons   and  loss  of  privileges).     27  
  28. 28. Strategy  5  In  Ac&on   •  Coali<ons  can  recognize  den<sts  who  have  received   training  on  prescribing  protocols  and  subsequently   prescribe  less  than  the  full  30  day  supply  of  pain   medicine  when  trea<ng  adolescents  who  have  their   wisdom  teeth  removed.   28  
  29. 29. Strategy  6:  Changing  Physical  Design   •  This  strategy  focuses  on  safeguarding  prescrip<on   medicines  to  ensure  that  they  will  not  be  misused   and  abused,  and  targets  everyone  in  the   community.     •  It  involves  changing  the  physical  design  or  structure   of  the  environment  to  reduce  access  and   availability.     29  
  30. 30. Strategy  6  In  Ac&on   •  The  Cherokee  Na<on  installed  a  permanent  medicine  drop  off   box  in  the  lobby  of  their  police  sta<on     •  It  also  partnered  with  local  homebuilders  to  ensure  that  the   installa<on  of  one  locking  medicine  cabinet  is  standard  in  every   new  home  that  is  built.     •  The  Jackson  County  An<-­‐Drug  Coali<on  purchased  an  incinerator   to  dispose  of  all  returned  medicines  in  their  community.     30  
  31. 31. Strategy  7:  Modifying  and  Changing   Policies   •  This  strategy  is  aimed  at  changing  policies,  laws  and   procedures  to  prevent  current  and  future  prescrip<on  drug   abuse.     •  The  target  audience  includes  lawmakers,  state  and  local   public  officials,  employers  and  others  involved  in  seMng  rules   and  regula<ons.     31  
  32. 32. Strategy  7  In  Ac&on   •  In  carrying  out  this  strategy,  coali<ons  oren  support  the  passage   and  u<liza<on  of  prescrip<on  drug  monitoring  programs,  drug   take-­‐back  and  disposal  legisla<on,  statutes  that  support   increased  penal<es  against  doctors  who  prac<ce  unscrupulous   prescribing  procedures,  those  who  par<cipate  in  doctor   shopping,  etc.     32  
  33. 33. Strategy  7  In  Ac&on   •  The  Metropolitan  Drug  Commission  submi9ed  an  applica<on   through  the  State  of  Tennessee  for  a  planning  grant  to:   1)  Develop  a  statewide  prescrip<on  drug  task  force  to  assist  in  the  early  detec<on,   interven<on  and  preven<on  of  prescrip<on  drug  abuse  and  addic<on;     2)  Educate  both  the  health  care  community  and  the  public;  and     3)  Assist  law  enforcement  with  access  to  the  developing  state  Prescrip<on  Drug  Program   created  through  the  Controlled  Substance  Monitoring  Act  of  2002.     33  
  34. 34. DFC  coali&ons  have  achieved  major   results   34  
  35. 35. In  this  DFC  community,  past  30  day  non-­‐medical  use  of  prescrip<on  drugs  decreased  at   a  rate  of  88.9%  among  10th  graders;  83.3%  among  12th  graders.     9   12   3   3   1   2   0   2   4   6   8   10   12   14   10th  Grade   12th  Grade   Carter  County  Drug  Task  Force   Grayson,  KY   Past  30  day  Non-­‐Medical  Use  of  Prescrip&on  Drugs   Among  10th  and  12th  Graders   2004   2010   2012   35  
  36. 36. •  Partnered  with  local  law  enforcement  to  implement  take  back  events  and   increase  DUI/drug  suppression  checks;     •  Provided  funding  for  law  enforcement  agencies  to  receive  drug  suppression   training;   •  Implemented  a  social  norms  media  campaign;     •  Provided  educa<on  to  parents,  teachers,  youth  and  healthcare  professionals;   and   •  Convened  a  key  leader  community  forum  to  educate  elected  officials  about  the   growing  prescrip<on  drug  problem   Strategies  Implemented  To  Achieve  Reduc&ons   36  
  37. 37. 18 7 0 5 10 15 20 25 Barrington Prevention Coalition (BAY TEAM) Barrington, RI Past 30 Day Non-Medical Use of Prescription Drugs Among 12th Graders In  this  DFC  community,  past  30  day  non-­‐medical  use  of  prescrip<on  drugs  decreased  at   a  rate  of  61.1%,  from  18%  in  2009  to  7%  in  2011.     ■2009  ■2011   37  
  38. 38. •  Partnered  with  local  law  enforcement  to:  1)  implement  three   take  back  events;  and  2)  distribute  “you  should  know”  le9ers   to  the  peers  of  any  youth  arrested  for  a  substance  abuse   related  offense   •  Provided  parent  educa<on   •  Developed  and  disseminated  a  brochure  on  the  dangers   associated  with  the  misuse  and  abuse  of  prescrip<on  drugs   Strategies  Implemented  To  Achieve  Reduc&ons   38  
  39. 39. CADCA’s  OTC  and  Rx  Drug  Abuse     Recommenda<ons  and  Resources   39  
  40. 40. OTC  and  Rx  Drug  Abuse  is  a  Concern   for  CADCA  Coali<ons     In  our  2013-­‐2013  Annual  Survey  of  Coali<ons  we   asked…   Does  your  coali<on  collect  data  on  any  of  the   following  substances?   •  Cough  medicine  –  25.31%   •  Hydrocodone  –  39.17%   •  Oxycodone  –  47.24%   •  Prescrip&on  drugs  (not  Hydro/Oxy)  –  74.54%   40  
  41. 41. OTC  and  Rx  Abuse  A  Concern,  Cont.     Rank  of  the  top  5  substances  that  are  causing   the  most  problems  in  your  community?   •  Cough  medicine  –  3.1%   •  Hydrocodone  –  17.36%   •  Oxycodone  –  28.43%   •  Prescrip&on  drugs  (not  Hydro/Oxy)  –  66.05%   41  
  42. 42. OTC  and  Rx  Abuse  A  Concern,  Cont.     Which  of  the  following  substances  is  your   coali<on  currently  addressing?   •  Cough  medicine  –  11.31%   •  Hydrocodone  –  24.32%   •  Oxycodone  –  30.41%   •  Prescrip&on  drugs  (not  Hydro/Oxy)  –  58.7%   42  
  43. 43. 1.  Expand  effec<ve  Prescrip&on  Drug  Monitoring  Programs  to   ensure  adequate  coverage  in  every  state  and  interoperability  to   share  data  where  appropriate.   2.  Enhance  educa<on  and  training  of  medical  and  dental   professionals  in  proper  prescribing  protocols.   3.  Raise  the  general  public’s  awareness  about  the  dangers  of   prescrip<on  drug  abuse  as  well  as  the  proper  ways  to  store  and   dispose  of  them.   4.  Enhance  opportuni<es  for  prescrip<on  take  back  and  other   large  scale  disposal  programs.   CADCA Recommendations 4343  
  44. 44. Recommenda&ons,  Cont.   5.  Support  increased  law  enforcement  and  legal  remedies  to   close  down  “pill  mills.”   6.  Require  manufacturers  to  create  abuse  deterrent   formula&ons  for  commonly-­‐abused  prescrip&on  painkillers.   7.  Expand  the  number  of  DFC  funded  communi&es  and   train  more  communi&es  to  implement  comprehensive,  data   driven  strategies  to  effec<vely  address  their  local   prescrip<on  drug  abuse  problems.   1144  
  45. 45. CADCA  Supports  the  Office  of  Na4onal   Drug  Control  Policy  (ONDCP)  Plan       and     the  Na4onal  Governor’s  Issue  Brief  “Six   Strategies  for  Reducing  Prescrip4on   Drug  Abuse”   4545  
  46. 46. CADCA’s  Resources  and  Ac&on        Published  first  Rx  abuse  preven<on  toolkit  in  2002    Dose  of  Preven<on  Toolkit  on  cough  medicine  abuse  in  2006    Town  hall  mee<ngs     with  partner  CHPA    Informa<onal  video  developed  for  communi<es    5  CADCA  TV  shows    Strategizer  publica<on  with  ONDCP  in  2008    Rx  Abuse  Preven<on  Toolkit:  From  Awareness  to  Ac<on  in  2010Na<onal   Medicine  Abuse  Awareness  Month    General  Dean  tes<fies  before  Congress      Hosted  two  half-­‐day  Rx  specific  trainings  at  the  2012  Mid-­‐Year      New  online  course  launched  October  2012   2846  
  47. 47. No-­‐Cost  Online  Medicine  Abuse     Preven&on  Course  for  Coali&ons   47 •  hkp://   •  10  modules  –  es<mated  6  hours  to  complete   •  Cer<ficate  upon  comple<on,  con<nuing   educa<on  credits.     •  Take  the  course  at  no  cost  –and  give  us   feedback  at   47  
  48. 48. Na&onal  Medicine  Abuse  Awareness  Month   •  CADCA’s  partner  is  the  Consumer  Healthcare   Products  Associa<on     •  Annual  CADCA  50  Challenge  encourages   coali<ons  to  host  educa<onal  events  in  October.   •  56  coali<ons,  represen<ng  35  states  par<cipated   •  Our  Dose  of  Preven<on  Award  recognizes  best   coali<on  outreach  on  OTC  and  Rx  Medicine   Abuse  Preven<on  each  year  at  the  CADCA   Forum.     •  CADCA  hosts  town  hall  mee<ngs,  Twi9er  chats,   and  webinars    each  October  to  raise  awareness.   30 48  
  49. 49. New  Partnerships  in  Rx  Drug  Abuse   Preven<on  a  focus  at  CADCA’s  Mid-­‐Year   Training  Ins<tute     •  An  in-­‐depth  and  unique  coali<on   training  experience,  featuring  1,   2  and  4-­‐day  courses.   •  Average  a9endance  is  1800.   •  July  21-­‐24,  2014  in  Orlando,  Fla.     •  Rx  courses  will  focus  on  unique   partnerships;  statewide   ini<a<ves/plans  and  new  places   coali<ons  can  have  an  impact   49  
  50. 50. Visit  us  on  the  Web  at   Call  us  at  1-­‐800-­‐54-­‐CADCA   Email  Membership:     Email  Training  and  TA:   Join  us  via  Social  Media:   Facebook:   Twi9er:  @cadca   Connected  Communi<es  Network:  h9p:// connectedcommuni<   YouTube:   Flickr:   Linkedin:  Linkedin/company/cadca   Stay Connected with CADCA 5050