Rx misuse among ya including pain relievers

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Information by medication misuse among young adults. This was presented by Jennifer Arbour, LMHC at the Substance Use Navigation (SUN) Project in Beverly, MA at the Tewksbury Public Library on 1/15/2014

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Rx misuse among ya including pain relievers

  1. 1. Introduction to Prescription Medication Misuse Among Youth and Young Adults Jennifer Arbour, LMHC Substance Use Navigation (SUN) Project Beverly MA Guest Speaker: Gina Borrazzo Learn to Cope Parent and Community Member Tewksbury, MA January 15, 2013
  2. 2. Keys Goals of Presentation • Identify prescription medications commonly misused by youth and young adults with focus on pain medications • Identify misuse, dependency, addiction • Briefly review developmental vulnerabilities normal to adolescence • Summarize relevant national trends • Identify resources • Parent Share from Learn2Cope • Group Discussion, Q&A 2
  3. 3. The SUN Project Overview • The SUN Project is a new, 3-year program funded by the Tower Foundation that will provide Substance Use Navigation to youth experiencing substance use issues and their families. • A Master’s Level Clinician and paraprofessional team will work directly with families as well as establish tools, resources, and trainings for LHBS staff, school personnel, community members, and families on issues related to substance use and recovery. 3
  4. 4. Key Goals of the Project 1. Train key staff to consistently and thoroughly screen youth for substance use 2. Increase staff skill in motivational interviewing 3. Increase the number of youth referred for substance use treatment 4. Provide resources and support to families. 4
  5. 5. Types of Prescription Medications
  6. 6. Types of Prescription Medications continued Stimulants: used to treat attentional difficulties Drug Name Brand Name Dextro-amphetamine Adderall (among others) Methylphenidate Ritalin, Concerta (among others) 6
  7. 7. Types of Prescription Medications continued Benzodiazepines: used to treat anxiety and panic difficulties. Drug Name Brand Name Diazepam Valium Clonazapine Klonopin Alprazolam Xanax Lorazepam Ativan 7
  8. 8. Types of Prescription Medications Opioids: used to manage pain related to end of life and terminal illness, major bodily injuries and discomforts related to old injuries Three classes: • Natural: chemical compounds from opium poppy plant • Semi-synthetic: created from natural opiates • Fully-synthetic: chemically made 8
  9. 9. Types of Prescription Medications continued Opioids continued Class Brand Name Morphine Natural Drug Name AVINza Kadian MS-Contin Ora-morph Codeine Thebaine (also called paramorphine) 9
  10. 10. Types of Prescription Medications continued Opioids continued Class Drug Name Brand Name Hydrocodone Lortab, Vicodin Hydromorphone Dilaudid, Exalgo Oxycodone OxyContin, Roxicodone, Percocet, Tylox, Percodan Semisynthetic Oxymorphone Opana Diacetylmorphine (heroin) Buprenorphine Butrans 10
  11. 11. Types of Prescription Medications continued Opioids continued Class Drug Name Brand Name Fentanyl Duragesic Fentora Onsolis Meperidine Demerol Methadone Fully Synthetic Tramadol Diskets Dolophine Methadose ConZip Rybix ODT Ryzolt Ultram 11
  12. 12. Misuse, Dependence, Addiction
  13. 13. Misuse Misuse, abuse or nonmedical use of prescription medications include: • Taking prescribed medication without a prescription (i.e. purchased from a dealer, given free from a friend, stolen from a friend or family members medicine cabinet) • Taking prescribed medication in a way that differs from a prescribing doctor’s instructions • Taking prescribed medication in a way other than what it is prescribed for and usually to create a particular experience or feeling • Double doctoring, also known as “doctor shopping”, meaning obtaining prescriptions for medications from different doctors without disclosing other sources for prescriptions within a 30 day period Sources: NIDA Drug Facts 2013; MassTAPP Guide Document: Prevention and Reduction of Opioid Misuse in Massachusetts 2013 13
  14. 14. Dependence and Addiction Source: MassTAPP Guide Document: Prevention and Reduction of Opioid Misuse in Massachusetts 2013 14
  15. 15. Addiction is Complex! 15
  16. 16. The Brain’s Reward Pathway 16
  17. 17. Addiction is characterized by •Compulsive Craving •Seeking Behaviors •Inability to Control Use •Continued Use Despite Negative Consequences 17
  18. 18. Adolescent and Young Adult Development • Brain completes maturation around ages 24-25 • Regions of the brain that control impulses and forward thinking are some of the last regions of the brain that mature • Critical time to develop coping skills for management of emotions and mood 18
  19. 19. Adolescent and Young Adult Development • Substances and prescription medications youth are exposed to today are very powerful. • When considering developmental norms re: adolescence and brain maturation • Casual experimentation can lead to problems regardless of various protective factors. 19
  20. 20. National Trends
  21. 21. Trends continued Ages 12 and older 21
  22. 22. Trends continued • National Survey on Drug Use and Health 2010-2011 findings • Estimate 1 in 22 persons ages 12 or older nationwide used pain relievers nonmedically in the past year • In 2011, more than 11.1 million persons ages 12 or older used pain relievers nonmedically in the past year • Opioid pain relievers among most common substances taken by adults 20 – 59 • Sales of opioid pain relievers quadrupled between 1999 - 2010 Sources: SAMHSA 2012 & 2013; Warner, Chen, Makuc, Anderson, & Minino, 2001; Morbidity and Mortality Weekly Report, 2011 as cited in MassTAPP Guide Document: Prevention and Reduction of Opioid Misuse in Massachusetts 2013 22
  23. 23. Trends continued Source: NIDA Drug Facts, Prescription and Over-theCounter Medications, May 2013 23
  24. 24. Trends continued • Massachusetts Youth Health Survey (YHS) 2011 findings conducted by Massachusetts Department of Public Health • Reports of nonmedical use of prescription medications which included opioid pain relievers Students Lifetime Use Current Use w/in last 30 days High School 14.5% 5.7% Middle School 3.9% 1.4% Sources: MassTAPP Guide Document: Prevention and Reduction of Opioid Misuse in Massachusetts 2013 24
  25. 25. Trends continued 25
  26. 26. Trends continued 26
  27. 27. Prevention
  28. 28. Prevention continued  Assess household safety  Use a locked safe/box to store medications at all times  Dispense medications to your child (even if you trust them)  Regularly monitor prescription medications to make sure you have the correct amount of tablets/pills 28
  29. 29. Prevention continued  Check with your town and/or regional public offices regarding medication disposal initiatives  Consult with your prescribing physicians and/or pharmacist about proper disposal 29
  30. 30. Prevention continued  Consult thoroughly with your prescribing physician, nurse practitioner, oral surgeon, and/or psychiatrist about the addictive potential of recommended medications  Discuss any concerns you have about how family history or other vulnerabilities may contribute to potential misuse and/or addictive tendencies with certain medications 30
  31. 31. Prevention continued  Advocate for your family – Examples  Do we really need a prescription for this type of medication for XX days to treat this injury?  What other alternatives are there for dealing with my child’s situation rather than/ in addition to medication therapy? 31
  32. 32. Prevention continued  Use teachable moments to casually explore your child’s world view on substance use  Discuss current events, media coverage of national and local news, etc • “What do you think about…??”  Relate events back to their life • “What might you do if...??” 32
  33. 33. Prevention continued • Substances and prescription medications youth are exposed to today are very powerful. • When considering developmental norms re: adolescence and brain maturation • Casual experimentation can lead to problems regardless of various protective factors. 33
  34. 34. Resources
  35. 35. Resources continued State Funded Intensive Youth Services in Massachusetts – Abbreviated, see full brochure online at www.mass.gov/dph/bsas - reference handout • 2 Detoxification and Stabilization Units: Inpatient level of care • 5 Residential Programs: 30 to 90 day placements • 3 Recovery Home Programs: Up to 6 month placements • 4 Recovery High Schools: Boston, Brockton, Beverly, Springfield 35
  36. 36. Resources continued For questions and connections regarding youth and young adult treatment Lahey Health Behavioral Services: www.nebhealth.org •SUN Project: 978-867-7137, www.sunprojectma.org Massachusetts Department of Public Health •Bureau of Substance Abuse Services: www.mass.gov/dph/bsas •Office of Youth and Young Adult Services: 617-624-5161 •Central Intake and Care Coordination for Youth Services: 617-661-3991, www.healthrecovery.org City of Lowell, Health Educator, Maria Ruggiero: 978-674-1076 36
  37. 37. Resources continued Parent Support Groups: • Learn to Cope: www.learn2cope.org • Al-Anon Family Groups of Massachusetts: www.ma-al-anon-alateen.org 37
  38. 38. Thank you for listening and take very good care! 38

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