Education & Advocacy: Building Local Capacity to Prevent Rx Drug Abuse -

1. Educa&on
&
Advocacy
Track:
Building
Local
Capacity
to
Prevent
Rx
Drug
Abuse
Presenters:
Terry
Cline,
PhD,
Commissioner
of
Health,
Oklahoma
Secretary
of
Health
and
Human
Services,
ASTHO
President
Gregg
Raduka,
PhD,
LPC,
ICPS,
Director
of
Preven&on/
Interven&on,
The
Council
on
Alcohol
and
Drugs
Christopher
Wood,
ICPS,
Georgia
DBHDD/Office
of
Preven&on
Moderator:
Regina
M.
LaBelle,
JD,
Chief
of
Staff,
White
House
Office
of
Na&onal
Drug
Control
Policy

2. Disclosures
• Terry
Cline
has
no
financial
rela2onships
with
proprietary
en22es
that
produce
health
care
goods
and
services.
• Gregg
Raduka
has
no
financial
rela2onships
with
proprietary
en22es
that
produce
health
care
goods
and
services.
• Christopher
Wood
has
no
financial
rela2onships
with
proprietary
en22es
that
produce
health
care
goods
and
services.

3. Learning
Objec2ves
1. Iden2fy
three
policy
and/or
programma2c
approaches
to
prevent
prescrip2on
drug
misuse,
abuse,
and
diversion
toward
the
long-­‐term
improvement
of
health
outcomes.
2. Describe
the
role
of
state
health
agencies
in
working
with
other
state
governmental
en22es
and
in
enhancing
collabora2on
with
tradi2onal
and
non-­‐tradi2onal
partners.
3. Build
replicable
ac2vi2es
to
form,
sustain
and
engage
an
ac2ve,
statewide
Rx
preven2on
collabora2ve.

4. Panel Session: Building Local Capacity to Prevent Rx Drug Abuse
Wednesday, April 23, 2014; 1:30 – 2:45 p.m.
Terry Cline, PhD
Commissioner of Health
Oklahoma Secretary of Health and Human Services
ASTHO President

5. Panel Session: Building Local Capacity to Prevent Rx Drug Abuse
Wednesday, April 23, 2014; 1:30 – 2:45 p.m.
Terry Cline has no financial relationships
with proprietary entities that produce health
care goods and services.

7. Source: CDC. Vital Signs: Overdoses of Prescription Opioid Pain Relievers—United
States, 1999-2008. CDC Policy Impact: Prescription Painkiller Overdoses. Available at:
www.cdc.gov/homeandrecreationalsafety/rxbrief/

8. American Academy of Pain Management
American Pharmacists Association
American Association of Poison Control Centers
American Society of Addiction Medicine
PDMP Center of Excellence (Brandeis University)
Centers for Disease Control and Prevention
Clinton Foundation
Federation of State Medical Boards
Kanawha-Charleston Health Department
Maryland Poison Control Center
National Alliance for Model State Drug Laws
National Association of Chain Drug Stores
National Association of County and City Health Officials
National Association of State Alcohol and Drug Abuse
Directors
National Governors Association
National Institute on Drug Abuse
Office of the Army Surgeon General
Ohio Department of Health
Oklahoma State Department of Health
Pennsylvania Department of Drug and Alcohol Programs
Personal Advocate
Pharmaceutical Research and Manufacturers of America
Project Lazarus
Safe States Alliance
Substance Abuse and Mental Health Services
Administration
Tennessee Department of Health
United States Department of Justice
University of Kansas School of Medicine
University of Rochester Medical Center
Vermont Department of Health
White House Office of National Drug Control Policy
Ongoing Work:
Expand and Strengthen Key Partnerships
and Collaborative Infrastructure
Prioritize multi-sector efforts and identify collaborations, partnerships, stakeholders, and
corresponding efforts to address prescription drug abuse.

12. Goal:
Improve health outcomes and reduce human and
economic costs associated with prescription drug
misuse, abuse, and overdose.
Pledge:
Reduce the rate of nonmedical use and the number
of unintentional overdose deaths involving controlled
prescription drugs* 15 percent by 2015.
*(including opioid analgesics, stimulants, tranquilizers, and sedatives)

13. Encourages all S/THOs to apply strategies to achieve
measurable reductions in controlled prescription drug
misuse, abuse, and overdose
Identify at least one policy or program to implement,
improve, or evaluate in the next year
Move beyond “silo-based” approaches to focus on
collaboration with partners to carry out aligned,
comprehensive efforts

15. Metric
TennCare Paid Live
Births1
TennCare non-
LBWT Births
TennCare Live
LBWT Births2 NAS Infants
Number of Births 45,205 40,437 4,768 528
Cost for Infant in First Year of
Life
$350,936,293 $171,336,964 $179,599,329 $33,249,612
Average Cost per Child $7,763 $4,237 $37,668 $62,973
Average Length of Stay (days)
4.8 3.2 18.3 32.5
1 This sample contains only children that were directly matched to TennCare’s records based on Social Security Number.
2 Any infant weighing under 2,500g at the time of birth was considered low birth weight (LBWT).
Infants Born in CY 2011 NAS Infants
Total # of Infants 55,578 528
Total # Infants in DCS 767 120
% in DCS 1.4% 22.7%
Percentage of Newborns in DCS Custody within One Year of Birth, CY 2011
Impact of NAS on Infant Health Care Expenditures, CY 2011

16. Source: Ohio Department of Alcohol and Drug Addiction Services
SFY 2012 Annual Report
This map uses hot spot analysis to display the number of clients
in treatment who list heroin (left), prescription opioids (right) as a
primary drug of choice by zipcode.

17. September 2012 – Governor Mary Fallin’s Prescription Drug Task Force Created
February 2013 – Finalized State Plan
October 2013 – Distributed Opioid Prescribing Guidelines
December 2013 – Governor’s Launch of Plan and Media Campaign
April 2014 – Naloxone Program Begins

18. HB 1781 – Prescription Drug Monitoring Program (PDMP) Access
Grants the Department of Health and the Department of Mental Health and Substance
Abuse Services access to PDMP; shared data may be used for statistical, research,
substance abuse prevention provided that confidentiality is maintained.
HB 1782 – Naloxone
Allows first responders to administer opiate antagonists without a prescription when
encountering a person exhibiting signs of a drug overdose, and allows prescriptions to
family members so they can administer in an overdose situation.
HB 1783 – Emergency Rule Changes Hydrocodone Refills
Limits hydrocodone refills with no automatic refills; new prescription required.
$1.2 million appropriated specifically for prescription drug initiatives annually

19. As of 04/09/2014, 27 states and one territory have accepted the Challenge!
www.astho.org/rx

21. BUILDING LOCAL CAPACITY
National Rx Drug Abuse Summit
April 23, 2014
Gregg Raduka, Ph.D., LPC, ICPS
Director of Prevention/Intervention
The Council on Alcohol and Drugs

22. Disclaimer:
Dr.
Gregg
Raduka
has
no
financial
rela&onships
with
proprietary
en&&es
that
produce
health
care
goods
and
services.

23. Learning Objectives of Dr.
Raduka’s Presentation will
enable attendees to:
1.
Iden2fy
three
policy
and/or
programma2c
approaches
to
prevent
prescrip2on
drug
misuse,
abuse,
and
diversion
toward
the
long-­‐term
improvement
of
health
outcomes.
2.
Build
replicable
ac2vi2es
to
form,
sustain
and
engage
an
ac2ve,
statewide
Rx
preven2on
collabora2ve.

24. Funded by the
Georgia Department of Behavioral Health
and Developmental Disabilities (DBHDD),
Office of Prevention Services & Programs

25. Services
based
on
4
Office
of
Na&onal
Drug
Control
Policy
(ONDCP)
priority
areas:
Educa&on
Advocacy/
Enforcement
Safe
Storage
and
Secure
Disposal
Uses
5
Steps
of
Strategic
Preven&on
Framework
Needs
Assessment
/
Capacity
Building
/
Planning
/
Implementa&on
/
Evalua&on

26. The
Ins&tute
of
Public
Health
at
Georgia
State
University,
in
concert
with
the
Ini&a&ve,
published
a
statewide
Needs
Assessment
re:
Rx
drug
abuse
in
Georgia
during
Year
01.
Tip:
Not
all
Evaluators
can
do
Needs
Assessments.
Needs
Assessment

27. Georgia
Prescrip&on
Drug
Abuse
Preven&on
Collabora&ve
4
Priority
Area
Facilitators
4
Priority
Area
Teams
4
Priority
Area
Ac&on
Plans
Educa&on
/
Advocacy
Safe
Storage
and
Secure
Disposal
Law
Enforcement

28. Collabora&ve
became
Policy
Educa&on
Body
as
one
of
its
func&ons
Major
strides
were
made
in
informing
policy
decisions
of
the
Georgia
General
Assembly
during
their
2013
and
2014
legisla&ve
sessions

29. We
clearly
defined
terms
–
“Advocacy”
used
as
Umbrella
Term
Collabora&ve
Members
informed
about
differences
between
“Lobbying”
and
“Policy
Educa&on”
(See
Handout
for
Defini&ons)
Lobbyists
hired
as
Policy
Educa&on
Advisors

30. Policy
Advisor
created
Tips
for
Communica&ng
with
Legislators
(see
Handout)
Major
Tips:
1. You
are
the
rela&ve
expert
2.
Don’t
be
afraid
to
talk
to
your
legislator

32. In
2013
the
Collabora&ve
was
instrumental
in
gedng
dispenser
Prescrip&on
Drug
Monitoring
Program
(PDMP)
sharing
as
well
as
a
Pill
Mill
bill
passed.
In
2014
the
Ini&a&ve
was
instrumental
in
gedng
prescriber
PDMP
sharing
passed,
helping
to
keep
PDMP
from
possibly
going
offline
in
2015.

33. Media
Awareness
Campaign
Website:
www.StopRxAbuseinGA

38. Drug
Drop
Box
Campaign
The
Council
on
Alcohol
and
Drugs,
with
the
assistance
of
DBHDD,
planned,
funded,
directed
and
executed
the
successful
placement
of
139
law
enforcement-­‐
maintained
Rx
&
OTC
drug
drop
boxes
across
the
state,
making
Georgia
the
leader
in
the
na&on
in
the
number
of
such
drug
drop
boxes.

39. What’s
in
the
Water?
The
Ini&a&ve
will
be
collabora&ng
with
the
Georgia
Water
Associa&on
to
protect
Georgia’s
public
water
supply
from
contamina&on
from
prescrip&on
drugs.

40. Gregg Raduka, Ph.D., LPC, ICPS
graduka@livedrugfree.org
404-223-2483

41. National Rx Drug Abuse Summit
April 23, 2014
Christopher Wood, ICPS
Georgia DBHDD/Office of Prevention

42. Christopher Wood has no financial
relationships with proprietary entities
that produce health care goods
and services.

43. Learning Objective:
o Identify three policy and/or
programmatic approaches to
prevent prescription drug misuse,
abuse, and diversion toward the
long-term improvement of health
outcomes.

44. o SAMHSA PFS II Grant
o High Need/Low Capacity Areas
o Objective & Target Populations
o Strategies /Approach
o ONDCP Rx Plan
o Needs Assessments

45. Strategies:
o Additional Rx Drug Drop Box
o Medicine Safes
o Parenting Classes
o Social Marketing Campaign
o Theater Troupe

46. Strategies:
o Multiple Drug Drop Boxes
o Pharmacy Sticker Shock
o Social Access Campaign
o Movie Theater PSA’s

47. Strategies:
o Additional Rx Drug Drop Box
o Multiple Take Back Events
o “Where’s the Box?” Media Campaign
o Water Ways
o Rx for Understanding

48. Christopher Wood, ICPS
chwood@dbhdd.ga.gov
404-657-2176