National Rx Drug Abuse Summit, April 2-4, 2013. General Session presentation, "Prevention and Prosecution," Frances M. Harding, Director, Center for Substance Abuse Prevention, SAMHSA

1. Preven&ng
Prescrip&on
Drug
Abuse
:
A
Behavioral
Health
Perspec&ve
Preven&on
and
Prosecu&on
April
3,
2013
Frances
M.
Harding,
Director
SAMHSA’s
Center
for
Substance
Abuse
Preven&on

2. SAMHSA’s
Vision
• Behavioral
health
is
essen.al
to
health.
• Preven.on
works.
• Treatment
is
effec.ve.
• People
recover.
America
is
a
na.on
that
understands
and
acts
on
the
knowledge
that
…

3. SAMHSA’s
Strategic
Ini&a&ves
 AIM:
Improving
the
Na.on’s
Behavioral
Health
1
Preven.on
2
Trauma
and
Jus.ce
3
Military
Families
4
Recovery
Support
 AIM:
Transforming
Health
Care
in
America
5
Health
Reform
6
Health
Informa.on
Technology
 AIM:
Achieving
Excellence
in
Opera.ons
7
Data,
Outcomes
&
Quality
8
Public
Awareness
&
Support

4. • Promote
emo.onal
health
• Reduce
the
likelihood
of
mental
illness,
substance
abuse
including
tobacco,
and
suicide
SAMHSA’s
Strategic
Ini&a&ve
#1:
Preven&on
of
Substance
Abuse
and
Mental
Illness
Crea&ng
communi&es
where
individuals,
families,
schools,
faith-­‐based
organiza.ons,
and
workplaces
take
ac.on
to:

5. SAMHSA’s
Strategic
Ini&a&ve
#1:
Preven&on
of
Substance
Abuse
and
Mental
Illness
Top
Priori&es
• Prevent
substance
abuse
and
improve
well-­‐being
in
states,
territories,
tribes
• Establish
preven&on
of
underage
drinking
as
a
priority
issue
for
states,
territories,
tribal
en..es,
colleges
and
universi.es,
and
communi.es.
• Increase
public
knowledge
of
the
warning
signs
for
suicide
and
ac.ons
to
take
in
response.
– Surgeon
General’s
Na.onal
Strategy
on
Suicide
Preven.on
• Reduce
prescrip&on
drug
misuse
and
abuse.

6. • About
22
million
Americans
star.ng
nonmedical
pain
reliever
use
since
2002.
• Use
is
down
in
10
states
and
did
not
increase
in
any
state.
• Rate
of
past
year
use
in
Americans
12
or
older
is
4.6
percent,
but
there
is
geographic
varia.on:
– 3.6
percent
in
Iowa
– 6.4
percent
in
Oregon
• Of
10
states
with
highest
2010,
2011
use
rates:
– 7
are
in
the
West
region
• Of
the
10
States
with
lowest
rates:
– 4
are
in
the
Midwest
region
– 4
are
in
the
Southern
region

7. Prescrip&on
Drug
Abuse
Affects
Everyone
• Rx,
over-­‐the-­‐counter
medica.ons
among
the
top
substances
abused
by
12th
graders
in
the
past
year.
• In
2011,
more
than
4,500
young
people
per
day
abused
a
prescrip.on
drug
for
the
first
.me.
• All
ages
are
affected.
• Older
Americans
• 2009:
approximately
1
U.S.
infant
born
per
hour
with
signs
of
drug
withdrawal.
• 55
to
94
percent
of
neonates
exposed
to
opioids
in
utero
experience
withdrawal
.

8. “ … lukewarm support among parents for
some policies that would discourage
the abuse of narcotic pain medicines.
Only 41 percent of parents said they
favor a policy that would require a
doctor's visit to obtain a refill on
these medicines, and about half do not
favor a requirement that unused pain
medicine be returned to a doctor or
pharmacy.”

9. Na&onal
Prescrip&on
Drug
Abuse
Preven&on
Strategy
• Prescriber
and
consumer
educa.on/awareness.
– More
than
half,
55
percent,
of
people
12
and
older
using
prescrip.on
pain
relievers
non-­‐medically
got
them
from
a
friend
or
rela&ve
for
free.
• Expanded
and
enhanced
use
of
prescrip.on
drug
monitoring
programs.
• Educa.on/awareness
about
safe
disposal
of
unused
medicines.

10. SAMHSA’s
Efforts
to
Curb
Prescrip&on
Drug
Abuse
• Partnerships
for
Success
grants
• Prescrip.on
Drug
Monitoring
Program
grants
• Preven.on
of
Prescrip.on
Abuse
in
the
Workplace
(PPAW)
Technical
Assistance
Center
• Promo.on
of
DEA’s
na.onal
take-­‐
back
day
(April
24,
2013)
• Not
Worth
the
Risk,
Even
If
It’s
Legal
series

11. How
States
Address
Prescrip&on
Drug
Misuse,
Abuse
• 34
states:
Rx
drugs
issue
“very
important
or
important”.
• 11
states:
Rx
drugs
“most
important
issue
they
face”.
• 29
states
currently
have
a
Rx
drugs
task
force.
• 7
states
had
a
Rx
drugs
task
force
that
already
completed
its
work.
• 32
states
passed
Rx
drugs
legisla.on
in
recent
years.
• 39
states
have
undertaken
public
educa.on
efforts.
• Nearly
two-­‐thirds
of
states:
PDMP
data
“very
useful
or
useful”.

12. Prescrip&on
Drug
Monitoring
Programs
By
State
Source:
The
Na0onal
Alliance
for
Model
State
Drug
Laws,
January
2013

14. Collabora&on
Is
Key!
Center
for
Substance
Abuse
Preven&on
Center
for
Mental
Health
Services
Center
for
Substance
Abuse
Treatment
Center
for
Behavioral
Health
Sta&s&cs
and
Quality
hSp://www.samhsa.gov