Activating Your Community

1. Activating Your Community
Presenters:
• Mary Elizabeth Elliott, Vice President, Communications, Membership
and IT, Community Anti-Drug Coalitions of America
• Catherine Thatcher Brunson, MS, Trainer/Consultant, National Coalition
Institute, Community Anti-Drug Coalitions of America
• Miranda Willis, Strategic Prevention Data Analyst, Chickasaw Nation
• Kasey Dean, SPF-TIG Tribal Liaison, Absentee Shawnee Tribe
Advocacy Track
Moderator: Karen H. Perry, Co-Founder and Executive Director,
Narcotics Overdose Prevention and Education (NOPE) Task Force,
and Member, Rx and Heroin Summit National Advisory Board

2. Disclosures
Catherine Thatcher Brunson, MS; Kasey Dean,
SPF-TIG; Mary Elizabeth Elliott; Miranda Willis;
and Karen H. Perry have disclosed no relevant,
real, or apparent personal or professional
financial relationships with proprietary entities
that produce healthcare goods and services.

3. Disclosures
• All planners/managers hereby state that they or their
spouse/life partner do not have any financial
relationships or relationships to products or devices
with any commercial interest related to the content of
this activity of any amount during the past 12 months.
• The following planners/managers have the following to
disclose:
– John J. Dreyzehner, MD, MPH, FACOEM – Ownership
interest: Starfish Health (spouse)
– Robert DuPont – Employment: Bensinger, DuPont &
Associates-Prescription Drug Research Center

4. Learning Objectives
1. Identify best practices by coalitions to implement
CADCA’s Seven Strategies for Community Change.
2. Outline the unique challenges to Rx drug
abuse/misuse advocacy faced by Native American
communities.
3. Describe how tribal communities can use the SPF to
build and implement evidence-based, culturally
appropriate and sustainable substance abuse
prevention programs.
4. Provide accurate and appropriate counsel as part of
the treatment team.

5. Advocacy Track: Activating Your
Community
Mary Elizabeth Elliott, VP, Communications,
Membership and IT, CADCA
Catherine Brunson, Trainer/Consultant/CADCA

6. Disclosure Statements
Mary Elizabeth Elliott, VP, Communications,
Membership and IT, CADCA has disclosed no
relevant, real or apparent personal or professional
financial relationships with proprietary entities that
produce health care goods and services.
Catherine Brunson, Consultant/Trainer, has
disclosed no relevant, real or apparent personal or
professional financial relationships with proprietary
entities that produce health care goods and
services.

7. Learning Objective
Identify best practices by coalitions to
implement CADCA’s Seven Strategies for
Community Change to specifically impact
medicine misuse, abuse and addiction.
A comprehensive approach to our nation’s
deadly opioid and heroin crisis.

8. 1. Expand effective Prescription Drug Monitoring Programs to
ensure adequate coverage in every state and interoperability to
share data where appropriate.
2. Enhance education and training of medical and dental
professionals in proper prescribing protocols, SBIRT and
addiction.
3. Raise the general public’s awareness about the dangers of
prescription drug abuse as well as the proper ways to store and
dispose of them.
4. Enhance opportunities for prescription take back and other
large scale disposal programs.
CADCA National Recommendations

9. Recommendations, Cont.
5. Support increased law enforcement and legal remedies to
close down “pill mills.”
6. Require manufacturers to create abuse deterrent
formulations for commonly-abused prescription painkillers.
7. Expand the number of DFC funded communities and
train more communities to implement comprehensive,
data driven strategies to effectively address their local
prescription drug abuse problems.

11. National Evaluation on Institute Impact
1. Overall Capacity
2. Use of Comprehensive
Strategies
3. Use of Environmental
Strategies
4. Student perception of
parental disapproval for
using:
a. marijuana
b. tobacco
30 Day Use of
Marijuana
SignificantIncreases
SignificantDecreases
Summary of Findings –
Longitudinal Evaluation of the Impact of CADCA’s Institute's Training & TA
On Coalition Effectiveness; Dr. Pennie Foster-Fishman, Ph.D.
Michigan State University, February 7, 2015

12. CADCA Rx Resources
• Toolkit especially for coalitions –
www.PreventRxAbuse.org
• National Medicine Abuse Awareness
Month every October
• CADCA has made a national
commitment to help coalitions host
100 town hall/community briefings on
opioid crisis
• Co-convener of Collaboration for
Effective Prescription Opioid Policies
(CEPOP) – cepoponline.org

13. Keys To Pushing Back Against The Misuse
and Abuse of Rx Drugs
• Approach that appropriately mobilizes each
of the key sectors and actors who have a role
in reducing access to and availability of
prescription drugs

14. 1. Provide information
2. Build skills
3. Provide social support
4. Reduce barriers / enhance access
5. Change consequences / incentives
6. Alter the physical design of the environment
7. Change policy and rules
Environmentally-
focused
Individually-
focused
Coalitions Pursuing Comprehensive Strategies
Source: KU Work Group for Community Health and Development, 2007

15. Problem: Teen Rx abuse is on the rise
But Why? Rx medications are easy to get
But Why Here? 3 pain clinics are located within the county
• Provide Information—Town Hall Meeting; Media stories; billboards
• Build Skills—Provide CME training on proper prescribing and addiction
• Provide Support—Establish relationship with treatment programs to
collaborate with law enforcement, schools, healthcare, etc. for
referrals
• Access / Barriers—Collaborate with law enforcement to increase
patrols within one mile radius of pain clinics during hours of operation
• Change Consequences – Promote and encourage licensing boards to
monitor and enforce appropriate prescribing practices and medical
record documentation of medical examinations and patient diagnosis
• Physical Design— Lock you meds campaign/disseminate lockboxes
• Policies or Regulations—Support legislation increasing penalties for
physicians with unscrupulous prescribing practices; work with zoning
board to increase zoning restrictions for “pill mills” in residentially
zoned areas.
Roane County Anti-Drug Coalition, TN

16. Strategy 1 Providing Information
• Woonsocket Prevention Coalition in Woonsocket, Rhode Island
implemented widespread media campaigns to raise awareness about
the dangers of prescription drug abuse in their communities utilizing
traditional and social media.
• Carter County Drug Task Force in Ashland, Kentucky distributed 35,000
Push Cards on “Preventing Abuse of Prescription and Over-the-Counter
Medications” and 35,000 Push cards distributed on “Guidelines for
Proper Disposal of Prescription Drugs.”
• Council Rock Coalition for Healthy Youth, Newtown PA debuted a PSA
at their local movie theaters to remind patrons to “Mind Your Meds” by
discouraging sharing and encouraging proper disposal.

17. Strategy 2: Enhancing Skills
• NCADD of Middlesex County, East Brunswick, NJ - Delivered
community education presentations to enhance the skills of
community members and provided training for emergency
responders on the proper use of naloxone to treat overdoses.
• Blount County Substance Abuse Action Team in Maryvale,
Tennessee provides Drug Recognition Education (DRE) training
for law enforcement.
• Alamance Citizens for a Drug Free Community in Snow Camp,
NC taught over 250 5th and 6th graders to understand a medicine
label and safely store medications though the OTC Medicine
Safety curriculum.

18. Strategy 3: Providing Support
• Shelby County Drug Free Coalition in Indiana provided
local pharmacies with materials on prescription drug
abuse to dispense with prescriptions.
• Roane County Anti-Drug Coalition, Kingston, Tennessee
distributed materials to funeral homes to encourage
individuals to have their homes monitored during the
funeral and remove medications.
• SAFE Coalition of Hunterdon and Somerset, NJ provides
Rx education to the attending residents at their regional
hospital on proper prescribing to reduce addiction.

19. Strategy 4: Enhancing Access or Reducing Barriers
• Drug-Free Collier County, based in Naples, Florida has 11
permanent drop boxes so residents can easily dispose of
medications and also offer drug disposal, or
deactivation, packets which are biodegradable and can safely be
disposed of with normal trash.
• Jackson County Anti-Drug Coalition, West Virginia developed a
Quitline to improve access to resources and treatment.
• SAFE Coalition of Hunterdon and Somerset, NJ distributes
warning labels for pharmacy bags in English and Spanish;
Distributed lockboxes to all homes involved in Juvenile Court.

20. Strategy 5: Changing Consequences
• The ASAP coalition in Maine recognizes
participating physicians and pharmacists
partners with a responsible business award
at annual event and window cling.
• In New Jersey, the SAFE coalition requires
all 11th graders and a parent to attend a
“Path from Pills to Heroin” educational
event or they are not eligible for a parking
spot their senior year of high school.

21. Strategy 6: Change Physical Design
• Jackson County Anti-Drug Coalition, West
Virginia purchased an incinerator to dispose
of all returned medicines in their community.
• The Cherokee Nation in Oklahoma installed
a permanent medicine drop off box in the
lobby of their police station and also
partnered with local homebuilders to ensure
that the installation of one locking medicine
cabinet is standard in every new home that is
built.
• DFC coalitions in 4 Florida counties are
giving out 40,000 drug disposal pouches as
part of a research project.

22. Strategy 7: Modifying and Changing Policies
• Sylvania Community Action Team (S.C.A.T.) in Ohio
partnered with local schools to implement clear and
strict policies related to the possession of illegal and
prescription drugs on school grounds.
• Tennessee coalitions worked collaboratively to pass a
Good Samaritan law.
• Missouri coalitions, led by ACT Missouri, are advocating
to bring the PDMP to their state. St. Louis County is not
waiting – they are creating their own local PDMP.

23. In Closing
• The comprehensive coalition approach remains the
best local solution to address any public health threat
– and is especially critical with the complex opioid and
heroin crisis we face as a nation.
• Data shows that DFC coalitions are having success in
this area and CADCA’s National Coalition Institute is a
factor in making coalitions more effective.
• CADCA is providing technical assistance, advocacy and
communications tools that can help more
communities “wake up” to this epidemic.

24. Visit us on the Web at www.cadca.org
Join us via Social Media:
•
Facebook: facebook.com/CADCA
• Twitter: @cadca
• YouTube: youtube.com/cadca09
• Linkedin: Linkedin/company/cadca
Stay Connected with CADCA
24

25. “Using the Strategic Prevention
Framework to Reduce Prescription
Drug Abuse/Misuse in Tribal
Communities”
Absentee Shawnee Tribe
Chickasaw Nation

26. • Kasey Dean, Absentee Shawnee Tribe SPF Specialist, has
disclosed no relevant, real or apparent personal or
professional financial relationships with proprietary entities
that produce health care goods and services.
• Miranda Willis, B.S., Chickasaw Nation Strategic Prevention
Data Analyst, has disclosed no relevant, real or apparent
personal or professional financial relationships with
proprietary entities that produce health care goods and
services.

27. Learning Objectives
• Outline the unique challenges to Rx drug
abuse/misuse advocacy faced by Native American
communities.
• Describe how tribal communities can use the SPF to
build and implement evidence-based, culturally
appropriate and sustainable substance abuse
prevention programs.

28. Outline
• Learning Objectives
• SPF-TIG Overview
• The Chickasaw Nation
• Define Your Direction
• Safe Storage and Disposal Initiative
• Absentee Shawnee Tribe
• MyDNA
• Naloxone Initiative

29. What some think Oklahoma looks like?

32. What it really looks like?

37. SPF-TIG Overview
• TEC located at the Oklahoma City Area
Intertribal Health Board (OCAITHB) was awarded
the SPF-TIG(2010)
• Inter Tribal Consortium (ITC):
- OCAITHB
- Absentee Shawnee Tribe
- Cheyenne and Arapaho Tribes
- the Chickasaw Nation
- Comanche Nation

39. SPF-TIG Overview
• Tribal Epidemiological Outcomes
Workgroup (TEOW)
- Epidemiological Profile and
Strategic Plan (2012)
- Priority Issues:
1. Underage Drinking
2. Prescription Drug Abuse/Misuse
• More community-level, tribal-specific data was needed.

40. SPF-TIG Overview
Strategic Prevention Framework:
1. Assessment
2. Capacity Building
3. Planning
4. Implementation
5. Evaluation
Goal: To reduce underage drinking and prescription
drug misuse/abuse in our communities.

41. Chickasaw Nation
• 13 counties located in south-central Oklahoma
• Population: *356,301
• American Indians: *35,065
* Based on 2013 U.S. Census estimates

44. Source: 2014 Oklahoma Prevention Needs Assessment Report: Chickasaw Nation Students

45. Chickasaw counties Grandparents raising grandchildren
Bryan 522
Carter 746
Coal 55
Garvin 337
Grady 772
Jefferson 69
Johnston 144
Love 219
McClain 330
Marshall 307
Murray 131
Pontotoc 433
Stephens 479
Total 4,544
Source: 2013 American Community Survey Estimates, United States Census, Census.gov.

46. Source: OSDH, Injury Prevention Service, Unintentional Poisonings Database

47. Source: 2014 Oklahoma Prevention Needs Assessment Report: Absentee Shawnee Tribe Students

49. Prescription Drug Logic Models

50. Awareness and Media Campaign

51. Safe Storage and Disposal Initiative
• Develop partnership with Chickasaw Nation
Division of Aging
• Provide education to seniors about safe
storage and proper disposal of prescription
drugs
• Provided Chickasaw Nation Seniors with…

53. Safe Storage and Disposal Initiative

54. Absentee Shawnee Tribe of Oklahoma
• 4 counties located in central Oklahoma
• Population: *1,142,553
• American Indian: *57, 848
* Based on 2013 U.S. Census estimates

55. Prescription Drug Logic Models

56. Awareness and Media Campaign

57. Naloxone Initiative
• Naloxone is a medication called an “opioid antagonist” used to counter
the effects of opioid overdose, for example morphine and heroin
overdose.

58. Partnerships
• Law Enforcement
• State SPF-SIG (Gateway to
Prevention)
• Austin Box Foundation
• Oklahoma Department of
Mental Health and Substance
Abuse Services (ODMHSAS)
• University of Oklahoma
Southwest Prevention Center

59. Training
• CLEET (2 hours of Mental Health Training for
officers)
• Train the Trainer
• Memorandum of Understanding (MOUs)

60. Naloxone Initiative Impact
• AST Tribal Police
• Kickapoo Tribal PD
• Citizen Pottawatomi Nation PD
• Moore PD*
• Pottawatomi County Sheriffs
Dept.
• Tecumseh PD
• Shawnee PD
• Mcloud PD
• Asher PD

61. Sources
• Dean, Kasey, Brown, Howard Jr. and Sucharat Tayarachakul. Absentee Shawnee
Tribe of Oklahoma SPF-TIG Program: SPF Survey 2015. 2015. Dataset.
Absentee Shawnee Tribe of Oklahoma.
• Byars-Chavez, Christie, Shahbandeh, J. Caleb, Willis, Miranda and Sucharat
Tayarachakul. Chickasaw Nation SPF-TIG Program: SPF Survey 2015. 2015.
Dataset. Chickasaw Nation.
• Oklahoma Department of Mental Health and Substance Abuse Services. 2014
Oklahoma Needs Prevention Assessment: Chickasaw Nation Students.
• Oklahoma Department of Mental Health and Substance Abuse Services. 2014
Oklahoma Needs Prevention Assessment: Absentee Shawnee Tribe of
Oklahoma.
• Oklahoma State Department of Health (OSDH), Injury Prevention Service.
Unintentional Poisonings Deaths Map. Unintentional Poisonings Database.
• United States Census. 2013 American Community Survey Estimates. US
Census. Census.gov

62. Thank You

63. Activating Your Community
Presenters:
• Mary Elizabeth Elliott, Vice President, Communications, Membership
and IT, Community Anti-Drug Coalitions of America
• Catherine Thatcher Brunson, MS, Trainer/Consultant, National Coalition
Institute, Community Anti-Drug Coalitions of America
• Miranda Willis, Strategic Prevention Data Analyst, Chickasaw Nation
• Kasey Dean, SPF-TIG Tribal Liaison, Absentee Shawnee Tribe
Advocacy Track
Moderator: Karen H. Perry, Co-Founder and Executive Director,
Narcotics Overdose Prevention and Education (NOPE) Task Force,
and Member, Rx and Heroin Summit National Advisory Board