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

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. 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. 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. 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. 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. 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. 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. 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. 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

11. These
results
are
being
mirrored
at
the
local
level
in
communi&es
throughout
the
country.
11

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. • 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. 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. • 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. DFC
coali&ons
have
achieved
major
results
34

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. • 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. 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. • 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. CADCA’s
OTC
and
Rx
Drug
Abuse
Recommenda<ons
and
Resources
39

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. 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. 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. 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. 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. 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. 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
 Stopmedicineabuse.org
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. No-­‐Cost
Online
Medicine
Abuse
Preven&on
Course
for
Coali&ons
47
• hkp://learning.cadca.org/
• 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
training@cadca.org.
47

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. 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. Visit
us
on
the
Web
at
www.cadca.org
Call
us
at
1-­‐800-­‐54-­‐CADCA
Email
Membership:
membership@cadca.org
Email
Training
and
TA:
training@cadca.org
Join
us
via
Social
Media:
Facebook:
facebook.com/CADCA
Twi9er:
@cadca
Connected
Communi<es
Network:
h9p://
connectedcommuni<es.ning.com
YouTube:
youtube.com/cadca09
Flickr:
flickr.com/photos/cadca
Linkedin:
Linkedin/company/cadca
Stay Connected with CADCA
5050