Two Models on New Approaches for Community-Based Anti-Drug Coalition National Rx Drug Abuse Summit 4-10-12

1. Two Models on New
Approaches for Community-
Based Anti-Drug Coalition:
State of Oregon and
the US Military
April 10-12, 2012
Walt Disney World Swan Resort

2. Learning Objectives:
1. Describe multiple strategies community anti-
drug coalitions in Oregon are employing to
prevent prescription drug abuse.
2. Describe how substance abuse is affecting
our military personnel and their families and
explain the military’s Prevention, Treatment
and Outreach prevention initiative.
3. Specify the successes and challenges of a
variety of prevention strategies and explain
how these strategies can be implemented in
both rural and urban communities.

3. Disclosure Statement
• All presenters for this session, Judy
Cushing and Peggy Quigg, have
disclosed no relevant, real or apparent
personal or professional financial
relationships.

4. THE RX DRUG ABUSE EPIDEMIC –
A State’s Collective Approach
to Policy Change
Judy Cushing CEO
April 10-12, 2012
Walt Disney World Swan Resort

5. Oregon’s Rx Abuse Scene
• High Overdose Rates (400 / year)
• Different Challenges Urban vs. Rural
• High Rates of Student Use
• Glorification of Rx in Pop Culture
• Rx Abuse among Returning Soldiers
And Veterans

6. Statewide Summits 2010 and 2011
Critical Elements:
• Lead by High Level Leaders
• National, State, and
Local Data
• Engaged the Business Community
• Many Coalitions Involved
• Robust Testimony and Dialogue

7. Overview:
Challenges and Opportunities
Prescription Drug Monitoring
• Challenges in Oregon
• Best Practices in Other States
• Third Party Payer Efforts and Experiences

8. Provider Perspectives
• Health Professionals – Best Practices for
Graduate and Undergraduate Training
• Pain Management - Assessing Patients for
Opioid Therapy and Nonopioid Management
• Pharmacists
• Medical and Dental Professionals
• Treatment Community

9. Public Education
• Changing the Norm
Public Education /Outreach
Media
• REMS
Abuse Deterrent Drugs and
FDA’s Safe Use Initiative
• Safe Rx Disposal and Drop Boxes – L/E & DEA
• Employer /HR Training

10. Returning Veterans
• Ease of Access to Rx
• Double Trouble:
Physical and Mental
Trauma and Injury
• Poor access to Treatment

11. Education Leaders
• Who to Engage….
– School Boards
– Administrators / School Leadership
– School Counselors
– Coaches
• How?
– Tool Kit for Educators
– Training
– Professional Development

12. Overarching Summit
Recommendation
Develop and enact statewide policies that
reduces prescription drug abuse, without
restricting safe access, focusing on the
following areas:

13. Recommendation for:
Prescribers: Physicians, Nurse Practitioners
and Physician Assistants
• Assessing risk should be a universal
precaution taken w/ all patients
• Assessment should be incorporated as a
standard practice when prescribing not just
opioids, but with any prescription with
significant abuse potential.

14. Recommendation for:
Health Insurers
• Insurance companies must develop
protocols & implement better training for their
investigators about recognizing and handling
Rx drug diversion
• States can reduce diversion and abuse of
Rx medications, as well as medicaid
expenses, through increased monitoring

15. Recommendations for
Electronic Systems and Controls
• E-prescribing systems must include a
number of safeguards to protect patient
privacy and information security
• Prescription forgery and diversion can
be greatly reduced through an effective
e-prescribing system

16. Recommendations for:
Prescription Monitoring Programs
• Patient confidentiality must be protected
• Health care professionals must be granted
access to data about their patients so they
can conduct an evaluation of patient’s use
• Law enforcement should be allowed
access, but only with probable cause.

17. Recommendations for
Law Enforcement
• Dedicate an investigator to pursue Rx theft, forgery &
manipulation and diversion, possession & illegal distribution of Rx
medications.
• Investigators should work closely with medical experts to
differentiate between a criminal case and a well intentioned
doctor
• Compile data systematically to determine pills diverted through
thefts and losses from the supply chain, the internet, int’l
smuggling, Rx forgery, doctor shopping, and patients selling or
sharing meds
Assign an Officer to the prevention of Rx drug diversion or abuse

18. Recommendations for
Public Education and Advocacy
• Focused education on safe storage and
disposal of prescription medications to prevent
theft and misuse
• Locking medicine cabinets should become
standard practice nationwide
• Pharmacies should stock lockboxes and
encourage consumers to store Rx meds in a
locked box.

19. Recommendations for:
Safe Storage / Responsible Disposal
• A take back program should be
coupled with strong public education
efforts on safe medication disposal.
• A buy back program or pharmacy
coupons in exchange could offer an
incentive to responsible disposal

20. Judy Cushing, CEO
jcushing@orpartnership.org
Portland, Oregon
971-244-1371