Information by medication misuse among young adults. This was presented by Jennifer Arbour, LMHC at the Substance Use Navigation (SUN) Project in Beverly, MA at the Tewksbury Public Library on 1/15/2014

1. Introduction to Prescription
Medication Misuse Among Youth
and Young Adults
Jennifer Arbour, LMHC
Substance Use Navigation (SUN) Project
Beverly MA
Guest Speaker: Gina Borrazzo
Learn to Cope
Parent and Community Member
Tewksbury, MA
January 15, 2013

2. Keys Goals of Presentation
• Identify prescription medications commonly misused by youth and young
adults with focus on pain medications
• Identify misuse, dependency, addiction
• Briefly review developmental vulnerabilities normal to adolescence
• Summarize relevant national trends
• Identify resources
• Parent Share from Learn2Cope
• Group Discussion, Q&A
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3. The SUN Project Overview
• The SUN Project is a new, 3-year
program funded by the Tower
Foundation that will provide
Substance Use Navigation to youth
experiencing substance use issues
and their families.
• A Master’s Level Clinician and
paraprofessional team will work
directly with families as well as
establish tools, resources, and
trainings for LHBS staff, school
personnel, community members,
and families on issues related to
substance use and recovery.
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4. Key Goals of the Project
1. Train key staff to consistently and thoroughly screen
youth for substance use
2. Increase staff skill in motivational interviewing
3. Increase the number of youth referred for substance
use treatment
4. Provide resources and support to families.
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5. Types of Prescription Medications

6. Types of Prescription Medications continued
Stimulants: used to treat attentional difficulties
Drug Name
Brand Name
Dextro-amphetamine
Adderall (among others)
Methylphenidate
Ritalin, Concerta (among
others)
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7. Types of Prescription Medications continued
Benzodiazepines: used to treat anxiety and panic difficulties.
Drug Name
Brand Name
Diazepam
Valium
Clonazapine
Klonopin
Alprazolam
Xanax
Lorazepam
Ativan
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8. Types of Prescription Medications
Opioids: used to manage pain related to end of life and terminal illness,
major bodily injuries and discomforts related to old injuries
Three classes:
• Natural: chemical compounds from opium poppy plant
• Semi-synthetic: created from natural opiates
• Fully-synthetic: chemically made
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9. Types of Prescription Medications continued
Opioids continued
Class
Brand Name
Morphine
Natural
Drug Name
AVINza
Kadian
MS-Contin
Ora-morph
Codeine
Thebaine (also called
paramorphine)
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10. Types of Prescription Medications continued
Opioids continued
Class
Drug Name
Brand Name
Hydrocodone
Lortab, Vicodin
Hydromorphone
Dilaudid, Exalgo
Oxycodone
OxyContin, Roxicodone,
Percocet, Tylox, Percodan
Semisynthetic Oxymorphone
Opana
Diacetylmorphine (heroin)
Buprenorphine
Butrans
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11. Types of Prescription Medications continued
Opioids continued
Class
Drug Name
Brand Name
Fentanyl
Duragesic
Fentora
Onsolis
Meperidine
Demerol
Methadone
Fully
Synthetic
Tramadol
Diskets
Dolophine
Methadose
ConZip
Rybix ODT
Ryzolt
Ultram
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12. Misuse, Dependence, Addiction

13. Misuse
Misuse, abuse or nonmedical use of prescription medications include:
•
Taking prescribed medication without a prescription (i.e. purchased from a
dealer, given free from a friend, stolen from a friend or family members
medicine cabinet)
•
Taking prescribed medication in a way that differs from a prescribing
doctor’s instructions
•
Taking prescribed medication in a way other than what it is prescribed for
and usually to create a particular experience or feeling
•
Double doctoring, also known as “doctor shopping”, meaning obtaining
prescriptions for medications from different doctors without disclosing other
sources for prescriptions within a 30 day period
Sources: NIDA Drug Facts 2013; MassTAPP Guide Document: Prevention and Reduction of Opioid Misuse in
Massachusetts 2013
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14. Dependence and Addiction
Source: MassTAPP Guide Document: Prevention and Reduction of Opioid Misuse in Massachusetts 2013
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15. Addiction is Complex!
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16. The Brain’s Reward Pathway
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17. Addiction is characterized by
•Compulsive Craving
•Seeking Behaviors
•Inability to Control Use
•Continued Use Despite Negative Consequences
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18. Adolescent and Young Adult Development
• Brain completes maturation around ages 24-25
• Regions of the brain that control impulses and forward
thinking are some of the last regions of the brain that
mature
• Critical time to develop coping skills for management of
emotions and mood
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19. Adolescent and Young Adult Development
• Substances and prescription medications youth
are exposed to today are very powerful.
• When considering developmental norms re:
adolescence and brain maturation
• Casual experimentation can lead to problems
regardless of various protective factors.
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20. National Trends

21. Trends continued
Ages 12 and older
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22. Trends continued
•
National Survey on Drug Use and Health 2010-2011 findings
•
Estimate 1 in 22 persons ages 12 or older nationwide used pain relievers
nonmedically in the past year
•
In 2011, more than 11.1 million persons ages 12 or older used pain relievers
nonmedically in the past year
•
Opioid pain relievers among most common substances taken by adults 20 –
59
•
Sales of opioid pain relievers quadrupled between 1999 - 2010
Sources: SAMHSA 2012 & 2013; Warner, Chen, Makuc, Anderson, & Minino, 2001; Morbidity and Mortality
Weekly Report, 2011 as cited in MassTAPP Guide Document: Prevention and Reduction of Opioid Misuse in
Massachusetts 2013
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23. Trends continued
Source: NIDA Drug Facts,
Prescription and Over-theCounter Medications, May
2013
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24. Trends continued
•
Massachusetts Youth Health Survey (YHS) 2011 findings conducted by
Massachusetts Department of Public Health
•
Reports of nonmedical use of prescription medications which included
opioid pain relievers
Students
Lifetime Use
Current Use w/in
last 30 days
High School
14.5%
5.7%
Middle School
3.9%
1.4%
Sources: MassTAPP Guide Document: Prevention and Reduction of Opioid Misuse in Massachusetts 2013
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25. Trends continued
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26. Trends continued
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27. Prevention

28. Prevention continued
 Assess household safety
 Use a locked safe/box to
store medications at all times
 Dispense medications to
your child (even if you trust
them)
 Regularly monitor
prescription medications to
make sure you have the
correct amount of
tablets/pills
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29. Prevention continued
 Check with your town and/or
regional public offices
regarding medication disposal
initiatives
 Consult with your prescribing
physicians and/or pharmacist
about proper disposal
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30. Prevention continued
 Consult thoroughly with your
prescribing physician, nurse
practitioner, oral surgeon, and/or
psychiatrist about the addictive
potential of recommended
medications
 Discuss any concerns you have
about how family history or other
vulnerabilities may contribute to
potential misuse and/or addictive
tendencies with certain medications
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31. Prevention continued
 Advocate for your family –
Examples
 Do we really need a
prescription for this type of
medication for XX days to treat
this injury?
 What other alternatives are
there for dealing with my
child’s situation rather than/ in
addition to medication
therapy?
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32. Prevention continued
 Use teachable moments to casually
explore your child’s world view on
substance use
 Discuss current events, media
coverage of national and local news,
etc
•
“What do you think about…??”
 Relate events back to their life
•
“What might you do if...??”
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33. Prevention continued
• Substances and prescription medications youth
are exposed to today are very powerful.
• When considering developmental norms re:
adolescence and brain maturation
• Casual experimentation can lead to problems
regardless of various protective factors.
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34. Resources

35. Resources continued
State Funded Intensive Youth Services in Massachusetts – Abbreviated,
see full brochure online at www.mass.gov/dph/bsas - reference handout
•
2 Detoxification and Stabilization Units: Inpatient level of care
•
5 Residential Programs: 30 to 90 day placements
•
3 Recovery Home Programs: Up to 6 month placements
•
4 Recovery High Schools: Boston, Brockton, Beverly, Springfield
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36. Resources continued
For questions and connections regarding youth and young adult treatment
Lahey Health Behavioral Services: www.nebhealth.org
•SUN Project: 978-867-7137, www.sunprojectma.org
Massachusetts Department of Public Health
•Bureau of Substance Abuse Services: www.mass.gov/dph/bsas
•Office of Youth and Young Adult Services: 617-624-5161
•Central Intake and Care Coordination for Youth Services: 617-661-3991,
www.healthrecovery.org
City of Lowell, Health Educator, Maria Ruggiero: 978-674-1076
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37. Resources continued
Parent Support Groups:
• Learn to Cope: www.learn2cope.org
• Al-Anon Family Groups of Massachusetts:
www.ma-al-anon-alateen.org
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38. Thank you for
listening and take
very good care!
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