The Benevolent and Protective Order of Elks’ Drug Awareness Program Presentation on Prescription Drug Abuse Kent Gade (National Director) 67597 550th Street Griswold, IA 51535 gadeins@netins.net WWW.ELKS.ORG

Prescription Drug Misuse (PDM) DEFINITION: The intentional use of someone else’s prescription medication for the purpose of alleviating symptoms that may be related to a health problem. ATTRIBUTES: No legal prescription for the drug Use is intentional Perceived barriers to medical care ( e.g. a prescription is not available to the person) Motive is to relieve a condition for which the medication, when prescribed, is generally intended (e.g. pain).

Prescription Drug Abuse (PDA) DEFINITION: The use of a scheduled prescription medication to experiment, to get high or to create an altered state. ATTRIBUTES: No legal prescription for the drug Use is intentional May involve use in combination with other drugs May involve delivering in a wrongful manner (e.g. IV, skin-popping, snorting or smoking). Motive to experiment, get high or to alleviate withdrawal symptoms

What are some of the commonly abused prescription drugs? Opioids, Which are most often prescribed to treat pain Central Nervous System (CNS) depressant, which are used to treat anxiety and sleep disorders Stimulants, which are prescribed to treat the sleep disorder narcolepsy and attention-deficit hyperactivity disorder (ADHD)

Millions of Americans Abuse Prescription Drugs Use of Prescription Drugs for Non-Medical Purposes 2002 National Survey on Drug Use and Health 4.4 million 4.5 4 Millions of Americans 3.5 3 2.2 million 2.5 2 1.2 million 1.5 1 0.5 Stimulants Sedatives Pain Relievers Millions of Americans Abuse Prescription Drugs

Trend in Prescription Drug Abuse Increase abuse among older adults, adolescents, and woman. An estimated 4.7 million Americans used prescription drugs non-medically for the first time in 2002.

Reasons for Concern These drugs can have serious medical consequences i.e lethal overdose with pain killers, psychosis with stimulant medications Misuse in elderly populations who are particularly sensitive to adverse medical reactions Increase use by adolescents of drugs that may have long term effects in brain development

Anyone Can Abuse Prescription Drugs College students Lawyers Blue-collar workers Celebrities Office managers Nurses White-collar professionals High school students Prescription Drug Abuse is done by: both genders and by people of all economic classes, ethnicities, and cultures.

Older Adults Persons 65 years of age and above comprise only 13 percent of the population, yet account for about one-third of all medications prescribed in the US. They are more likely to be prescribed long-term and multiple prescriptions, which could lead to unintentional misuse.

Older Adults In addition to prescription medications, a large percentage of older adults also use OTC medications and dietary supplements. Do to their high rates of comorbid illnesses, change in their metabolism, and the potential for drug interactions, prescription and OTC drug abuse and misuse, older adults can have a more adverse health consequences than seen in younger populations.

Adolescents and Young Adults Studies indicate that the nonmedical use of prescription medications is increasing in the U.S. among adolescents and young adults. The nonmedical use of prescription medications is associated with higher rates of tobacco, alcohol and other drug use. The nonmedical use of medication continues to dominate 5% of 12 to 17 year olds reported nonmedical use of scheduled pain medications*; 12% of 18 to 25 year olds reported nonmedical use of scheduled pain medications*.

Diversion (7th-12th grades) Thirty-six percent of students reported having a recent prescription for one of the 4 drug classes. A higher percentage of girls gave away their medications than boys (27.5% vs. 17.4%, respectively) Girls were significantly more likely than boys to divert to female friends (64.0% vs. 21.2%, respectively; while boys diverted to male friends (45.5% vs. 25.6%, respectively Ten percent diverted their drugs to parents.

Adolescents and Young Adults The lifetime prevalence of nonmedical use was highest for pain medication (17.5%): Sleeping medication (5.8%), sedative/anxiety mediation (3.5%), and stimulant medication (2.5%). Girls were significantly more likely to report nonmedical use of pain medication . No gender differences in nonmedical use of the other classes of prescription drugs. White students were more likely than Black students to report nonmedical use of prescription sedative/anxiety and stimulant medications.

Source: Monitoring the Future Study, 2003. Percent of Students Reporting Abuse of Pain Killers in Past 12 Months in 2003 12.0 10.5 10.0 8.0 7.2 Percent 8th Grade 6.0 10th Grade 4.5 3.6 12th Grade 4.0 2.8 1.7 2.0 0.0 Oxycontin Vicodin Source: Monitoring the Future Study, 2003.

Motivations to Misuse: Reasons Varied by Drug Class 80% for the purpose of relieving pain 16% for the purpose of helping to sleep 20% for the purpose of getting high 3% because they are safer than street drugs

Nonmedical use of prescription drugs, reported by 6 Nonmedical use of prescription drugs, reported by 6.2 million persons in 2002, is second only to marijuana use. Past Month Users, Ages 12 and Older (in Millions) Source: SAMHSA, 2002 National Survey on Drug Use and Health.

Pain relievers account for the largest portion of nonmedical use of prescription drugs. Past Month Users, Ages 12 and Older (Thousands) Source: SAMHSA, 2002 National Survey on Drug Use and Health.

Over 2 million are estimated to be dependent on or abusing prescription drugs in the past year. Past Year Dependent/Abusers, Ages 12 or Older (in Thousands) Source: SAMHSA, 2002 National Survey on Drug Use and Health.

Gender Differences Overall, men and women have roughly similar rates of abuse of prescription drugs. An exception is found among 12-17 year olds. Where young women are more likely than young men to misuse psychotherapeutic. Research has shown that women are at increased rick for nonmedical use of narcotic, analgesics, and tranquilizers.

Gender Differences in Sources for Prescription Abuse Peer category consisted of friends, peers, roommate, boyfriend, girlfriend and teammate. Family category consisted of mother, family, parent, father, sibling, aunt, brother, husband and cousin. Other category consisted of don’t know, self, drug dealer and abroad. ** ***

Why Has the Abuse of Prescription Drugs Increased? Increasing numbers of prescriptions (greater availability) Attention by the media and advertising (television and newspaper) Easier access (e.g. internet availability) Improper knowledge and monitoring (adverse effects go unrecognized)

Increased Media Attention

“Some reasons why you should consider using this pharmacy” Availability on the Internet Delivered in the Privacy of your Home “Some reasons why you should consider using this pharmacy” No prescription required!

Prevention Requires Community Involvement A community working together includes: Parents, youth, and families Faith communities Media Schools Professional and civic groups Health and social services Courts/law enforcement Businesses Treatment agencies and health organizations

Summary The nonmedical use of prescription medications is increasing in the U.S. among adolescents and young adults. Students who abuse or misuse prescription medications are significantly more likely to smoke cigarettes, use marijuana and use other illegal drugs. College men and high school boys are more likely than their female counterparts to obtain prescription opioid medications from peer sources, while girls/ women from family. Students NOT obtaining prescription drugs directly via the internet but they learn about them from the Internet/TV/print media, peers and family.

Summary This form of scheduled medication use/misuse/abuse challenges traditional ideas about substance abusers. Self-treatment appears to be one motivation for the nonmedical use of prescription opioid analgesics Unlike users of many street drugs, there appears to be at least two groups of nonmedical users of prescription medications: Those that Self-treat and those that get High, or Experiment

Resources SAMHSA’s National Clearinghouse for Alcohol and Drug Information at 1-800-729-6686; www.SAMHSA.gov. Click on the “Drug Facts” icon Informational Web sites www.preventiondss.org www.whitehousedrugpolicy.gov www.nida.nih.gov www.cadca.org

For more information on the Elks National Drug Awareness Program or other Elks Programs: Visit: www.elks.org Presentation Prepared By the Illinois Elks Association – Drug Awareness Program