1. Preventing Rx Abuse in Your Community

2. About this presentation
The following PowerPoint slides were obtained from presentations on Rx abuse prevention from the National Association of Drug Diversion Investigators (NADDI), the National Council on Patient Information and Education (NCPIE) and CADCA. Coalitions should feel free to adapt these slides into their education and outreach activities. Here’s what you’ll find:
The Teen – Rx Abuse Connection
Facts & Stats
Teen & Adult Attitudes About Rx Abuse
Outreach to Teens, Parents, Families & Community
Want to Learn More?
We have placed relevant source information in the notes section of each slide
Rx Abuse Prevention Toolkit - from awareness to action

3. The Teen – Rx Abuse Connection
Rx Medications are All Around Us…and Teens Notice
Patients leave the doctor’s office with a prescription in hand in 7 out of 10 visits.
Direct-to-consumer advertising on TV and in magazines is pervasive.
Many people don’t know how to safely use these medications or ignore their doctor’s instructions.
SOURCE: Not Worth the Risk – Maximizing Your Role as a Teen Influencer: What You Can Do To Help Prevent Teen Prescription Drug Abuse, NCPIE.
Prescription drugs are often a mainstay of treatment for various illnesses including migraines, infections, heart disease, diabetes, depression, arthritis and cancer. TV and print media are also filled with ads for these, and other medications designed to appease pain and cure diseases. As such, it’s understandable why teens may come to believe that there is a pill for everything.
Given the fact that our society is so pill-driven, it seems a bit surprising that most of us have missed the boat on medication safety. What do we need? To be better educated about how to safely use, store and get rid of these medications when they’re not longer needed. We’ll talk about this more later.
Rx Abuse Prevention Toolkit - from awareness to action

4. As a result… Rx drugs are part of teen culture. Teens:
Normalize this form of drug abuse.
Take these meds for legitimate reasons – with or without a prescription – to stay awake, remain alert or to go to sleep.
Purposely abuse these drugs to get high. They participate in “pharming” and “bowling” parties.
Are often unaware that these activities can lead to disastrous results.
SOURCE: Not Worth the Risk – Maximizing Your Role as a Teen Influencer: What You Can Do To Help Prevent Teen Prescription Drug Abuse, NCPIE.
Unfortunately, prescription drugs are a noticeable part of teen culture these days. The truth is that some teens take these medications for legitimate reasons – whether they have a prescription or not. We know some teens will abuse different classes of drugs for their practical effects – one to help them focus or stay up all night to write a term paper or cram for the next exam, another to help take the edge off and still another to help them fall asleep.
Other teens abuse these drugs to get high. The latest abuse trend takes place at “pharming” or “bowling” parties.
[Ask the group to raise their hands if they’ve heard of these.]
At these parties, teens will mix different kinds of prescription drugs together in a bowl or a bag (also called making “trail mix”) and will consume a handful of pills. They often don’t know what drugs they are taking or how they will affect their mind or body, nor would emergency medical responders in the event that they need to treat a teen and counteract the drug’s effect.
Rx Abuse Prevention Toolkit - from awareness to action

5. that abusing Rx drugs can:
Teenagers don’t know
that abusing Rx drugs can:
Increase blood pressure or heart rate.
Damage the brain and other organs.
Lead to accidental overdose / poisonings.
Cause physical dependency and / or addiction.
Disrupt breathing (respiratory depression).
Lead to risks associated with mixing multiple drugs or combining with alcohol.
Cause seizures and even death.
SOURCE: Not Worth the Risk – Maximizing Your Role as a Teen Influencer: What You Can Do To Help Prevent Teen Prescription Drug Abuse, NCPIE.
Abusing prescription drugs can be dangerous – from increasing your blood pressure and damaging the brain and other organs to disrupting breathing (respiratory depression) and causing physical dependency/addiction, seizures and even death.
Rx Abuse Prevention Toolkit - from awareness to action

6. Facts & Stats
While Rx drugs serve an important purpose when used under a doctor’s care, the misuse of Rx drugs is a growing, under-recognized problem that puts young lives at risk.
SOURCE: Not Worth the Risk – Maximizing Your Role as a Teen Influencer: What You Can Do To Help Prevent Teen Prescription Drug Abuse, NCPIE.
We all know that Rx medications cure certain diseases, relieve symptoms and restore quality of life. When taken by the right person, at the right dose, at the right time and in the right way, medications are incredibly valuable.
Many people are unaware that teens are misusing and abusing Rx drugs – the very same medicines that are used to legitimately relieve pain and treat conditions such as anxiety or sleep disorders, depression or ADHD.
“Misuse” includes self-medication and recreational use of these medicines.
The misuse or “nonmedical use” of these drugs is dangerous and as I just indicated, can lead to overdose, addiction and death.
Rx Abuse Prevention Toolkit - from awareness to action

7. Next to marijuana, the most common illegal drugs teens are abusing are prescription medications.
Twenty percent of U.S. high school students say they have taken Rx drugs without consulting a doctor.
1 in 5 teens has abused Rx drugs.
1 in 3 teens say there is “nothing wrong” with abusing Rx medications “every once in a while.”
Every day, almost 2,500 teens abuse an Rx medication for the first time.
SOURCES: Center for Disease Control and Prevention and Not Worth the Risk – Maximizing Your Role as a Teen Influencer: What You Can Do To Help Prevent Teen Prescription Drug Abuse, NCPIE.
While the rate of tobacco, alcohol and illicit drug abuse is down overall, more teens are turning to prescription drugs.
[Refer to the statistics on the slide. Consider asking the group what surprises them most about these numbers.]
These numbers paint a sobering picture. It’s a problem that needs more attention – and it must be consistently addressed at home, in schools, on the athletic field and in doctors’ offices.
Did you know?
Rx Abuse Prevention Toolkit - from awareness to action

8. Teens’ Rx Drugs of Choice For Abuse
How they work
Abused by teens to:
Drug names
Strong pain relievers
Used to relieve moderate-to-severe pain, these medications block pain signals to the brain
Get high, increase feelings of well being by affecting the brain regions that mediate pleasure
Vicodin, OxyContin,
Percocet, Lorcet, Lortab, Actiq, Darvon, codeine, morphine,
methadone
Stimulants
Primarily used to treat ADHD type symptoms, these speed up brain activity causing increased alertness, attention, and energy that comes with elevated blood pressure, increased heart rate and breathing
Feel alert, focused and full of energy—perhaps around final exams or to manage coursework, lose weight
Adderall, Dexedrine, Ritalin, Concerta
Sedatives or tranquilizers
Used to slow down or “depress” the functions of the brain and central nervous system pressure, increased heart rate and breathing
Feel calm, reduce stress, sleep
Valium, Xanax, Ativan, Klonopin, Restoril, Ambien, Lunesta, Mebaral, Nembutal, Soma
SOURCE: Not Worth the Risk – Maximizing Your Role as a Teen Influencer: What You Can Do To Help Prevent Teen Prescription Drug Abuse, NCPIE.
Drugs commonly used by teens include:
Strong pain medications that are prescribed to treat moderate-to-severe pain. Teens often go in search of these to get high or feel pleasure. Some street names include: Captain Cody, China Girl, vikes, hillbilly heroin, oxy 80s, OCs, percs, demmies.
Stimulants, or uppers speed up brain activity, resulting in greater alertness, attention, and energy. Teens turn to these to feel alert and be able to pull all-nighters to stay on top of coursework. Stimulants can make the heart beat faster and put the user at risk for stroke or heart attack. Some popular street names are uppers, vitamin R, Skippy.
Sedatives, or downers slow down brain activity. The result is a drowsy or calming effect. Other sedatives include tranquilizers and muscle relaxants. Sedatives can reduce heart rate and the body’s response to breathing. Street names include candy, downers, tranks, barbs.
Teens also abuse cough medicines and other over-the-counter medicines.
Rx Abuse Prevention Toolkit - from awareness to action

9. Rx Access Points— Friends & Family Source of Concern
Source: COMMUNITY RX CRISIS – Balance and Perspective on Prescription Drug Abuse, NADDI.
Recent Federal data indicate that over 50% of those who abuse Rx medications, obtain them for free from friends or relatives. This reality points to the need for education and outreach targeting families and friends that highlights the importance of not sharing medications and proper medication storage and disposal strategies.
SAMHSA. (2008). Results from the 2007 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series: H-34, DHHS Publication No. SMA ). Rockville, MD.
Available at:
Rx Abuse Prevention Toolkit - from awareness to action

10. attitudes about Rx abuse
Teens & Adult
attitudes about Rx abuse
MIXING OVER-THE-COUNTER COLD MEDICATION and someone else's prescription painkillers CAUSED THE DEATH OF MY SON…I could get my hands on prescription medicines AS FAST AS I COULD BUY A PIZZA…the problem IS AS CLOSE AS YOUR MEDICINE CABINET…PART OF ME DIED THAT DAY when my daughter was taken away on a gurney…TEEN RX ABUSE is more than an emerging problem.
We’ve gone from the general to the specific. We talked about the connection between teens and Rx abuse and obtained a statistical picture of abuse. We’re ready to talk about what teens and adult caregivers think about prescription drug abuse. A common theme relevant to teens and their families is that a lack of information and awareness can sometimes lead to disastrous results.
Rx Abuse Prevention Toolkit - from awareness to action

11. Teens say that… 40% 31% 29% % Agree strongly/somewhat
Rx drugs, even if they are not prescribed by a doctor, are much safer to use than illegal drugs.
40%
There is nothing wrong with using Rx drugs without a doctor’s prescription once in a while.
31%
Rx pain relievers, even if they are not prescribed by a doctor, are not addictive.
29%
Source: COMMUNITY RX CRISIS – Balance and Perspective on Prescription Drug Abuse, NADDI.
These myths create an unrealistic picture of Rx abuse that does not take the short- and long-term effects of these drugs into account.
Rx Abuse Prevention Toolkit - from awareness to action

12. beliefs & attitudes Parental / Guardian
Many parents aren’t aware of the dangers of Rx abuse – it’s just not on their radar screen.
Rx medicines can be found in homes of family or friends, and parents don’t realize the connection between teen Rx abuse and easy availability.
Many parents do not know how to effectively talk with their teens about Rx drug abuse.
They often find out about an Rx problem when it is too late.
Here’s part of the problem – parents are caught unaware that Rx abuse is even an issue because typically, they’re busy worrying about marijuana, alcohol and other drugs.
Rx Abuse Prevention Toolkit - from awareness to action

13. Watch for Physical Warning Signs
EDUCATE
Watch for Physical Warning Signs
Excessive sweating, urination or thirst
Nausea and vomiting
Uncontrollable diarrhea
Spastic shaking
Drowsiness, dizziness and insomnia
Loss of consciousness
Physical dependence
Addiction
Three mantras – educate, communicate, safeguard – are critical to protecting young people against Rx medication abuse.
Rx Abuse Prevention Toolkit - from awareness to action

14. Watch for Physical Warning Signs
EDUCATE
Watch for Physical Warning Signs
Sudden mood changes, including irritability, negative attitude, personality change.
Extreme changes in groups of friends or hangout locations.
Lying or being deceitful, unaccounted time away from home/missed school days, avoiding eye contact.
Losing interest in personal appearance, extracurricular activities or sports.
Poor performance at school.
Borrowing money or having extra cash.
Visiting and even purchasing from pro-drug abuse (illegal) web sites.
SOURCE: Not Worth the Risk – Maximizing Your Role as a Teen Influencer: What You Can Do To Help Prevent Teen Prescription Drug Abuse, NCPIE.
It’s very important to watch for physical signs of trouble. Remember that the physical signs of abuse will be very different depending on the individual and the drug that is abused. The ones listed here are general. Seek immediate medical assistance if a teenager under your charge exhibits these signs.
Rx Abuse Prevention Toolkit - from awareness to action

15. Talk to teens about Rx abuse
COMMUNICATE
Talk to teens about Rx abuse
Teens learn by example. When they see mom, dad, a sibling or grandparent taking a pill – even responsibly – it doesn’t seem so bad.
Many teens report that their parents have the greatest influence on their drug use attitudes and decisions.
Kids who continue to learn about the risks of drugs at home are up to 50% less likely to use drugs than those who are not taught about these dangers.
SOURCE: Not Worth the Risk – Maximizing Your Role as a Teen Influencer: What You Can Do To Help Prevent Teen Prescription Drug Abuse, NCPIE.
There are also behavioral clues…[read from slide or allow audience to read]
Rx Abuse Prevention Toolkit - from awareness to action

16. Talking to teens COMMUNICATE
“DENORMALIZE” THE BEHAVIOR While 1 in 5 teens are abusing Rx drugs, 4 in 5 are not.
DEBUNK COMMON MYTHS: Rx abuse is just as dangerous as abusing other substances; it can be addictive; and it’s not OK to misuse these drugs even “once in a while.”
PROVIDE CLEAR GUIDELINES If you’re a parent, let teens know you will be disappointed if they abuse Rx medications and watch how you use medicines in front of teens.
GIVE TEENS ESCAPE ROUTES Teach them how to get out of bad situations; and suggest responses they can use so they don’t feel “uncool.”
“No, thanks – not into it.”
“Not today.”
“I’m not interested.”
SOURCE: Not Worth the Risk – Maximizing Your Role as a Teen Influencer: What You Can Do To Help Prevent Teen Prescription Drug Abuse, NCPIE.
Kids learn by example, so when they see mom, dad, a sibling or a grandparent taking a pill, it doesn’t seem so bad. If you take medications in front of young children or teens, explain why and stress the fact that these are powerful medications that are only safe to use by the person for whom the doctor recommended it.
Rx Abuse Prevention Toolkit - from awareness to action

17. Keep track of your meds SAFEGUARD
Parents (and other family members) are in the best position to reduce access to prescription drugs by locking up medicines and properly disposing of expired or unused medicines.
Monitor all medications in the home—prescription and OTC medicines.
Safely store medicines out of children’s reach and sight Consider locking them up.
Get rid of old or unused medicines.
SOURCE: Not Worth the Risk – Maximizing Your Role as a Teen Influencer: What You Can Do To Help Prevent Teen Prescription Drug Abuse, NCPIE.
Communicating to teens about Rx abuse – providing them with facts, setting limits, safeguarding your meds, giving them the tools to say “no” – are critical to preventing the abuse of these important medications. And if you leave them with anything, let them know that “everyone is NOT doing it.” Four out of 5 teens are NOT abusing these drugs!
Rx Abuse Prevention Toolkit - from awareness to action

18. Guidelines for Rx drug disposal
SAFEGUARD
Guidelines for Rx drug disposal
FEDERAL GUIDELINES
Refer to October 15, 2009 FDA Guidelines for Disposal by Flushing.
Do not flush down toilet or drain unless label or accompanying patient information specifically instructs you to do so.
Dispose of Rx drugs not labeled to be flushed through community drug take-back programs. If a program is not available, dispose of medications appropriately:
Take medication out of its original packaging and place it into a disposable container with a lid or into a sealable bag.
Mix drugs with an undesirable substance (e.g., cat litter or used coffee grounds).
Place sealed container with the mixture and original packaging (be sure to remove all personal information from the packaging) in the trash.
SOURCE: Not Worth the Risk – Maximizing Your Role as a Teen Influencer: What You Can Do To Help Prevent Teen Prescription Drug Abuse, NCPIE.
How often do you go through your medicine cabinet to get rid of unused or expired medicines? Do you even know what’s in there? Probably not. Anyone who has teens living in or possibly visiting their household should take these precautions:
Monitor all prescription and over-the-counter medicines that you and other family members keep in the house, count the pills and check for missing medicine.
Safely store medicines in a dry, cool place (the bathroom medicine cabinet is not an ideal place anyway – it’s warm and damp). Don’t stockpile prescription drugs, and keep them in a safe place out of children’s sight and reach. Many people will save medications, especially antibiotics, pain or sleep medications, for themselves or other family members to use in “emergency” situations. Don’t give your medicines to someone else – you never know how the drug will affect them.
Properly dispose of old or unused medications. Most prescriptions drugs can be placed in a non-see-through container mixed with coffee grinds or kitty litter and thrown in the garbage. Be sure to consult your pharmacist or the drug information accompanying your prescription as certain controlled substances should be flushed down the toilet.
Office of National Drug Control Policy. Proper Disposal of Prescription Drugs Available at:
Rx Abuse Prevention Toolkit - from awareness to action

19. Guidelines for Rx drug disposal
SAFEGUARD
Guidelines for Rx drug disposal
FEDERAL GUIDELINES
Refer to October 15, 2009 FDA Guidelines for Disposal by Flushing.
Do not flush down toilet or drain unless label or accompanying patient information specifically instructs you to do so.
Dispose of Rx drugs not labeled to be flushed through community drug take-back programs. If a program is not available, dispose of medications appropriately:
Take medication out of its original packaging and place it into a disposable container with a lid or into a sealable bag.
Mix drugs with an undesirable substance (e.g., cat litter or used coffee grounds).
Place sealed container with the mixture and original packaging (be sure to remove all personal information from the packaging) in the trash.
Source: COMMUNITY RX CRISIS – Balance and Perspective on Prescription Drug Abuse, NADDI.
There are lots of ways to properly dispose of medications:
Participate in drug take-back programs and household hazardous waste collection activities (contact this coalition for details).
Some drugs are flushable, others are not. Check your medications for instructions, and when in doubt, contact your pharmacist.
Follow the guidelines on how to properly dispose of Rx and over-the-counter medications.
Office of National Drug Control Policy. Proper Disposal of Prescription Drugs Available at:
Rx Abuse Prevention Toolkit - from awareness to action

20. Want to learn more?
ABOVE THE INFLUENCE
COMMUNITY ANTI-DRUG COALITIONS OF AMERICA
THE DRUG TAKE-BACK NETWORK
NATIONAL CONCIL ON PATIENT INFORMATION AND EDUCATION
NATIONAL ASSOCIATION OF DRUG DIVERSION INVESTIGATORS
NATIONAL INSTITUTE ON DRUG ABUSE, PRESCRIPTION DRUGS
PARTNERSHIP FOR A DRUG-FREE AMERICA
WHITE HOUSE OFFICE OF NATIONAL DRUG CONTROL POLICY, EFFORTS TO REDUCE PRESCRITION DRUG ABUSE
Rx Abuse Prevention Toolkit - from awareness to action