1. 1 Alcohol and Substance Abuse Council of Jefferson County, Inc. 167 Polk Street, Suite 320 Watertown, New York 13601 Voice: 315-788-4660; Fax: 315-788-4922; Web: www.jcasac.com; Blog: www.jcasac.com/blogwww.jcasac.com

2.  Use of a medication without a prescription  Use in ways other than as prescribed  Use for the experience or feelings elicited 2 Source: http://www.drugabuse.gov/publications/research-reports/prescription-drugs/what-prescription-drug-abusehttp://www.drugabuse.gov/publications/research-reports/prescription-drugs/what-prescription-drug-abuse

3.  Type of poisoning  Prescription drugs used in AMOUNTS or IN WAYS NOT recommended  No harm intended by user  Limited number of ingestions by young children or innocent mistakes by patients 3 Source: Public Health Grand Rounds, February 17, 2011, Center for Disease Control and Prevention

4.  Types of Drugs  Drugs that depress breathing ▪ Opioid pain medication ▪ Sedative/hypnotics  Usually multiple drugs involved  Frequently combined with illicit drugs  Reasons for use  Original use: relief of pain and anxiety  Development of tolerance  Escalated use for “high” Source: Public Health Grand Rounds, February 2011, Center for Disease Control and Prevention 4

5. OPIOIDS – INDICATED FOR PAIN  Hydrocodone (Vicodin)  Oxycontin  Propoxyphene (Darvon)  Diphenoxylate (Lomotil)  Fentanyl DEPRESSANTS – INDICATED FOR ANXIETY AND SLEEP DISORDERS  Barbiturates  Pentobartil sodium (Nembutal)  Benzodiazepines  Diazepam (Valium)  Alprazolam (Xanax)  Corvalolum 5 Source: www.oasas.ny.gov/StopRxMisuse/comRX.cfm

6. 6 Source: http://www.drugabuse.gov/publication s/research-reports/prescription- drugs/what-are-some-commonly- abused-prescription-drugs http://www.drugabuse.gov/publication s/research-reports/prescription- drugs/what-are-some-commonly- abused-prescription-drugs

7.  Because of the increase in the number of prescriptions drugs, more medications are available for misuse/abuse and diversion  Prescription drug misuse/abuse and diversion have tremendous impacts on the individual, the community, and the healthcare and judicial systems 7

8.  2008 – 15,000 fatal overdoses  1999 – 4,000 fatal overdoses  2010 - 1 in 20 people age 12> reported using prescription painkiller for nonmedical reasons in the past year  2009 – Approx. 500,000 ER visits due to misuse or abuse of prescription medication  1 Month – Enough prescription painkillers were prescribed in 2010 to medicate every American adult 24/7 for a month  More men than women die of overdoses from prescription painkillers  People in rural counties are 2 times as likely to overdose on prescription painkillers Source: CDC Vital Signs, November 2011 8

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10. In 2008, 14,800 prescription pain medication deaths  For every 1 death there are ▪ 10 treatment admissions for abuse ▪ 32 emergency department visits for misuse or abuse ▪ 130 people who abuse or are dependent ▪ 825 nonmedical users 10 Source: http://www.questdiagnostics.com/dms/Documents/health-trends/PDF-MI3040_PDM- Report_24638_FIN_Digital_4-20-12/PDF%20MI3040_PDM%20Report_24638_FIN_Digital_4-20-12.pdfhttp://www.questdiagnostics.com/dms/Documents/health-trends/PDF-MI3040_PDM- Report_24638_FIN_Digital_4-20-12/PDF%20MI3040_PDM%20Report_24638_FIN_Digital_4-20-12.pdf

11. 11 Source: http://www.questdiagnostics.com/dms/Documents/health-trends/PDF-MI3040_PDM- Report_24638_FIN_Digital_4-20-12/PDF%20MI3040_PDM%20Report_24638_FIN_Digital_4-20-12.pdfhttp://www.questdiagnostics.com/dms/Documents/health-trends/PDF-MI3040_PDM- Report_24638_FIN_Digital_4-20-12/PDF%20MI3040_PDM%20Report_24638_FIN_Digital_4-20-12.pdf

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13. 13 Source: Center for Disease Control, Public Health Grand Rounds, National Center for Health Statistics. Vital Health Stat 13 (163). 2006; www.cdc.gov/nchs/data/series/sr_13/sr_13163.pdfwww.cdc.gov/nchs/data/series/sr_13/sr_13163.pdf

14. Source: Public Health Grand Rounds, February 2011, National Survey on Drug Use and Health. Summary of national findings, 2008-2009, www.oas.samhsa.govwww.oas.samhsa.gov 14

15. Source : JEFFERSON COUNTY PUBLIC HEALTH SERVICE, MEDICAL EXAMINER PROGRAM, Numbers of Deaths from Total Overdoses; Opiates Overdoses, 2012:. Through September 2012, there have been 8 confirmed overdoses, with another 3 suspected (under review). Of the confirmed cases, 6 are opiates overdoses. 15

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17. 17 SOURCE: Adapted by CESAR from Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Detailed Tables, 2012. Available online at http://www.samhsa.gov/data/NSDUH/2011SummNatFindDetTables/Index.aspx.

18.  Education  Increase Awareness  Safe medication use, storage, and disposal  Education for health care providers  Appropriate prescribing  Adverse events and drug interactions  Identifying those at risk for abuse  Counseling on proper storage and disposal  Screening, intervention, and referral for those misusing or abusing prescription drugs 18 Source: Source: Public Health Grand Round, February 17, 2011, Center for Disease Control and Prevention;

19.  Tool to identify  Inappropriate prescribing, dispensing, and drug- seeking behavior  Drug interactions and therapeutic duplication  Goals  All states have operational PDMPs  Mechanisms in place for communication between states  High utilization among health care providers ▪ Regular part of office visit like checking insurance coverage 19 Source: Public Health Grand Rounds, February 2011, Center for Disease Control and Prevention

20.  Goals  To be easily accessible and an environmentally friendly method of drug disposal  To be cost-effective and not a burden on consumers  To reduce the amount of prescription drugs available for diversion and abuse 20 Source: Public Health Grand Round, February 17, 2011, Center for Disease Control and Prevention

21.  Assist in addressing doctor and pharmacy shopping  Support prescription drug abuse-related training programs for law enforcement 21 Source: Public Health Grand Round, February 17, 2011, Center for Disease Control and Prevention

22.  Signed into effect on September 18, 2011  Rationale: To save lives; to grant limited shield from charge and prosecution  In 2008, 900 people died from accidental drug overdoses in New York State  www.drugpolicy.org www.drugpolicy.org  http://www.ithaca.edu/sacl/healthpromotion/docs/nysgoodsamaritan.pdf http://www.ithaca.edu/sacl/healthpromotion/docs/nysgoodsamaritan.pdf 22

23.  Discussions  Who needs to be at the table but is not?  Who will invite that person or entity?  Other 23