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Educa&on  &  Advocacy  Track:  Building  Local  Capacity  to  Prevent  Rx  Drug  Abuse  

Presenters:  

Terry  Cline,  PhD,  Commissioner  of  Health,  Oklahoma  Secretary  of  Health  and  Human  Services,  ASTHO  President  

Gregg  Raduka,  PhD,  LPC,  ICPS,  Director  of  Preven&on/  Interven&on,  The  Council  on  Alcohol  and  Drugs  

Christopher  Wood,  ICPS,  Georgia  DBHDD/Office  of  Preven&on  

Moderator:    Regina  M.  LaBelle,  JD,  Chief  of  Staff,  White  House  Office  of  Na&onal  Drug  Control  Policy    

Disclosures  

•  Terry  Cline  has  no  financial  rela2onships  with  proprietary  en22es  that  produce  health  care  goods  and  services.  

•  Gregg  Raduka  has  no  financial  rela2onships  with  proprietary  en22es  that  produce  health  care  goods  and  services.  

•  Christopher  Wood  has  no  financial  rela2onships  with  proprietary  en22es  that  produce  health  care  goods  and  services.  

Learning  Objec2ves  

1.  Iden2fy  three  policy  and/or  programma2c  approaches  to  prevent  prescrip2on  drug  misuse,  abuse,  and  diversion  toward  the  long-­‐term  improvement  of  health  outcomes.    

2.  Describe  the  role  of  state  health  agencies  in  working  with  other  state  governmental  en22es  and  in  enhancing  collabora2on  with  tradi2onal  and  non-­‐tradi2onal  partners.    

3.  Build  replicable  ac2vi2es  to  form,  sustain  and  engage  an  ac2ve,  statewide  Rx  preven2on  collabora2ve.    

Panel Session: Building Local Capacity to Prevent Rx Drug Abuse Wednesday, April 23, 2014; 1:30 – 2:45 p.m.

Terry Cline, PhD Commissioner of Health

Oklahoma Secretary of Health and Human Services ASTHO President

Panel Session: Building Local Capacity to Prevent Rx Drug Abuse Wednesday, April 23, 2014; 1:30 – 2:45 p.m.

Terry Cline has no financial relationships with proprietary entities that produce health

care goods and services.

Source: CDC. Vital Signs: Overdoses of Prescription Opioid Pain Relievers—United States, 1999-2008. CDC Policy Impact: Prescription Painkiller Overdoses. Available at:

www.cdc.gov/homeandrecreationalsafety/rxbrief/

American Academy of Pain Management American Pharmacists Association American Association of Poison Control Centers American Society of Addiction Medicine PDMP Center of Excellence (Brandeis University) Centers for Disease Control and Prevention Clinton Foundation Federation of State Medical Boards Kanawha-Charleston Health Department Maryland Poison Control Center National Alliance for Model State Drug Laws National Association of Chain Drug Stores National Association of County and City Health Officials National Association of State Alcohol and Drug Abuse Directors National Governors Association National Institute on Drug Abuse Office of the Army Surgeon General Ohio Department of Health Oklahoma State Department of Health Pennsylvania Department of Drug and Alcohol Programs

Personal Advocate Pharmaceutical Research and Manufacturers of America Project Lazarus Safe States Alliance Substance Abuse and Mental Health Services Administration Tennessee Department of Health United States Department of Justice University of Kansas School of Medicine University of Rochester Medical Center Vermont Department of Health White House Office of National Drug Control Policy

Ongoing Work: Expand and Strengthen Key Partnerships

and Collaborative Infrastructure

Prioritize multi-sector efforts and identify collaborations, partnerships, stakeholders, and corresponding efforts to address prescription drug abuse.

Goal: Improve health outcomes and reduce human and economic costs associated with prescription drug misuse, abuse, and overdose.

Pledge: Reduce the rate of nonmedical use and the number of unintentional overdose deaths involving controlled prescription drugs* 15 percent by 2015.

*(including opioid analgesics, stimulants, tranquilizers, and sedatives)

Encourages all S/THOs to apply strategies to achieve measurable reductions in controlled prescription drug misuse, abuse, and overdose

Identify at least one policy or program to implement, improve, or evaluate in the next year

Move beyond “silo-based” approaches to focus on collaboration with partners to carry out aligned, comprehensive efforts

Metric TennCare Paid Live Births1 TennCare non-

LBWT Births TennCare Live LBWT Births2 NAS Infants

Number of Births 45,205 40,437 4,768 528 Cost for Infant in First Year of Life $350,936,293 $171,336,964 $179,599,329 $33,249,612 Average Cost per Child $7,763 $4,237 $37,668 $62,973 Average Length of Stay (days) 4.8 3.2 18.3 32.5

1 This sample contains only children that were directly matched to TennCare’s records based on Social Security Number. 2 Any infant weighing under 2,500g at the time of birth was considered low birth weight (LBWT).

Infants Born in CY 2011 NAS Infants Total # of Infants 55,578 528 Total # Infants in DCS 767 120 % in DCS 1.4% 22.7%

Percentage of Newborns in DCS Custody within One Year of Birth, CY 2011

Impact of NAS on Infant Health Care Expenditures, CY 2011

Source: Ohio Department of Alcohol and Drug Addiction Services SFY 2012 Annual Report

This map uses hot spot analysis to display the number of clients in treatment who list heroin (left), prescription opioids (right) as a

primary drug of choice by zipcode.

September 2012 – Governor Mary Fallin’s Prescription Drug Task Force Created

February 2013 – Finalized State Plan

October 2013 – Distributed Opioid Prescribing Guidelines

December 2013 – Governor’s Launch of Plan and Media Campaign

April 2014 – Naloxone Program Begins

HB 1781 – Prescription Drug Monitoring Program (PDMP) Access Grants the Department of Health and the Department of Mental Health and Substance Abuse Services access to PDMP; shared data may be used for statistical, research, substance abuse prevention provided that confidentiality is maintained.

HB 1782 – Naloxone Allows first responders to administer opiate antagonists without a prescription when encountering a person exhibiting signs of a drug overdose, and allows prescriptions to family members so they can administer in an overdose situation.

HB 1783 – Emergency Rule Changes Hydrocodone Refills Limits hydrocodone refills with no automatic refills; new prescription required.

$1.2 million appropriated specifically for prescription drug initiatives annually

As of 04/09/2014, 27 states and one territory have accepted the Challenge!  

www.astho.org/rx

BUILDING LOCAL CAPACITY National Rx Drug Abuse Summit

April 23, 2014 Gregg Raduka, Ph.D., LPC, ICPS

Director of Prevention/Intervention The Council on Alcohol and Drugs

Disclaimer:    Dr.  Gregg  Raduka  has  no  

financial  rela&onships  with  proprietary  en&&es  that  produce  health  care  goods  

and  services.

Learning Objectives of Dr. Raduka’s Presentation will

enable attendees to: 1.  Iden2fy  three  policy  and/or  programma2c  approaches  to  prevent  prescrip2on  drug  misuse,  abuse,  and  diversion  toward  the  long-­‐term  improvement  of  health  outcomes.  2.  Build  replicable  ac2vi2es  to  form,  sustain  and  engage  an  ac2ve,  statewide  Rx  preven2on  collabora2ve.  

Funded by the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD), Office of Prevention Services & Programs

Services  based  on  4  Office  of  Na&onal  Drug  Control  Policy  (ONDCP)  priority  areas:  

Educa&on  Advocacy/  Enforcement    Safe  Storage  and  Secure  Disposal    

Uses  5  Steps  of  Strategic  Preven&on  Framework    Needs  Assessment  /  Capacity  Building  /  Planning  /  Implementa&on  /  Evalua&on  

The  Ins&tute  of  Public  Health  at  Georgia  State  University,    in  concert  with  the  Ini&a&ve,  published  a  statewide  Needs  Assessment  re:  Rx  drug  abuse  in  Georgia  during  Year  01.  

Tip:  Not  all  Evaluators  can  do    Needs  Assessments.  

Needs  Assessment    

Georgia  Prescrip&on  Drug  Abuse                                            Preven&on  Collabora&ve  

4  Priority  Area  Facilitators    4  Priority  Area  Teams  4  Priority  Area  Ac&on  Plans  

     Educa&on  /  Advocacy    Safe  Storage  and  Secure  Disposal    Law  Enforcement  

Collabora&ve  became    Policy  Educa&on  Body    as  one  of  its  func&ons  

Major  strides  were  made  in  informing  policy  decisions  of  the  Georgia  General  Assembly    

during  their  2013  and  2014    legisla&ve  sessions  

We  clearly  defined  terms  –  “Advocacy”  used  as    Umbrella  Term  

Collabora&ve  Members  informed  about  differences  between    

“Lobbying”  and  “Policy  Educa&on”  (See  Handout  for  Defini&ons)  

Lobbyists  hired  as    Policy  Educa&on  Advisors  

Policy  Advisor  created  Tips  for  Communica&ng  with  Legislators  

(see  Handout)  

Major  Tips:  1.   You  are  the  rela&ve  expert  

2.  Don’t  be  afraid  to                                                                    talk  to  your  legislator  

In  2013  the  Collabora&ve  was  instrumental  in  gedng  dispenser  Prescrip&on  Drug  Monitoring  Program  (PDMP)  sharing  as  well  as  a  Pill  Mill  bill  passed.  

In  2014  the  Ini&a&ve  was  instrumental  in  gedng  prescriber  PDMP  sharing  passed,  helping  to  keep  PDMP  from  possibly  going  offline  in  2015.

Media  Awareness  Campaign  

Website:  www.StopRxAbuseinGA  

Drug  Drop  Box  Campaign  

The  Council  on  Alcohol  and  Drugs,  with  the  assistance  of  DBHDD,    planned,  funded,  directed  and  executed  the  successful  placement  of  139  law  enforcement-­‐

maintained  Rx  &  OTC  drug  drop  boxes  across  the  state,  making  Georgia  the  leader  in  the  

na&on  in  the  number  of  such    drug  drop  boxes.  

What’s  in  the  Water?  

The  Ini&a&ve  will  be  collabora&ng  with  the  Georgia  Water  Associa&on  to  protect  Georgia’s  public  water  supply  from  contamina&on  from  

prescrip&on  drugs.    

Gregg Raduka, Ph.D., LPC, ICPS graduka@livedrugfree.org

404-223-2483

National Rx Drug Abuse Summit April 23, 2014

Christopher Wood, ICPS Georgia DBHDD/Office of Prevention

Christopher Wood has no financial relationships with proprietary entities

that produce health care goods and services.

Learning Objective: o  Identify three policy and/or

programmatic approaches to prevent prescription drug misuse, abuse, and diversion toward the long-term improvement of health outcomes.

o  SAMHSA PFS II Grant o  High Need/Low Capacity Areas o  Objective & Target Populations o  Strategies /Approach o  ONDCP Rx Plan

o  Needs Assessments

Strategies: o  Additional Rx Drug Drop Box o  Medicine Safes o  Parenting Classes o  Social Marketing Campaign o  Theater Troupe

Strategies: o  Multiple Drug Drop Boxes o  Pharmacy Sticker Shock o  Social Access Campaign o  Movie Theater PSA’s

Strategies: o  Additional Rx Drug Drop Box o  Multiple Take Back Events o  “Where’s the Box?” Media Campaign o  Water Ways o  Rx for Understanding

Christopher Wood, ICPS chwood@dbhdd.ga.gov

404-657-2176