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• 1.Educa&on&AdvocacyTrack: BuildingLocalCapacityto PreventRxDrugAbuse Presenters: TerryCline,PhD,CommissionerofHealth,OklahomaSecretaryof HealthandHumanServices,ASTHOPresident GreggRaduka,PhD,LPC,ICPS,DirectorofPreven&on/ Interven&on,TheCouncilonAlcoholandDrugs ChristopherWood,ICPS,GeorgiaDBHDD/OceofPreven&on Moderator:ReginaM.LaBelle,JD,ChiefofSta,WhiteHouse OceofNa&onalDrugControlPolicy

2. Disclosures TerryClinehasnonancialrela2onshipswith proprietaryen22esthatproducehealthcaregoods andservices. GreggRadukahasnonancialrela2onshipswith proprietaryen22esthatproducehealthcaregoods andservices. ChristopherWoodhasnonancialrela2onships withproprietaryen22esthatproducehealthcare goodsandservices. 3. LearningObjec2ves 1. Iden2fythreepolicyand/orprogramma2c approachestopreventprescrip2ondrugmisuse, abuse,anddiversiontowardthelong-term improvementofhealthoutcomes. 2. Describetheroleofstatehealthagenciesin workingwithotherstategovernmentalen22es andinenhancingcollabora2onwithtradi2onal andnon-tradi2onalpartners. 3. Buildreplicableac2vi2estoform,sustainand engageanac2ve,statewideRxpreven2on collabora2ve. 4. 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 5. 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. 6. Source: CDC. Vital Signs: Overdoses of Prescription Opioid Pain RelieversUnited States, 1999-2008. CDC Policy Impact: Prescription Painkiller Overdoses. Available at: www.cdc.gov/homeandrecreationalsafety/rxbrief/ 7. 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. 8. 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) 9. 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 10. 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 TennCares 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 11. 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. 12. September 2012 Governor Mary Fallins Prescription Drug Task Force Created February 2013 Finalized State Plan October 2013 Distributed Opioid Prescribing Guidelines December 2013 Governors Launch of Plan and Media Campaign April 2014 Naloxone Program Begins 13. 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 14. As of 04/09/2014, 27 states and one territory have accepted the Challenge! www.astho.org/rx 15. 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 16. Disclaimer: Dr.GreggRadukahasno nancialrela&onshipswith proprietaryen&&esthat producehealthcaregoods andservices. 17. Learning Objectives of Dr. Radukas Presentation will enable attendees to: 1.Iden2fythreepolicyand/or programma2capproachestoprevent prescrip2ondrugmisuse,abuse,and diversiontowardthelong-term improvementofhealthoutcomes. 2.Buildreplicableac2vi2estoform, sustainandengageanac2ve, statewideRxpreven2oncollabora2ve. 18. Funded by the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD), Office of Prevention Services & Programs 19. Servicesbasedon4OceofNa&onal DrugControlPolicy(ONDCP)priority areas: Educa&onAdvocacy/Enforcement SafeStorageandSecureDisposal Uses5StepsofStrategicPreven&on Framework NeedsAssessment/CapacityBuilding/ Planning/Implementa&on/Evalua&on 20. TheIns&tuteofPublicHealthat GeorgiaStateUniversity, inconcertwiththeIni&a&ve, publishedastatewideNeeds Assessmentre:Rxdrugabusein GeorgiaduringYear01. Tip:NotallEvaluatorscando NeedsAssessments. NeedsAssessment 21. GeorgiaPrescrip&onDrugAbuse Preven&onCollabora&ve 4PriorityAreaFacilitators 4PriorityAreaTeams 4PriorityAreaAc&onPlans Educa&on/Advocacy SafeStorageandSecureDisposal LawEnforcement 22. Collabora&vebecame PolicyEduca&onBody asoneofitsfunc&ons Majorstridesweremadeininformingpolicy decisionsoftheGeorgiaGeneralAssembly duringtheir2013and2014 legisla&vesessions 23. Weclearlydenedterms Advocacyusedas UmbrellaTerm Collabora&veMembersinformedabout dierencesbetween LobbyingandPolicyEduca&on (SeeHandoutforDeni&ons) Lobbyistshiredas PolicyEduca&onAdvisors 24. PolicyAdvisorcreatedTipsfor Communica&ngwithLegislators (seeHandout) MajorTips: 1. Youaretherela&veexpert 2.Dontbeafraidto talktoyourlegislator 25. In2013theCollabora&vewasinstrumentalin gedngdispenserPrescrip&onDrug MonitoringProgram(PDMP)sharingaswell asaPillMillbillpassed. In2014theIni&a&vewasinstrumentalin gedngprescriberPDMPsharingpassed, helpingtokeepPDMPfrompossiblygoing oinein2015. 26. MediaAwarenessCampaign Website: www.StopRxAbuseinGA 27. DrugDropBoxCampaign TheCouncilonAlcoholandDrugs,withthe assistanceofDBHDD,planned,funded, directedandexecutedthesuccessful placementof139lawenforcement- maintainedRx&OTCdrugdropboxesacross thestate,makingGeorgiatheleaderinthe na&oninthenumberofsuch drugdropboxes. 28. WhatsintheWater? TheIni&a&vewillbecollabora&ng withtheGeorgiaWaterAssocia&on toprotectGeorgiaspublicwater supplyfromcontamina&onfrom prescrip&ondrugs. 29. Gregg Raduka, Ph.D., LPC, ICPS graduka@livedrugfree.org 404-223-2483 30. National Rx Drug Abuse Summit April 23, 2014 Christopher Wood, ICPS Georgia DBHDD/Office of Prevention 31. Christopher Wood has no financial relationships with proprietary entities that produce health care goods and services. 32. 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. 33. 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 34. Strategies: o Additional Rx Drug Drop Box o Medicine Safes o Parenting Classes o Social Marketing Campaign o Theater Troupe 35. Strategies: o Multiple Drug Drop Boxes o Pharmacy Sticker Shock o Social Access Campaign o Movie Theater PSAs 36. Strategies: o Additional Rx Drug Drop Box o Multiple Take Back Events o Wheres the Box? Media Campaign o Water Ways o Rx for Understanding 37. Christopher Wood, ICPS chwood@dbhdd.ga.gov 404-657-2176