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Coali&ons At Work: Implemen&ng the Seven Behavior

Change Strategies at the Community Level ________________________

Sue Thau, Public Policy Consultant Mary Elizabeth Ellio9, VP, Communica<ons, Membership & IT

CADCA

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Community an<-‐drug coali<ons play a unique role that involves:

•  Reducing access and availability;

•  Enforcing consequences;

•  Changing aMtudes and percep<ons;

•  Changing social norms;

•  Raising awareness about costs and consequences; and

•  Building skills in youth, parents and communi<es to deal with these issues effec<vely

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What is a coali&on? A coali<on is a formal arrangement for

coopera<on and collabora<on between groups or sectors of the community, in which each group retains its iden<ty but all agree to work together towards a common goal of building a safe, healthy and drug-‐free community.

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Coali<ons convene and combine talent and resources to address local substance abuse issues:

Key Sectors

• Law enforcement • Youth • Parents • Businesses • Media • Schools • Youth serving organiza<ons

• Faith based community • Civic and volunteer groups • Health care professionals • State, local or tribal agencies • Other organiza<ons involved in reducing substance abuse

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Environmental and Popula&on Level Strategies Are Effec&ve

Effec<ve substance abuse preven<on is comprehensive, community-‐wide and includes environmental and popula<on level strategies designed to change or strengthen norms against alcohol and drug use.

Environmental strategies involve changes in legisla<on, policy and enforcement throughout an en<re community.

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The community coali&on model, specifically the Drug Free Communi&es program, has proven successful in reducing substance use/abuse,

including the misuse and abuse of prescrip&on drugs

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DFC Program

•  Na<onal program, created by Congress in 1997

•  Reauthorized in 2001 and again in 2006 •  Recognizes the importance of mul<sector comunity

coali<ons in reducing substance abuse

•  Establishes funding for local community coali<ons – (local coali<ons can apply for up to $125,000 dollars per year for a period of up to five years -‐ renewable)

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DFC Program Requirements To be eligible to compete for a DFC grant, a coali&on must:

•  Have the reduc<on of substance abuse among youth as its principal mission, and must target mul<ple drugs

•  Have been in existence for at least 6 months •  Have representa<on from the each of the 12 sectors •  Be able to demonstrate through its mee<ng minutes that it func<ons as a unique en<ty and is more than a group of agency and organiza<on representa<ves or a board of directors of a direct service delivery organiza<on

•  Coali<ons are only eligible to receive as much federal funding as they can match, dollar for dollar, with non-‐ Federal support, up to $125,000

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Na&onal Drug Free Communi&es (DFC) Program Evalua&on Findings

• Past 30-‐day use of alcohol, tobacco, and marijuana have declined significantly and in all grade levels between DFC coali<ons’ first and most recent data report.

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These results are being mirrored at the local level in communi&es throughout the

country.

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In this DFC community, past 30 day use of marijuana use among 10th graders decreased to 10.6% in 2010, a 47.3% decrease since 2002. During this same <me frame, according to Monitoring the Future (MTF), the na<onal rate decreased to 16.7%, a 6.2% decrease since

2002.

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• Partnering with schools to implement zero tolerance policies related to any substance that is illegal or the abuse of legal drugs (over the counter drug or prescrip<on drugs);

• Providing youth leadership training and parent educa<on workshops; and

• Partnering with local newspapers to raise awareness about the risks/harms associated with illegal drugs and alcohol

Strategies Implemented To Achieve Reduc&ons

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In this DFC community, past 30 day use of marijuana use among 12th graders decreased to 14% in 2012, a 36.4% decrease since 2004. During this same <me frame,

according to Monitoring the Future (MTF), the na<onal rate actually increased to 22.9%, a 15.1% increase since 2004.

2004 2012 Na<onal MTF Rate (2004) Na<onal MTF Rate (2012)

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2004 2012

Past 30 Day Use of Marijuana Among 12th Graders

Carter County Drug Task Force

Ashland, KY

22.9

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•  Developing and implemen<ng public awareness and media campaigns;

•  Increasing parent training and educa<on; and

•  Promo<ng meaningful opportuni<es for youth par<cipa<on.


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DFC coali&ons are singularly situated to deal with emerging drug trends, such as the misuse and abuse of prescrip&on drugs because they have the necessary infrastructure in place

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Keys To Pushing Back Against The Misuse and Abuse of Rx Drugs

•  Taking a comprehensive, data driven approach that appropriately mobilizes each of the key sectors and actors who have a role in reducing access to and availability of prescrip<on drugs

•  Changing social norms about the harm that misuse and abuse of these substances can cause is also cri<cal

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Seven Strategies To Affect Community Change:

Based on local data and condi<ons, coali<ons implement mutually reinforcing combina<ons of seven strategies to

achieve popula<on level reduc<ons in the misuse and abuse of prescrip<on drugs

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Strategy 1: Providing informa&on

•  This strategy involves raising awareness within the community-‐at-‐large -‐ to include youth, parents, police officers, healthcare providers and educators, etc. – with educa<onal presenta<ons, workshops or seminars and data or media presenta<ons.

•  The goal is to increase the knowledge base of the community and raise general awareness around prescrip<on drug abuse.

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Strategy 1 In Ac&on

•  The Woonsocket Preven<on Coali<on implemented media campaigns to raise widespread awareness about the dangers of prescrip<on drug abuse in their communi<es.

•  The Carter County Drug Task Force in Ashland, Kentucky distributed 35,000 Push Cards on “Preven<ng Abuse of Prescrip<on and Over-‐the-‐Counter Medica<ons” and 35,000 Push cards distributed on “Guidelines for Proper Disposal of Prescrip<on Drugs”.

•  Coali<ons oren launch these types of campaigns during Na<onal Medicine Abuse Awareness Month, held every October.

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Strategy 2: Enhancing Skills

•  This strategy provides workshops, seminars or other ac<vi<es designed to increase the skills of those who can prevent, iden<fy and treat prescrip<on drug abuse, including:

•  Healthcare and dental providers;

•  Pharmacists;

•  Parents and adult care givers;

•  Educators;

•  Law enforcement;

•  Businesses; and

•  Youth

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Strategy 2 In Ac&on

•  NCADD of Middlesex County delivered community educa<on presenta<ons to enhance the skills of community members who can prevent and iden<fy prescrip<on drug abuse, such as law enforcement, youth, parents and the medical community

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Strategy 3: Providing Support

•  This strategy provides reinforcement and encouragement for par<cipa<on in ac<vi<es that prevent prescrip<on drug abuse

•  The goal is to stop prescrip<on drug abuse before it ever starts

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Strategy 3 In Ac&on

•  The Shelby County Drug Free Coali<on partnered with local pharmacies to distribute prescrip<on drug warnings to raise awareness about the dangers of abuse.

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Strategy 4: Enhancing or Reducing Access and Barriers

•  This strategy u<lizes the systems and services that reduce illegal access to prescrip<on medica<ons while protec<ng access for those who legi<mately need medica<ons to relieve pain.

•  It targets healthcare providers, pharmacists, law enforcement officials, educators and public health officials and encourages en<re communi<es to take ac<on.

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Strategy 4 In Ac&on

•  The Delaware Coordina<ng Council to Prevent Alcohol and Other Drug Abuse reduced barriers to proper medicine disposal by partnering with the Delaware County TRIAD program, a community based organiza<on sponsored by the Delaware County Sheriff’s office, which provides proper disposal of unused and expired medica<on.

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Strategy 5: Changing Consequences

This strategy focuses on increasing or decreasing the probability of a specific behavior by changing the consequences (e.g., increasing public recogni<on for deserved behavior, individual and business rewards, taxes, cita<ons, fines, revoca<ons and loss of privileges).

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Strategy 5 In Ac&on

•  Coali<ons can recognize den<sts who have received training on prescribing protocols and subsequently prescribe less than the full 30 day supply of pain medicine when trea<ng adolescents who have their wisdom teeth removed.

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Strategy 6: Changing Physical Design

•  This strategy focuses on safeguarding prescrip<on medicines to ensure that they will not be misused and abused, and targets everyone in the community.

•  It involves changing the physical design or structure of the environment to reduce access and availability.

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Strategy 6 In Ac&on

•  The Cherokee Na<on installed a permanent medicine drop off box in the lobby of their police sta<on

•  It also partnered with local homebuilders to ensure that the installa<on of one locking medicine cabinet is standard in every new home that is built.

•  The Jackson County An<-‐Drug Coali<on purchased an incinerator to dispose of all returned medicines in their community.

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Strategy 7: Modifying and Changing Policies

•  This strategy is aimed at changing policies, laws and procedures to prevent current and future prescrip<on drug abuse.

•  The target audience includes lawmakers, state and local public officials, employers and others involved in seMng rules and regula<ons.

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Strategy 7 In Ac&on

•  In carrying out this strategy, coali<ons oren support the passage and u<liza<on of prescrip<on drug monitoring programs, drug take-‐back and disposal legisla<on, statutes that support increased penal<es against doctors who prac<ce unscrupulous prescribing procedures, those who par<cipate in doctor shopping, etc.

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Strategy 7 In Ac&on

•  The Metropolitan Drug Commission submi9ed an applica<on through the State of Tennessee for a planning grant to:

1)  Develop a statewide prescrip<on drug task force to assist in the early detec<on, interven<on and preven<on of prescrip<on drug abuse and addic<on;

2)  Educate both the health care community and the public; and

3)  Assist law enforcement with access to the developing state Prescrip<on Drug Program created through the Controlled Substance Monitoring Act of 2002.

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DFC coali&ons have achieved major results

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In this DFC community, past 30 day non-‐medical use of prescrip<on drugs decreased at a rate of 88.9% among 10th graders; 83.3% among 12th graders.

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10th Grade 12th Grade

Carter County Drug Task Force Grayson, KY

Past 30 day Non-‐Medical Use of Prescrip&on Drugs Among 10th and 12th Graders

2004 2010 2012

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•  Partnered with local law enforcement to implement take back events and increase DUI/drug suppression checks;

•  Provided funding for law enforcement agencies to receive drug suppression training;

•  Implemented a social norms media campaign;

•  Provided educa<on to parents, teachers, youth and healthcare professionals; and

•  Convened a key leader community forum to educate elected officials about the growing prescrip<on drug problem


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Barrington Prevention Coalition (BAY TEAM)

Barrington, RI

Past 30 Day Non-Medical Use of Prescription Drugs

Among 12th Graders

In this DFC community, past 30 day non-‐medical use of prescrip<on drugs decreased at a rate of 61.1%, from 18% in 2009 to 7% in 2011.

■2009 ■2011

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•  Partnered with local law enforcement to: 1) implement three take back events; and 2) distribute “you should know” le9ers to the peers of any youth arrested for a substance abuse related offense

•  Provided parent educa<on

•  Developed and disseminated a brochure on the dangers associated with the misuse and abuse of prescrip<on drugs


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CADCA’s OTC and Rx Drug Abuse Recommenda<ons and Resources

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OTC and Rx Drug Abuse is a Concern for CADCA Coali<ons

In our 2013-‐2013 Annual Survey of Coali<ons we asked… Does your coali<on collect data on any of the following substances? •  Cough medicine – 25.31% •  Hydrocodone – 39.17% •  Oxycodone – 47.24% •  Prescrip&on drugs (not Hydro/Oxy) – 74.54%

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OTC and Rx Abuse A Concern, Cont.

Rank of the top 5 substances that are causing the most problems in your community?

•  Cough medicine – 3.1%

•  Hydrocodone – 17.36% •  Oxycodone – 28.43% •  Prescrip&on drugs (not Hydro/Oxy) – 66.05%

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OTC and Rx Abuse A Concern, Cont.

Which of the following substances is your coali<on currently addressing?

•  Cough medicine – 11.31%

•  Hydrocodone – 24.32% •  Oxycodone – 30.41% •  Prescrip&on drugs (not Hydro/Oxy) – 58.7%

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1.  Expand effec<ve Prescrip&on Drug Monitoring Programs to ensure adequate coverage in every state and interoperability to share data where appropriate.

2.  Enhance educa<on and training of medical and dental professionals in proper prescribing protocols.

3.   Raise the general public’s awareness about the dangers of prescrip<on drug abuse as well as the proper ways to store and dispose of them.

4.  Enhance opportuni<es for prescrip<on take back and other large scale disposal programs.

CADCA Recommendations

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Recommenda&ons, Cont.

5. Support increased law enforcement and legal remedies to close down “pill mills.”

6. Require manufacturers to create abuse deterrent formula&ons for commonly-‐abused prescrip&on painkillers.

7. Expand the number of DFC funded communi&es and train more communi&es to implement comprehensive, data driven strategies to effec<vely address their local prescrip<on drug abuse problems.

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CADCA Supports the Office of Na4onal Drug Control Policy (ONDCP) Plan

and the Na4onal Governor’s Issue Brief “Six Strategies for Reducing Prescrip4on

Drug Abuse”

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CADCA’s Resources and Ac&on  Published first Rx abuse preven<on toolkit in 2002

 Dose of Preven<on Toolkit on cough medicine abuse in 2006

 Town hall mee<ngs

 Stopmedicineabuse.org with partner CHPA

 Informa<onal video developed for communi<es

 5 CADCA TV shows

 Strategizer publica<on with ONDCP in 2008

 Rx Abuse Preven<on Toolkit: From Awareness to Ac<on in 2010Na<onal Medicine Abuse Awareness Month

 General Dean tes<fies before Congress

 Hosted two half-‐day Rx specific trainings at the 2012 Mid-‐Year

  New online course launched October 2012

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No-‐Cost Online Medicine Abuse Preven&on Course for Coali&ons

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•  hkp://learning.cadca.org/

•  10 modules – es<mated 6 hours to complete

•  Cer<ficate upon comple<on, con<nuing educa<on credits.

•  Take the course at no cost –and give us feedback at [email protected].

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Na&onal Medicine Abuse Awareness Month

•  CADCA’s partner is the Consumer Healthcare Products Associa<on

•  Annual CADCA 50 Challenge encourages coali<ons to host educa<onal events in October.

•  56 coali<ons, represen<ng 35 states par<cipated

•  Our Dose of Preven<on Award recognizes best coali<on outreach on OTC and Rx Medicine Abuse Preven<on each year at the CADCA Forum.

•  CADCA hosts town hall mee<ngs, Twi9er chats, and webinars each October to raise awareness.

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New Partnerships in Rx Drug Abuse Preven<on a focus at CADCA’s Mid-‐Year

Training Ins<tute •  An in-‐depth and unique coali<on

training experience, featuring 1, 2 and 4-‐day courses.

•  Average a9endance is 1800. •  July 21-‐24, 2014 in Orlando, Fla. •  Rx courses will focus on unique

partnerships; statewide ini<a<ves/plans and new places coali<ons can have an impact

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Visit us on the Web at www.cadca.org

Call us at 1-‐800-‐54-‐CADCA

Email Membership: [email protected]

Email Training and TA: [email protected]

Join us via Social Media: Facebook: facebook.com/CADCA

Twi9er: @cadca

Connected Communi<es Network: h9p://connectedcommuni<es.ning.com

YouTube: youtube.com/cadca09

Flickr: flickr.com/photos/cadca

Linkedin: Linkedin/company/cadca

Stay Connected with CADCA

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