Rx misuse among ya including pain relievers

Introduction to Prescription Medication Misuse Among Youth and Young Adults

Jennifer Arbour, LMHCSubstance Use Navigation (SUN) Project Beverly MA

Guest Speaker: Gina Borrazzo Learn to CopeParent and Community MemberTewksbury, MA

January 15, 2013

Keys Goals of Presentation

• Identify prescription medications commonly misused by youth and young adults with focus on pain medications

• Identify misuse, dependency, addiction

• Briefly review developmental vulnerabilities normal to adolescence

• Summarize relevant national trends

• Identify resources

• Parent Share from Learn2Cope

• Group Discussion, Q&A

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• The SUN Project is a new, 3-year program funded by the Tower Foundation that will provide Substance Use Navigation to youth experiencing substance use issues and their families.

• A Master’s Level Clinician and paraprofessional team will work directly with families as well as establish tools, resources, and trainings for LHBS staff, school personnel, community members, and families on issues related to substance use and recovery.

The SUN Project Overview

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Key Goals of the Project

1. Train key staff to consistently and thoroughly screen youth for substance use

2. Increase staff skill in motivational interviewing

3. Increase the number of youth referred for substance use treatment

4. Provide resources and support to families.

Types of Prescription Medications

Types of Prescription Medications continued

Stimulants: used to treat attentional difficulties

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Drug Name Brand Name

Dextro-amphetamine Adderall (among others)Methylphenidate Ritalin, Concerta (among

others)


Benzodiazepines: used to treat anxiety and panic difficulties.

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Drug Name Brand Name

Diazepam ValiumClonazapine KlonopinAlprazolam XanaxLorazepam Ativan

Types of Prescription Medications

Opioids: used to manage pain related to end of life and terminal illness,

major bodily injuries and discomforts related to old injuries

Three classes:• Natural: chemical compounds from opium poppy plant

• Semi-synthetic: created from natural opiates

• Fully-synthetic: chemically made

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Opioids continued

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Class Drug Name Brand Name

Natural

Morphine AVINzaKadianMS-ContinOra-morph

Codeine

Thebaine (also called paramorphine)

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Opioids continued


Semi-synthetic

Hydrocodone Lortab, VicodinHydromorphone Dilaudid, Exalgo

Oxycodone OxyContin, Roxicodone,

Percocet, Tylox, Percodan

Oxymorphone Opana

Diacetylmorphine (heroin)

Buprenorphine Butrans


Opioids continued

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Fully Synthetic

Fentanyl DuragesicFentoraOnsolis

Meperidine Demerol

Methadone DisketsDolophineMethadose

Tramadol ConZipRybix ODTRyzoltUltram

Misuse, Dependence, Addiction

Misuse

Misuse, abuse or nonmedical use of prescription medications include:

• Taking prescribed medication without a prescription (i.e. purchased from a dealer, given free from a friend, stolen from a friend or family members medicine cabinet)

• Taking prescribed medication in a way that differs from a prescribing doctor’s instructions

• Taking prescribed medication in a way other than what it is prescribed for and usually to create a particular experience or feeling

• Double doctoring, also known as “doctor shopping”, meaning obtaining prescriptions for medications from different doctors without disclosing other sources for prescriptions within a 30 day period

Sources: NIDA Drug Facts 2013; MassTAPP Guide Document: Prevention and Reduction of Opioid Misuse in Massachusetts 2013

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Dependence and Addiction

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Source: MassTAPP Guide Document: Prevention and Reduction of Opioid Misuse in Massachusetts 2013

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Addiction is Complex!

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The Brain’s Reward Pathway

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Addiction is characterized by

•Compulsive Craving

•Seeking Behaviors

•Inability to Control Use

•Continued Use Despite Negative Consequences

Adolescent and Young Adult Development

• Brain completes maturation around ages 24-25

• Regions of the brain that control impulses and forward thinking are some of the last regions of the brain that mature

• Critical time to develop coping skills for management of emotions and mood

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Adolescent and Young Adult Development

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• Substances and prescription medications youth are exposed to today are very powerful.

• When considering developmental norms re: adolescence and brain maturation

• Casual experimentation can lead to problems regardless of various protective factors.

National Trends

Trends continued

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Ages 12 and older

• National Survey on Drug Use and Health 2010-2011 findings

• Estimate 1 in 22 persons ages 12 or older nationwide used pain relievers nonmedically in the past year

• In 2011, more than 11.1 million persons ages 12 or older used pain relievers nonmedically in the past year

• Opioid pain relievers among most common substances taken by adults 20 – 59

• Sales of opioid pain relievers quadrupled between 1999 - 2010

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Trends continued

Sources: SAMHSA 2012 & 2013; Warner, Chen, Makuc, Anderson, & Minino, 2001; Morbidity and Mortality Weekly Report, 2011 as cited in MassTAPP Guide Document: Prevention and Reduction of Opioid Misuse in Massachusetts 2013

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Trends continued

Source: NIDA Drug Facts, Prescription and Over-the-Counter Medications, May 2013

• Massachusetts Youth Health Survey (YHS) 2011 findings conducted by Massachusetts Department of Public Health

• Reports of nonmedical use of prescription medications which included opioid pain relievers

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Trends continued

Students Lifetime UseCurrent Use w/in

last 30 days

High School 14.5% 5.7%

Middle School 3.9% 1.4%

Sources: MassTAPP Guide Document: Prevention and Reduction of Opioid Misuse in Massachusetts 2013

Trends continued

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Trends continued

Prevention

Prevention continued Assess household safety

Use a locked safe/box to store medications at all times

Dispense medications to your child (even if you trust them)

Regularly monitor prescription medications to make sure you have the correct amount of tablets/pills

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Check with your town and/or regional public offices regarding medication disposal initiatives

Consult with your prescribing physicians and/or pharmacist about proper disposal

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Prevention continued

Consult thoroughly with your prescribing physician, nurse practitioner, oral surgeon, and/or psychiatrist about the addictive potential of recommended medications

Discuss any concerns you have about how family history or other vulnerabilities may contribute to potential misuse and/or addictive tendencies with certain medications

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Advocate for your family – Examples

Do we really need a prescription for this type of medication for XX days to treat this injury?

What other alternatives are there for dealing with my child’s situation rather than/ in addition to medication therapy?

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Use teachable moments to casually explore your child’s world view on substance use

Discuss current events, media coverage of national and local news, etc

• “What do you think about…??”

Relate events back to their life

• “What might you do if...??”

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• Substances and prescription medications youth are exposed to today are very powerful.

• When considering developmental norms re: adolescence and brain maturation

• Casual experimentation can lead to problems regardless of various protective factors.

Resources

Resources continued

State Funded Intensive Youth Services in Massachusetts – Abbreviated, see full brochure online at www.mass.gov/dph/bsas - reference handout

• 2 Detoxification and Stabilization Units: Inpatient level of care

• 5 Residential Programs: 30 to 90 day placements

• 3 Recovery Home Programs: Up to 6 month placements

• 4 Recovery High Schools: Boston, Brockton, Beverly, Springfield

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http://www.mass.gov/dph/bsas

Resources continuedFor questions and connections regarding youth and young adult treatment

Lahey Health Behavioral Services: www.nebhealth.org

•SUN Project: 978-867-7137, www.sunprojectma.org

Massachusetts Department of Public Health

•Bureau of Substance Abuse Services: www.mass.gov/dph/bsas

•Office of Youth and Young Adult Services: 617-624-5161

•Central Intake and Care Coordination for Youth Services: 617-661-3991, www.healthrecovery.org

City of Lowell, Health Educator, Maria Ruggiero: 978-674-1076

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http://www.healthrecovery.org/

Parent Support Groups:

• Learn to Cope: www.learn2cope.org

• Al-Anon Family Groups of Massachusetts: www.ma-al-anon-alateen.org

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Resources continued

http://www.learn2cope.org/

http://www.ma-al-anon-alateen.org/

Thank you for listening and take very good care!

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Rx misuse among ya including pain relievers

Education

Transcript of Rx misuse among ya including pain relievers