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This document outlines an advocacy track presentation on activating communities to address prescription drug abuse. It provides biographies of the presenters and moderators and discloses any conflicts of interest. The learning objectives are to identify best practices for implementing CADCA's seven strategies for community change to impact prescription drug issues. It then provides examples of how various coalitions across the country are utilizing each of the seven strategies, such as providing education, enhancing skills, supporting communities, and changing policies.
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- 1. Activating Your Community Presenters: • Mary Elizabeth Elliott, Vice President, Communications, Membership and IT, Community Anti-Drug Coalitions of America • Catherine Thatcher Brunson, MS, Trainer/Consultant, National Coalition Institute, Community Anti-Drug Coalitions of America • Miranda Willis, Strategic Prevention Data Analyst, Chickasaw Nation • Kasey Dean, SPF-TIG Tribal Liaison, Absentee Shawnee Tribe Advocacy Track Moderator: Karen H. Perry, Co-Founder and Executive Director, Narcotics Overdose Prevention and Education (NOPE) Task Force, and Member, Rx and Heroin Summit National Advisory Board
- 2. Disclosures Catherine Thatcher Brunson, MS; Kasey Dean, SPF-TIG; Mary Elizabeth Elliott; Miranda Willis; and Karen H. Perry have disclosed no relevant, real, or apparent personal or professional financial relationships with proprietary entities that produce healthcare goods and services.
- 3. Disclosures • All planners/managers hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months. • The following planners/managers have the following to disclose: – John J. Dreyzehner, MD, MPH, FACOEM – Ownership interest: Starfish Health (spouse) – Robert DuPont – Employment: Bensinger, DuPont & Associates-Prescription Drug Research Center
- 4. Learning Objectives 1. Identify best practices by coalitions to implement CADCA’s Seven Strategies for Community Change. 2. Outline the unique challenges to Rx drug abuse/misuse advocacy faced by Native American communities. 3. Describe how tribal communities can use the SPF to build and implement evidence-based, culturally appropriate and sustainable substance abuse prevention programs. 4. Provide accurate and appropriate counsel as part of the treatment team.
- 5. Advocacy Track: Activating Your Community Mary Elizabeth Elliott, VP, Communications, Membership and IT, CADCA Catherine Brunson, Trainer/Consultant/CADCA
- 6. Disclosure Statements Mary Elizabeth Elliott, VP, Communications, Membership and IT, CADCA has disclosed no relevant, real or apparent personal or professional financial relationships with proprietary entities that produce health care goods and services. Catherine Brunson, Consultant/Trainer, has disclosed no relevant, real or apparent personal or professional financial relationships with proprietary entities that produce health care goods and services.
- 7. Learning Objective Identify best practices by coalitions to implement CADCA’s Seven Strategies for Community Change to specifically impact medicine misuse, abuse and addiction. A comprehensive approach to our nation’s deadly opioid and heroin crisis.
- 8. 1. Expand effective Prescription Drug Monitoring Programs to ensure adequate coverage in every state and interoperability to share data where appropriate. 2. Enhance education and training of medical and dental professionals in proper prescribing protocols, SBIRT and addiction. 3. Raise the general public’s awareness about the dangers of prescription drug abuse as well as the proper ways to store and dispose of them. 4. Enhance opportunities for prescription take back and other large scale disposal programs. CADCA National Recommendations
- 9. Recommendations, Cont. 5. Support increased law enforcement and legal remedies to close down “pill mills.” 6. Require manufacturers to create abuse deterrent formulations for commonly-abused prescription painkillers. 7. Expand the number of DFC funded communities and train more communities to implement comprehensive, data driven strategies to effectively address their local prescription drug abuse problems.
- 11. National Evaluation on Institute Impact 1. Overall Capacity 2. Use of Comprehensive Strategies 3. Use of Environmental Strategies 4. Student perception of parental disapproval for using: a. marijuana b. tobacco 30 Day Use of Marijuana SignificantIncreases SignificantDecreases Summary of Findings – Longitudinal Evaluation of the Impact of CADCA’s Institute's Training & TA On Coalition Effectiveness; Dr. Pennie Foster-Fishman, Ph.D. Michigan State University, February 7, 2015
- 12. CADCA Rx Resources • Toolkit especially for coalitions – www.PreventRxAbuse.org • National Medicine Abuse Awareness Month every October • CADCA has made a national commitment to help coalitions host 100 town hall/community briefings on opioid crisis • Co-convener of Collaboration for Effective Prescription Opioid Policies (CEPOP) – cepoponline.org
- 13. Keys To Pushing Back Against The Misuse and Abuse of Rx Drugs • Approach that appropriately mobilizes each of the key sectors and actors who have a role in reducing access to and availability of prescription drugs
- 14. 1. Provide information 2. Build skills 3. Provide social support 4. Reduce barriers / enhance access 5. Change consequences / incentives 6. Alter the physical design of the environment 7. Change policy and rules Environmentally- focused Individually- focused Coalitions Pursuing Comprehensive Strategies Source: KU Work Group for Community Health and Development, 2007
- 15. Problem: Teen Rx abuse is on the rise But Why? Rx medications are easy to get But Why Here? 3 pain clinics are located within the county • Provide Information—Town Hall Meeting; Media stories; billboards • Build Skills—Provide CME training on proper prescribing and addiction • Provide Support—Establish relationship with treatment programs to collaborate with law enforcement, schools, healthcare, etc. for referrals • Access / Barriers—Collaborate with law enforcement to increase patrols within one mile radius of pain clinics during hours of operation • Change Consequences – Promote and encourage licensing boards to monitor and enforce appropriate prescribing practices and medical record documentation of medical examinations and patient diagnosis • Physical Design— Lock you meds campaign/disseminate lockboxes • Policies or Regulations—Support legislation increasing penalties for physicians with unscrupulous prescribing practices; work with zoning board to increase zoning restrictions for “pill mills” in residentially zoned areas. Roane County Anti-Drug Coalition, TN
- 16. Strategy 1 Providing Information • Woonsocket Prevention Coalition in Woonsocket, Rhode Island implemented widespread media campaigns to raise awareness about the dangers of prescription drug abuse in their communities utilizing traditional and social media. • Carter County Drug Task Force in Ashland, Kentucky distributed 35,000 Push Cards on “Preventing Abuse of Prescription and Over-the-Counter Medications” and 35,000 Push cards distributed on “Guidelines for Proper Disposal of Prescription Drugs.” • Council Rock Coalition for Healthy Youth, Newtown PA debuted a PSA at their local movie theaters to remind patrons to “Mind Your Meds” by discouraging sharing and encouraging proper disposal.
- 17. Strategy 2: Enhancing Skills • NCADD of Middlesex County, East Brunswick, NJ - Delivered community education presentations to enhance the skills of community members and provided training for emergency responders on the proper use of naloxone to treat overdoses. • Blount County Substance Abuse Action Team in Maryvale, Tennessee provides Drug Recognition Education (DRE) training for law enforcement. • Alamance Citizens for a Drug Free Community in Snow Camp, NC taught over 250 5th and 6th graders to understand a medicine label and safely store medications though the OTC Medicine Safety curriculum.
- 18. Strategy 3: Providing Support • Shelby County Drug Free Coalition in Indiana provided local pharmacies with materials on prescription drug abuse to dispense with prescriptions. • Roane County Anti-Drug Coalition, Kingston, Tennessee distributed materials to funeral homes to encourage individuals to have their homes monitored during the funeral and remove medications. • SAFE Coalition of Hunterdon and Somerset, NJ provides Rx education to the attending residents at their regional hospital on proper prescribing to reduce addiction.
- 19. Strategy 4: Enhancing Access or Reducing Barriers • Drug-Free Collier County, based in Naples, Florida has 11 permanent drop boxes so residents can easily dispose of medications and also offer drug disposal, or deactivation, packets which are biodegradable and can safely be disposed of with normal trash. • Jackson County Anti-Drug Coalition, West Virginia developed a Quitline to improve access to resources and treatment. • SAFE Coalition of Hunterdon and Somerset, NJ distributes warning labels for pharmacy bags in English and Spanish; Distributed lockboxes to all homes involved in Juvenile Court.
- 20. Strategy 5: Changing Consequences • The ASAP coalition in Maine recognizes participating physicians and pharmacists partners with a responsible business award at annual event and window cling. • In New Jersey, the SAFE coalition requires all 11th graders and a parent to attend a “Path from Pills to Heroin” educational event or they are not eligible for a parking spot their senior year of high school.
- 21. Strategy 6: Change Physical Design • Jackson County Anti-Drug Coalition, West Virginia purchased an incinerator to dispose of all returned medicines in their community. • The Cherokee Nation in Oklahoma installed a permanent medicine drop off box in the lobby of their police station and also partnered with local homebuilders to ensure that the installation of one locking medicine cabinet is standard in every new home that is built. • DFC coalitions in 4 Florida counties are giving out 40,000 drug disposal pouches as part of a research project.
- 22. Strategy 7: Modifying and Changing Policies • Sylvania Community Action Team (S.C.A.T.) in Ohio partnered with local schools to implement clear and strict policies related to the possession of illegal and prescription drugs on school grounds. • Tennessee coalitions worked collaboratively to pass a Good Samaritan law. • Missouri coalitions, led by ACT Missouri, are advocating to bring the PDMP to their state. St. Louis County is not waiting – they are creating their own local PDMP.
- 23. In Closing • The comprehensive coalition approach remains the best local solution to address any public health threat – and is especially critical with the complex opioid and heroin crisis we face as a nation. • Data shows that DFC coalitions are having success in this area and CADCA’s National Coalition Institute is a factor in making coalitions more effective. • CADCA is providing technical assistance, advocacy and communications tools that can help more communities “wake up” to this epidemic.
- 24. Visit us on the Web at www.cadca.org Join us via Social Media: • Facebook: facebook.com/CADCA • Twitter: @cadca • YouTube: youtube.com/cadca09 • Linkedin: Linkedin/company/cadca Stay Connected with CADCA 24
- 25. “Using the Strategic Prevention Framework to Reduce Prescription Drug Abuse/Misuse in Tribal Communities” Absentee Shawnee Tribe Chickasaw Nation
- 26. • Kasey Dean, Absentee Shawnee Tribe SPF Specialist, has disclosed no relevant, real or apparent personal or professional financial relationships with proprietary entities that produce health care goods and services. • Miranda Willis, B.S., Chickasaw Nation Strategic Prevention Data Analyst, has disclosed no relevant, real or apparent personal or professional financial relationships with proprietary entities that produce health care goods and services.
- 27. Learning Objectives • Outline the unique challenges to Rx drug abuse/misuse advocacy faced by Native American communities. • Describe how tribal communities can use the SPF to build and implement evidence-based, culturally appropriate and sustainable substance abuse prevention programs.
- 28. Outline • Learning Objectives • SPF-TIG Overview • The Chickasaw Nation • Define Your Direction • Safe Storage and Disposal Initiative • Absentee Shawnee Tribe • MyDNA • Naloxone Initiative
- 29. What some think Oklahoma looks like?
- 32. What it really looks like?
- 37. SPF-TIG Overview • TEC located at the Oklahoma City Area Intertribal Health Board (OCAITHB) was awarded the SPF-TIG(2010) • Inter Tribal Consortium (ITC): - OCAITHB - Absentee Shawnee Tribe - Cheyenne and Arapaho Tribes - the Chickasaw Nation - Comanche Nation
- 39. SPF-TIG Overview • Tribal Epidemiological Outcomes Workgroup (TEOW) - Epidemiological Profile and Strategic Plan (2012) - Priority Issues: 1. Underage Drinking 2. Prescription Drug Abuse/Misuse • More community-level, tribal-specific data was needed.
- 40. SPF-TIG Overview Strategic Prevention Framework: 1. Assessment 2. Capacity Building 3. Planning 4. Implementation 5. Evaluation Goal: To reduce underage drinking and prescription drug misuse/abuse in our communities.
- 41. Chickasaw Nation • 13 counties located in south-central Oklahoma • Population: *356,301 • American Indians: *35,065 * Based on 2013 U.S. Census estimates
- 44. Source: 2014 Oklahoma Prevention Needs Assessment Report: Chickasaw Nation Students
- 45. Chickasaw counties Grandparents raising grandchildren Bryan 522 Carter 746 Coal 55 Garvin 337 Grady 772 Jefferson 69 Johnston 144 Love 219 McClain 330 Marshall 307 Murray 131 Pontotoc 433 Stephens 479 Total 4,544 Source: 2013 American Community Survey Estimates, United States Census, Census.gov.
- 46. Source: OSDH, Injury Prevention Service, Unintentional Poisonings Database
- 47. Source: 2014 Oklahoma Prevention Needs Assessment Report: Absentee Shawnee Tribe Students
- 49. Prescription Drug Logic Models
- 50. Awareness and Media Campaign
- 51. Safe Storage and Disposal Initiative • Develop partnership with Chickasaw Nation Division of Aging • Provide education to seniors about safe storage and proper disposal of prescription drugs • Provided Chickasaw Nation Seniors with…
- 53. Safe Storage and Disposal Initiative
- 54. Absentee Shawnee Tribe of Oklahoma • 4 counties located in central Oklahoma • Population: *1,142,553 • American Indian: *57, 848 * Based on 2013 U.S. Census estimates
- 55. Prescription Drug Logic Models
- 56. Awareness and Media Campaign
- 57. Naloxone Initiative • Naloxone is a medication called an “opioid antagonist” used to counter the effects of opioid overdose, for example morphine and heroin overdose.
- 58. Partnerships • Law Enforcement • State SPF-SIG (Gateway to Prevention) • Austin Box Foundation • Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) • University of Oklahoma Southwest Prevention Center
- 59. Training • CLEET (2 hours of Mental Health Training for officers) • Train the Trainer • Memorandum of Understanding (MOUs)
- 60. Naloxone Initiative Impact • AST Tribal Police • Kickapoo Tribal PD • Citizen Pottawatomi Nation PD • Moore PD* • Pottawatomi County Sheriffs Dept. • Tecumseh PD • Shawnee PD • Mcloud PD • Asher PD
- 61. Sources • Dean, Kasey, Brown, Howard Jr. and Sucharat Tayarachakul. Absentee Shawnee Tribe of Oklahoma SPF-TIG Program: SPF Survey 2015. 2015. Dataset. Absentee Shawnee Tribe of Oklahoma. • Byars-Chavez, Christie, Shahbandeh, J. Caleb, Willis, Miranda and Sucharat Tayarachakul. Chickasaw Nation SPF-TIG Program: SPF Survey 2015. 2015. Dataset. Chickasaw Nation. • Oklahoma Department of Mental Health and Substance Abuse Services. 2014 Oklahoma Needs Prevention Assessment: Chickasaw Nation Students. • Oklahoma Department of Mental Health and Substance Abuse Services. 2014 Oklahoma Needs Prevention Assessment: Absentee Shawnee Tribe of Oklahoma. • Oklahoma State Department of Health (OSDH), Injury Prevention Service. Unintentional Poisonings Deaths Map. Unintentional Poisonings Database. • United States Census. 2013 American Community Survey Estimates. US Census. Census.gov
- 62. Thank You
- 63. Activating Your Community Presenters: • Mary Elizabeth Elliott, Vice President, Communications, Membership and IT, Community Anti-Drug Coalitions of America • Catherine Thatcher Brunson, MS, Trainer/Consultant, National Coalition Institute, Community Anti-Drug Coalitions of America • Miranda Willis, Strategic Prevention Data Analyst, Chickasaw Nation • Kasey Dean, SPF-TIG Tribal Liaison, Absentee Shawnee Tribe Advocacy Track Moderator: Karen H. Perry, Co-Founder and Executive Director, Narcotics Overdose Prevention and Education (NOPE) Task Force, and Member, Rx and Heroin Summit National Advisory Board