Prescription Drug Misuse and Abuse in the States
Robert Morrison, Executive Director
National Association of State Alcohol and Drug Abuse Directors
The National Association of State Alcohol and Drug Abuse Directors (NASADAD) recently reported initial results from an inquiry of its members regarding key actions being taken by state substance abuse agency directors related to prescription drug misuse and abuse. NASADAD is an educational, scientific, and informational organization incorporated in 1971 to serve State Drug Agency Directors. In 1978 the membership was expanded to include State Alcoholism Agency Directors. The Association's basic purpose is to foster and support the development of effective alcohol and other drug abuse prevention and treatment programs throughout every state.
The Association's initial analysis of its findings from the inquiry, developed by NASADAD's Research and Program Applications Department, can be accessed by visiting http://nasadad.org/wp-content/uploads/2010/12/NASADAD-Prescription-Drug-Abuse-Inquiry-FINAL-04-2012-3.pdf. In all, 46 states and the District of Columbia responded to the inquiry. Some highlights of the findings are presented below.
Importance of Prescription Drug Abuse Issue
Ninety-six percent of states (45) participating in the inquiry noted that prescription drug misuse and abuse is a critical issue.
States with a Prescription Drug Abuse Task Force
Sixty-two percent of states responding (29) noted that they currently have a task force designed to specifically address the problem of prescription drug abuse. Another 15% of states (7 states) previously had a task force but the body completed its work. California's task force, for example, was created in 2008 and led by the state substance abuse agency. It included approximately 40 people from both the public and private sectors. The task force issued a report in 2009 titled, Summary Report and Recommendations on Prescription Drugs: Misuse, Abuse and Dependency, which can be found by visiting: http://www.adp.cahwnet.gov/Director/pdf/Prescription_Drug_Task_Force.pdf.
At the time of the inquiry, 68% of respondents (32 states) reported that state legislation pertaining to prescription drug abuse had been passed within the past five years. An additional 11% (5 states) indicated they had legislation pending. It was also found that more than half (53%) of those responding described legislation in their state as focused on reducing demand (e.g. prevention, treatment, recovery activities) and 38% of state respondents described their legislation as focused on the supply side of prescription drug abuse (some states had both elements in the laws that were passed).
General Education of the Public and Special Population Targets
The inquiry found that 83% of states (39 states) were moving forward with activities to educate the general public regarding prescription drug abuse. In terms of special target populations, more than half of state substance abuse agencies responding (53%) were engaging in activities focused on adolescents/young adults.
Family and Prescriber/Physician Education
The inquiry found that approximately half (51%) of state substance abuse agency respondents were engaging in activities to educate prescribers and physicians and 53% were engaging in activities to educate families about the problems associated with abuse and misuse.
Importance of, and Linkage to, Prescription Drug Monitoring Programs (PDMPs)
NASADAD found that a large majority of states, or 77%, found the data generated by their state's Prescription Drug Monitoring Program (PDMP) to be useful. Yet, of the 28 states asked to describe the extent to which their state substance abuse agency is involved with the PDMP, 12 states (43% of those responding to this question) cited no involvement.
The inquiry yielded a number of innovative actions being taken by state substance abuse agencies across the country.
In Ohio, for example, the issue has been identified by Governor Kasich as a top priority and a task force has moved a number of initiatives forward. One such initiative, Recovery to Work, is a collaborative approach between the state substance abuse agency, state Rehabilitative Services Agency, and county authorities that integrates addiction treatment with vocational rehabilitative services to focus on job readiness and placement.
In Vermont, the state substance abuse agency is leading its "Hub and Spoke Initiative" to focus on opiate dependence. Five locations across the state focus on specialty assessment, treatment and care coordination (Hub), with ongoing care being provided with local/community-based prescribing physicians, substance use disorder professionals, and recovery services (Spokes).
In Oregon, the state substance abuse agency developed the Prescription Opioid Poisoning Prevention Action Plan (POP) to reduce analgesic overdose in the state.
State substance abuse agencies identified a number of remaining challenges: lack of funding, easy access to prescription drugs, need for workforce development, and difficulties with data collection and analysis.
Additional findings from the inquiry will be presented and discussed during a panel on prescription drug abuse to be held June 26-28 in Savannah, Georgia, at NASADAD's Annual Meeting. To learn more about this meeting, visit http://nasadad.org/annual-meeting.
Rob Morrison presented NASADAD's findings during the National Rx Drug Abuse Summit held April 11, 2012, in Orlando, Florida. To learn more about the National Rx Drug Abuse Summit, visit http://nationalrxdrugabusesummit.org.