Wednesday, April 30, 2014

Multi-pronged approach to teen drug use prevention

Last Saturday was National Drug Take-Back Day during which people could safely dispose of unused prescription drugs in an environmentally-friendly manner at local police precincts.  This is one activity that is part of a national strategy for preventing youth substance use.

Effective youth substance use prevention strategies need to include multiple activities targeting multiple risk factors conducted by multiple organizations.  This was made clear during a recent House of Representatives committee meeting about prescription drug and heroin abuse.

Many factors contribute to prescription drug abuse
The first person to testify was Joseph Rannazzisi from the Drug Enforcement Administration.  His testimony highlights the multiple factors contributing to prescription drug abuse:

The problem of prescription drug abuse has increased exponentially in the last 15 years due to a combination of excessive prescribing, drug availability through friends and family, Internet trafficking, rogue pain clinics, prescribers who prescribe pharmaceutical controlled substances without a legitimate medical purpose or outside the usual course of professional practice, pharmacies that dispense illegitimate prescriptions, and supply chain wholesalers and manufacturers that fail to provide effective controls and procedures to guard against diversion—all of which fueled illicit access at the expense of public health and safety.

Prevention activities address multiple factors
Rannazzisi goes on to describe a “holistic approach” to prevent diversion of prescription drugs and reduce availability for abuse.

Non-medical drug use cannot be addressed through law enforcement action alone. The Office of National Drug Control Policy’s 2011 Prescription Drug Abuse Prevention Plan, a multi-pronged approach that includes education, tracking and monitoring, proper medicine disposal, and enforcement is a science-based and practical way to address this national epidemic.

Preventing teen drug use prevents adult substance abuse problems
Michael Botticelli from the White House Office of National Drug Control Policy emphasized that most adults with substance abuse problems started using drugs before they became adults.

We also know that substance use disorders, including those driven by opioids, are a progressive disease. Most people who develop a substance use disorder begin using at a young age and often start with alcohol, tobacco, and/or marijuana. 

Multi-pronged prevention strategy
He then discussed the White House’s plan for preventing prescription drug abuse:

The Plan focuses on improving education for patients and healthcare providers, supporting the expansion of state-based prescription drug monitoring programs, developing more convenient and environmentally responsible disposal methods to remove unused medications from the home, and reducing the prevalence of pill mills and doctor shopping through targeted enforcement efforts.

Remarks from Daniel Sosin, representing the Centers from Disease Control and Prevention, supported previous testimony and outlined what his agency doing.   Nora Volkow from the National Institutes on Drug Abuse provided information about how prescription drugs and heroin affect the brain.

Westley Clark from the Substance Abuse and Mental Health Services Administration discussed prevention efforts conducted through his agency.  Among them:

SAMHSA also supports the “Not Worth the Risk, Even If It’s Legal” education campaign, which
encourages parents to talk to their teens about preventing prescription drug abuse. Another
educational program, “Prevention of Prescription Abuse in the Workplace,” is designed to
support workplace-based prevention of misuse and abuse of prescription drugs for employers,
employees, and their families.

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