Author: Nira Kadakia

What does it take to raise passion and awareness?

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The Pharmacy Alumni Society Pharmathon 5K is an idea that arose from the passion and desire of one graduate to raise awareness about prescription drug misuse. It has become an annual event at Ohio State.

The Pharmacy Alumni Society Pharmathon 5K is an idea that arose from one graduate’s passion and desire to raise awareness about prescription drug misuse.

The Generation Rx initiative is a cause I’ve been involved with for over half of my time as a higher education student. I fell into it partly by chance: I have a passion for teaching and had an opportunity to participate in an event for high school students, teaching them about pharmacy and medication safety. It was during this event that I first learned about The Generation Rx Initiative and its history at The Ohio State University College of Pharmacy, and I’ve been involved with the cause in various ways since then. I have come to appreciate the unique ways one can participate in spreading awareness about this public health issue. Through my work, I’ve learned what it takes to raise awareness about a particular cause. Here are three of the most important lessons I’ve gathered from other students’ passions and my own work with Generation Rx:

  1. Discover your passion. It is not necessary to have a completely clear understanding of where you want your career to end up or how to get there. While you can, take time to explore things you might be curious about. Get involved in projects that pique your interest, even slightly. You never know how it can lead you down a path you might not have otherwise discovered. A classmate and coworker of mine became interested in naloxone. By working with a doctor at the hospital at which we are interns, she was able to learn about naloxone and the impact she could have on patient care with it. Since working with that doctor, she has become an advocate for naloxone in Ohio and provided testimony on the subject, which eventually led to the passing of an Ohio bill that allows pharmacists and pharmacy interns to dispense naloxone without a prescription. (See her post here.) Once you find a subject about which you are interested, you can make a great impact on the community, too.
  2. Be proactive. If you see an opportunity to do something great or fill a void, take it. Be willing to take risks on opportunities that may come your way. Don’t wait for the “perfect moments” to come to you; sometimes, you need to create them yourself. For example, at Ohio State, students came together to form an interdisciplinary veterinary pharmacy student organization to fulfill an unmet need. The group, started at the beginning of the 2015-2016 academic year, has raised awareness about topics within the field of veterinary pharmacy, such as zoonotic diseases (diseases that can be spread from animals to humans) and over-the-counter medications that are safe to use in animals.
  3. Ask for help. Even the most capable person needs to ask for help sometimes. In pursuing a passion or a cause, mentorship can go a long way. Your mentors can connect you with resources (human or otherwise) that can help you move your cause or passion forward. Additionally, plans can go awry, but asking for help should not be considered a sign of weakness. A classmate of mine planned to present a series of medication safety modules at an area high school. Due to extenuating circumstances, he was unable to continue working with the school with which he had originally planned to work. With the help of a trusted mentor, he was able to connect with a different school that ended up working wonderfully for his project.

Now, I will not suggest that these three tips are the only requirements in pursuing a cause. However, they have served me well in my work with Generation Rx. I encourage you to keep these guidelines in mind to grow your own passions and see where you can go with them.

imageNira Kadakia is a fourth-year Doctor of Pharmacy candidate at The Ohio State University College of Pharmacy. She has been involved with the Generation Rx Initiative since 2012, serving as a student assistant at the Generation Rx Lab at the Center of Science Industry (COSI) and as president of OSU’s Generation Rx Collaborative. She also served as student editor for the Generation Rx University Voices blog for almost two years.

Collegiate Recovery Community partnerships and activities allow for drug misuse education

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By Sarah Nerad

My name is Sarah Nerad and I am a person in long-term recovery, which means I have not used alcohol or drugs since August 16, 2007. Recovery has given me the ability to be a leader on my campus and to give back to other students what was so freely given to me. One of the major ways I do this is through my role at Ohio State where I am the Program Manager for Student Life’s Collegiate Recovery Community (CRC). The CRC is a supportive peer community with specific programming for students in recovery to enable them to have an authentic college experience while maintaining their recovery.

The CRC at the 2015 NOPE Candlelight Vigil, where one of our members shared a recovery story (photo courtesy of Sarah Nerad).

The CRC at the 2015 NOPE Candlelight Vigil, where one of our members shared a recovery story (photo courtesy of Sarah Nerad).

Since the CRC began in March of 2013, the Ohio State College of Pharmacy and the Generation Rx Initiative have been tremendous supporters and partners of ours. Some of the ways we have worked together over the years include having a CRC member speak at the NOPE Candlelight Vigil, volunteer at and help promote the prescription drug take-back days, efforts to increase access to naloxone both on and off campus, sharing our recovery stories at their events and collaborating to include information about recovery in prescription drug misuse education.

The CRC at our 3rd Annual CRC Graduation Dinner where we recognize our members that are graduating from Ohio State clean and sober by presenting them with purple honor cords (photo courtesy of Sarah Nerad).

The CRC at our 3rd Annual CRC Graduation Dinner where we recognize our members that are graduating from Ohio State clean and sober by presenting them with purple honor cords (photo courtesy of Sarah Nerad).

We have also partnered to deliver educational presentations to students on prescription drug misuse prevention on campus. Having a CRC student come and share their story humanizes the addiction and recovery journey for the audience and makes the message more relatable. We are able to leave the audience with resources if they or someone they know needs help as well as leave them with hope that people can and do recover.

One of the things I’ve enjoyed most about our partnership with the Ohio State College of Pharmacy and Generation Rx Initiative is that it’s an “outside of the box” partner. To marry prescription drug misuse prevention messages with recovery messaging is a powerful way to reach new audiences and bring hope to those that have been impacted by addiction. It’s also important that we work together because we need more people to understand the reality that addiction is treatable and people can recover. By getting outside of our silos and working together to reach new audiences, we are able to have the collective impact that we want.

imageSarah Nerad has made it her life purpose to create the same opportunities that she had to enter and sustain recovery for young people across the country. She was a founding member of Young People in Recovery, a Substance Abuse and Mental Health Services Administration (SAMHSA) intern in the Center for Substance Abuse Treatment Department of Consumer Affairs, and a past board member of The Association of Recovery Schools and Ohio Citizen Advocates for Addiction Recovery. She helped create the Collegiate Recovery Community at Ohio State and currently serves as the Program Manager. She also helped establish OSU’s Higher Education Center for Alcohol and Drug Prevention and Recovery and serves as its Director of Recovery. Additionally, she was appointed to serve on the SAMHSA Advisory Committee for Women’s Services to represent the needs of women and girls in recovery.

 

Student-Athlete Prescription Drug Misuse and Abuse

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by Laura K. Farleman

Disclaimer: What is included in this blog is the opinion of the individual writing the blog and does not explicitly represent the thoughts or opinions of the NCAA.

Student-athletes face excessive pressure related to academic and athletic life. These pressures are key factors that influence prescription misuse within the student-athlete experience. Stressors faced more often and to a greater degree than their peers include: time demands, sleep deprivation, relationships with coaches and scheduling missed class/exams. Other pressures stem from self-imposed and coaching expectations regarding academic and athletic performance. According to Mind, Body and Sport, an NCAA publication seeking to provide insight and support for student-athlete mental wellness, student-athletes appear to be less likely to seek help or receive mental health services when dealing with these stressors.[1]

Additionally, a higher percentage of student-athletes are prescribed narcotics for pain management than the general student body.[2] Research indicates increasing trends of ADHD and pain medication use both with and without a prescription with almost 25% of NCAA student-athletes reporting prescription pain mediation use.[3],[4] Further, student-athletes who reported taking ADHD medication(s) indicated that they were more likely to use without a prescription.

Add in the mental health factors associated with injury and recovery, and the potential for misuse is plain. The tough question is: how do we address it? My solution involves three simple steps.

1. Change the Environment.

We need to change the attitudes we have towards prescription misuse/abuse. A mindset focused on harnessing internal motivations provides a foundation for positive change. Changing the attitude associated with prescription abuse begins to break the “no talk, don’t talk” bubble. The impact of prescription drug abuse goes beyond the individual. Its ripple effects can be traced to the team, campus life, and the community. It is everyone’s problem.

2. Address the Misconception

Student-athletes need more than just “don’t do it”. Historically we see how a “just say no” philosophy fails to address abusive behavior. Education regarding what prescription misuse and abuse entails and the health impacts misusing or abusing prescription medications can have, is critical. Student-athletes are held legally responsible for what they ingest.

3. Develop a Proactive Plan

Institutions and athletic departments should focus on designing a proactive plan to address key factors influencing student-athlete prescription misuse, including student-athlete access to academic and mental health services. Conversations with institutional Student-Athlete Advisory Committee’s (SAAC’s) will be essential to engaging the student-athlete voice when developing a proactive plan to address prescription drug abuse.

A screenshot from the pilot student athlete Generation Rx toolkit, courtesy of Laura Farleman.

A screenshot from the pilot student athlete Generation Rx toolkit, courtesy of Laura Farleman.

A student-athlete Generation Rx toolkit is currently in development. Together with the help of the NCAA, Cedarville University School of Pharmacy and The Ohio State University College of Pharmacy, the pilot Student-Athlete Generation Rx toolkit will launch in 2016. This toolkit will ultimately provide resources to start addressing prescription drug abuse from within the athletic experience.

 

 

References

  1. Davoren AK, Hwang S. Depression and anxiety prevalence in student-athletes. In: Hainline B, Kroshus E, Wilfert M, eds. Mind, body, and sport understanding and supporting student-athlete mental wellness. 1st ed. NCAA; 2014:38 -39.
  2. Hainline B, Bell L, Wilfert M. Substance use and abuse. In: Hainline B, Kroshus E, Wilfert M, eds. Mind, body, and sport understanding and supporting student-athlete mental wellness. 1st ed. NCAA; 2014:40-45.
  3. NCCA national study of substance use habits of college student-athletes. National Collegiate Athletic Association. NCAA.org. https://www.ncaa.org/sites/default/files/Substance%20Use%20Final%20Report_FINAL.pdf. Published 2013. Updated 2014. Accessed December 20, 2015.
  4. NCCA student-athlete substance use study: executive summary august 2014. National Collegiate Athletic Association. NCAA.org. http://www.ncaa.org/about/resources/research/ncaa-student-athlete-substance-use-study-executive-summary-august-2014. Published 2014. Accessed December 20, 2015.

LKF HeadshotLaura Farleman is in her second professional year at Cedarville University School of Pharmacy, and in her last year as a Division II student-athlete.. She serves as the Great-Midwest Athletic Conference National Student-Athlete Advisory Committee Representative and the Division II student-athlete representative to the Committee on Competitive Safeguards and Medical Aspects of Sports, contributing student-athlete insight about health and safety in collegiate athletics. Long term, Laura is pursuing a career in neurology in hopes of improving the longevity and quality of life of individuals with neurological conditions.

 

Biology of Variation in Response to Pain

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by Lane Wallace

Opioid medications are effective pain relievers but have varying responses in individuals, which can make them challenging to work with. (Photo courtesy of NYTimes.com)

Opioid medications are effective pain relievers but have varying responses in individuals, which can make them challenging to work with. (Photo courtesy of NYTimes.com)

Two major challenges for optimizing analgesic therapy with opioid drugs are the immense differences between individuals in sensitivity to pain and the equally immense differences between people in sensitivity to response to opioid drugs. The goal of this communication is to provide a very brief overview of the major principles underlying the variations in response.

An important concept is that pain is a homeostatic system. Homeostatic systems are controllers designed to keep a function within an acceptable range. For example, heating and air-conditioning in our buildings are homeostatic systems that keep air temperature within an acceptable range. Pain is a homeostatic system with the purpose of helping maintain tissue integrity. There are some people who are born with an inability to experience pain. These people do not thrive. If they put their hand on a burning stove, there is no signal to tell them to remove it. As infants learning to chew food, there is no signal to tell them their tongue is in the way, so they bite their tongue. Thus, they never learn how to move the tongue out of the way of the teeth, and eating becomes extremely difficult. Some homeostatic systems, such as regulation of core body temperature, are designed to maintain a very narrow range of acceptable values. However, pain is different. We need to vary response of the pain system to accommodate to changes in life circumstances. For example, if a person in the jungle is attacked and mauled by a tiger, the immediate need is not to fix the injury. The immediate need is to escape the tiger. After escaping the tiger, one can worry about the injury. In this situation, the pain homeostatic system has to temporarily shut down to allow the person to deal with the immediate priority. In terms of biology, this means that there are a variety of pieces of information that interact both at the level of pain detectors and within the integration circuits to determine what the appropriate output should be.

There are many signaling molecules that interact at the pain detectors to move the set point for pain threshold up and down. There are many more signaling molecules that influence interpretation of the signals and our response to it. The activity of each one of these is influenced by genetic makeup and then further modified by the painful (or lack of painful) experiences that are part of life. The small differences in many players can sum to a very large effect at the systems level, accounting for variability between individuals. Mu-opioid receptors, the targets for opioid pain relieving drugs, are located in two different processing areas within the pain homeostatic system and are important players on the teams that modulate processing of pain. The same genetic and life history factors that influence the processing of pain determine sensitivity to opioid drugs, explaining why there is so much diversity between individuals.

Looking to the future, one goal should be the capability to identify sensitivity to both pain and to opioid drugs before initiating therapy. With the genetic and tissue analysis tools that are either currently available or likely on the horizon, we should see great advances in the relatively near future.

Wallace_cp150Lane Wallace is a professor and chair of pharmacology at The Ohio State University College of Pharmacy. He specializes in neuropharmacology and mechanism of action of addicting drugs.

Addressing Prescription Stimulant Medication Misuse, Abuse and Diversion with Peer Education

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by Ann Quinn-Zobeck

Image courtesy of cpamm.org

Image courtesy of cpamm.org

Despite the increased awareness of prescription drug abuse nationwide, the misuse, abuse and diversion of ADHD prescription stimulant medication remains a serious issue, especially among college students. Though recent research has revealed varying rates of misuse, a 2013 study at one large public university found that nearly 10 percent of college students reported nonmedical use of prescription stimulant medication in the past year. Meanwhile, questions remain about whether students recognize the risks, including the legal, medical and academic consequences, of misusing or diverting ADHD prescription stimulant medication.

In an effort to address the issue, organizations representing the medical community, pharmaceutical community, mental health advocacy groups, college administrators and student leaders formed the Coalition to Prevent ADHD Medication Misuse (CPAMM). The Coalition works to help prevent the misuse, abuse and diversion of ADHD prescription stimulant medication, specifically among college students, and strives to be a trusted source of information on the issue by raising awareness and taking action through the development of programs, tools and tactics to prevent misuse, abuse and diversion. Partner organizations include: American Academy of Family Physicians (AAFP), BACCHUS Initiatives of NASPA, Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), The JED Foundation, NASPA – Student Affairs Administrators in Higher Education, and Shire.

The BACCHUS Initiatives of NASPA plans to engage collegiate peer educators to assist campus efforts to help prevent the misuse, abuse and diversion of ADHD prescription stimulant medication. Peer education is essentially a program where trained students interact with their peers in meaningful ways to disseminate information and make referrals to on-campus services. Peer educators spread important health and safety information. Peer education has become a preferred method for communicating with students and is an important part of an overall prevention strategy. Trained peer can be instrumental in addressing stimulant medication misuse and abuse on college campuses.

What Peer Educators Can Do to Address Stimulant Medication Misuse and Abuse
The results of a Harris Poll survey conducted on behalf of CPAMM found that college students are busy and feel stressed, and ADHD prescription stimulant misuse is seen by many as a way to keep up with their academic demands and non-academic activities. Many college students feel pressured to succeed – at any cost. Sixty-four percent of survey respondents said they would do anything to get an A.

Students overestimate the misuse and abuse of prescription stimulants. While the majority of college students are not abusing these medications, many students believe misuse is somewhat common and that ADHD prescription stimulants are easy to obtain without a prescription and no more harmful than a cup of coffee or energy drink.

Image courtesy of cpamm.org

Image courtesy of cpamm.org

With proper training, peer educators can provide factual information about ADHD medication and reduce the misperception of wide spread abuse. Through presentations, peer theater, social media messaging, and skill building trainings, peer educators can reach out to their fellow students to

  • teach healthy study and stress reduction skills
  • present facts about the actual rate of misuse to combat social norming of the issue (e.g., everyone is not doing it)
  • educate on perceived short-term benefits (e.g., achieving academic success) vs. potential long-term effects
  • dispel the myth of the “smart drug” as there is no evidence that students who misuse stimulant medication do better academically
  • address misinformation or lack of awareness about the misuse and diversion of ADHD medication (e.g., it’s a Schedule II controlled substance, illegal to divert or misuse, how it helps the ADHD student).

As part of CPAMM, NASPA and its BACCHUS Initiatives are partnering with the University of Washington to research what messages about prescription stimulant medication misuse and abuse resonate with college students. The results of this research will be used to develop peer-to-peer interventions for use by college students to help prevent the non-medical use of ADHD stimulant medication.

If you would like to know more about CPAMM, visit cpamm.org. To find out how to start a peer education group and for other peer education resources, visit naspa.org/BACCHUS.

Ann Quinn-ZobeckAnn Quinn-Zobeck is the Senior Director of BACCHUS Initiatives and Training at NASPA – Student Affairs Administrators in Higher Education.

Addressing the Misuse of Prescription Drugs While Being in the “At-Risk” Population

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by Jason Anderson

Emergency department visits in 2011 related to drug misuse or abuse and other causes

Emergency department visits in 2011 related to drug misuse or abuse and other causes

As a fourth-year student practicing in the pharmacy, I see the face of addiction every week. The signs of drug addiction are no longer presented as shady drug deals in a dark alley but are now disguised as early refill requests for opioid pain medication and stimulant ADHD medications. The description of the stereotypical drug abuser has changed drastically over the last few years. For example, the highest rate of emergency department visits in 2011 related to drug misuse or abuse was between the age range 18-29. This, coincidentally, is the demographic of the college population. Fifty-one percent of these cases involved non-medical use of pharmaceuticals. The real question is this: how do we overcome these biological changes of addiction to alter prescription drug misuse behaviors?

In order the overcome the biological and physical changes associated with addiction, we need to change how we address prescription drug misuse. It is imperative to incorporate innovative ways to change college students’ behaviors. Before we are able to change their behaviors, we need to first change their perceptions regarding prescription drug misuse. Let’s examine an example of prescription stimulant use without a medical indication such as ADHD. In a study conducted by Lookatch et. al in 2014, the researchers found that non-medical use of stimulants for “studying purposes” was perceived as more acceptable by college students than the need “to get high.” This generally accepted, albeit irrational, thought process, validates prescription drug misuse in the minds of college students because the anticipated outcome of higher grades can positively impact their academic achievements. Changing these deeply rooted perceptions is the first step required to reverse the ingrained behaviors of college students towards prescription drug misuse.

Let’s continue our example of prescription stimulant misuse and look at innovative ways to change behaviors long term. Since prescription drug misuse is a growing problem on college campuses, we will need to attack the issue from multiple angles. One strategy, which is currently used at Miami University in Ohio, involves minimizing abuse by maximizing care. All students who seek medication for ADHD must first attend a “brain boosting” workshop. In this workshop, students are taught integral attention skills such as time management, distraction minimization and procrastination reduction. In addition to this workshop, prescribing of medication for ADHD is addressed in a step-wise function. Students are first prescribed medications without addictive potential, such as Strattera® (atomoxetine)‎. This reduces the exposure of the college population to stimulant ADHD medications. In addition to maximizing care, we could also add in social media or universal text messages to engage the entire student body. These text messages would be sent around the time frame when student would be most at risk for abusing prescription stimulants, such as finals week. While text messaging alone has not been shown to be effective in changing student behavior (Quanbeck et al., 2014), this strategy, when used in combination with other methods to combat prescription drug abuse, might be beneficial. Lastly, attention must be focused on preventing the diversion of prescription medications. This could be achieved by educating those with prescription medications about the dangers of theft and the consequences of sharing prescription medications. Providing students with a lockbox for their medications is one proposed strategy for reducing theft.

As the face of addiction changes, we have to change the way prescription drug misuse on the college campus is addressed. We need to develop and implement novel ways to alter behavior. These innovative methods could include maximizing non-pharmacological care, engaging students via text messaging or social media and decreasing diversion with lockboxes. Prescription drugs have the ability to make a drastic medical impact on those who truly need the medication but also deter bright college students, who are the creators of our future, from obtaining their highest potential. The age range of emergency department visits is a gloomy statistic. However, it also holds potential for us to make a drastic impact via innovative interventions that will help change the face of addiction for future generations.

References

Lookatch SJ, Moore TM, Katz EC. Effects of gender and motivations on perceptions of nonmedical use of prescription stimulants. J Am Coll Health. 2014;62(4):255-262. doi:10.1080/07448481.2014.891593.

Substance Abuse and Mental Health Services Administration, Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits. HHS Publication No. (SMA) 13-4760, DAWN Series D-39. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.

Quanbeck A, Chih M-Y, Isham A, Johnson R, Gustafson D. Mobile Delivery of Treatment for Alcohol Use Disorders. Alcohol Res. 2014;36(1):111-122.

Jason andersonJason Anderson is currently a fourth-year student in the PharmD/PhD program at The Ohio State University College of Pharmacy. For his PhD, Jason works on a National Institute of Health research project at OSU regarding inhibitors of HIV integrase. He spent the month of November doing an Advanced Pharmacy Practice Experience rotation at the Center of Science and Industry (COSI) in Columbus, Ohio, teaching the museum visitors about prescription drug safety.

Why Do We Have Candlelight Vigils?

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by Karen Perry

[NOPE Task Force candlelight vigils are held every October, during Red Ribbon Week, a campaign created to raise awareness about alcohol, tobacco and other drug use. These candlelight vigils honor those who died of drug overdose.]

During the last week of October, NOPE Task Force organizes dozens of candle light vigils across the United States and Canada in memory of those lost to and those suffering from substance abuse.

We’ve done this for many years for one main reason: to raise awareness and open the doors to recovery by eliminating the prejudice that has followed the disease of addiction.

It’s a mission NOPE has supported since our founding a decade ago. But changing this attitude isn’t easy.

Too many people still think of addiction as a moral failing. In many circles, addiction is still spoken of in hushed tones, and patients and their families are considered weak and somehow deserving of their fate and are less worthy of our care. The stigma associated with the disease of addiction is one of the largest contributors to our nation’s drug overdose epidemic.

So how do we change this?

Let’s start by getting people into treatment. Many people who struggle with an addictive disorder fail to seek treatment, partially because of their fear that they will be labeled as an “addict,” and that the stigma will stick to them in both their professional and personal lives. If we removed the guilt and shame from the equation, more people would find it easier to make a realistic assessment of their substance problems and discuss it openly with health care providers.

The medical profession is another place to address stigma. For many years, doctors were slow to recognize addiction as treatable, and so patients were left to find help outside of the traditional medical community. Today, the medical community is recognizing unhealthy, addictive behavior as part of its focus on patients and applying evidence-based approaches in their practices. We need to make sure that continues and expands as advocated by the federal healthcare reforms.

Additional funding for drug treatment also should be factored in to fight stigma. As we know, there’s a huge impact and cost of addictive disorders on our society, but the funding for such treatment is disproportionately low compared to many other forms of medical illnesses. For many, the coverage that’s available is not sufficient, leaving them without the treatment needed at critical moments that can alter the course of their lives. In a world without stigma, addiction should be paid for on a level playing field with other medical problems.

Stigma follows people even in recovery, especially when it comes to employment, education, insurance, the ability to vote, and many other important aspects of living. Just because someone struggled with addiction in the past should not make life that much more difficult today.

Students and community members gather for a candlelight vigil at The Ohio State University on October 29. 2015 (photo courtesy of Wendy Lin).

Students and community members gather for a candlelight vigil at The Ohio State University on October 29. 2015 (photo courtesy of Wendy Lin).

Things have to change.

By eliminating stigma and prejudice, the tragic loss of life from drug and alcohol related deaths will diminish. With the removal of shame comes the hope for recovery and survival.

That’s what we’ll strive to accomplish during our vigils.

Join us in making this happen.

Learn about our vigils here: nopetaskforce.org/about-vigils.php

This article was originally published on nopetaskforce.org.

img-historyKaren Perry is the executive director of NOPE Task Force.

“Dreamland” and the College Campus

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by Kenneth M. Hale

Dreamland-HC-197x300 The misuse of prescription drugs and the resulting effects on our society is one of our most serious public health problems. This phenomenon has a bearing on the development of substance use disorders, worker productivity, personal relationships, the rising epidemic of heroin use, drug overdose deaths, and more. Dreamland: The True Tale of America’s Opiate Epidemic by Sam Quinones (Bloomsbury Press, 2015) does a masterful job of elucidating an important aspect of this problem – factors driving the misuse of opioid pain medications and their relevance to the upsurge in the use of black tar heroin. This book is a must-read for anyone wishing to understand the influence of pressures to enhance treatment regimen for chronic pain, marketing approaches within the pharmaceutical industry, unscrupulous prescribing practices in so called “pill mills,” and a different business model for providing black tar heroin to those becoming dependent on these substances. Underlying all of this is a change in our culture, signaling a departure from “Dreamland” and the strength of our communities which can serve as a deterrent to this opiate epidemic that thrives in the isolation of our citizens.

Sam Quinones, author of "Dreamland"

Sam Quinones, author of “Dreamland”

I had the opportunity to interview Sam Quinones for a short podcast to be posted soon by the Higher Education Center for Alcohol and Drug Misuse Prevention and Recovery (HECAOD.osu.edu). I asked him about the significance of the Dreamland story for our college campuses. After all, we know that the traditional college student is at the average age when the misuse of prescription medications begins. So the lessons learned through his exhaustive research surely have relevance to our prevention efforts among college students. His response and his stories, like the fundamental theme of his book, relate to culture. How can we return to a collegiate dreamland were more of our students focus on the excitement of learning as opposed to the misuse of alcohol and drugs? How can we ensure that student athletes are not exposed to potentially dangerous pain medications in the interest of keeping them on the playing field? How can we make sure that more of our students have access to collegiate recovery communities to support their successful navigation of the college experience?

As Mr. Quinones spoke, our need for more holistic environmental approaches to prescription drug misuse prevention was on my mind. We certainly need to use resources such as those provided through the Generation Rx Initiative (GenerationRx.org) to educate our students about safe medication practices, but “Dreamland” will be built around other efforts as well. We must establish policies to guide our use of medications and consequences for misuse. We must partner with law enforcement, counseling services, student health, residence and Greek life, and disability services. We must engage well-trained peer educators. We must incorporate screening, brief interventions, and referral to treatment (SBIRT) models relating to prescription drug misuse. We must provide safe alternatives for our students to prevent recreational drug misuse or self-medicating tendencies. We must limit student accessibility to medications that are not prescribed for them by educating those who have prescription drugs legitimately about secure storage and by providing drug disposal options. And we must consider mechanisms for making naloxone available on our campuses to help prevent opiate overdose deaths.

Mr. Quinones has chronicled how Portsmouth, Ohio, has come “up from the rubble” to emerge from their status as “ground zero” in the opiate epidemic. Together, through the use of a more holistic approach to medication safety, we can help keep our campuses and our students out of the rubble as well.

Ken Hale 4X6 Kenneth M. Hale, RPh, PhD, serves as Co-Director of the Generation Rx Initiative, Associate Director of the Higher Education Center for Alcohol and Drug Misuse Prevention and Recovery at The Ohio State University, and clinical professor in the Department of Pharmacy Practice and Administration at The Ohio State University College of Pharmacy. His professional interests and specializations include prescription drug misuse prevention. He recently was awarded Cardinal Health’s Pillar of Strength Award for his work with the Generation Rx Initiative.

Have a Plan: A Mindful Approach to College Student Wellness

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by Christyn Bergquist

have a a plan general poster fall 2015_web (1)From Nancy Regan’s “Just Say No” to the more recent “Above the Influence,” there have been many well-known campaigns geared toward warning young people to stay away from drugs and alcohol.  At the University of Massachusetts Lowell, the office of Health Education and Promotion is launching a new campaign: “Have A Plan.”

The concept of “Have A Plan” is based on mindful and intentional decision-making.  The “Have A Plan” campaign was realized when we acknowledged the decisions that students continuously make regarding alcohol, drugs and other hot button topics.  We committed to encouraging students to think about their choices and create a plan for their approach before they find themselves in risky situations.  Instead of saying “don’t do this” or “do that,” we want to give students as much information as possible in hopes that it will resonate with them or spark a change in their thought process that influences positive choices.

To promote the “Have A Plan” campaign we created ten posters, each of which are dedicated to a unique topic: getting involved, going out, sleep, getting consent, eating well, staying active, quitting smoking, taking medications, studying and managing stress.  Each poster contains suggestions for making decisions related to the topic.  Each suggestion is intentionally short and to the point because students are unlikely to stop and read much longer text while on-the-go.  Our strategy is to have the posters displayed all over campus and integrate them into university-owned social media outlets so that students are exposed to our messaging multiple times.  We hope that repeat exposure will encourage students to more seriously consider topics they may not have reflected on previously.  With this reflection we hope to influence them to have a plan for these situations.

have a plan campaign spring 2015_5_web

Image courtesy of Christyn Bergquist.

One of the topics addressed in the poster series is “Taking Medications” (pictured).  We know that most students who use prescription drugs for nonmedical use get these drugs from a friend.  We wanted to make it clear that students should not share their medications with others and that this is a specific violation in our conduct code.  As we discuss this posters with students, we emphasize the impact that choosing to share their medication or taking medication not prescribed to them may have on their college career.  Many students arrive on campus without thinking about how they will manage their medication.  They may not expect a peer to be interested in using their medication.  Hopefully, through this campaign, we will raise awareness of this possibility and be prepared to respond.

As we progress into the first semester of this campaign, we are integrating the concept of “Have A Plan” into many of our outreach efforts, including class room presentations and campus programming.  Our goal is to influence students to be prepared with a plan and the ability to make a mindful decision and response in high risk situations, minimizing their involvement in high risk behavior and increasing their potential for success.

CBergquist HeadshotChristyn Bergquist is the Coordinator for Health Education at UMass Lowell.  Her focus is on alcohol and other drugs and mindfulness practices.  Christyn earned her MBA from Nichols College and her BS in sociology from University of Massachusetts Lowell.

Gen Rx U Spotlight: University of Mississippi School of Pharmacy

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by Rachel Strait and Kelsey Carol Stephens 

Students performed skits during University of Mississippi Generation Rx presentations. (Photo courtesy of R. Strait and K. C. Stephens)

Students performed skits during University of Mississippi Generation Rx presentations. (Photo courtesy of R. Strait and K. C. Stephens)

The University of Mississippi School of Pharmacy Academy of Student Pharmacists (ASP) Chapter first implemented a Generation Rx program during the spring semester of 2013. The program, initially targeting middle school and high school students, delivered a PowerPoint presentation with medication abuse statistics and an entertaining skit and concluded with a “Jeopardy” game. After learning from the first year, the goal for the subsequent year was to improve upon the information shared with students as well as expand the program to include college-aged students, in particular, entering freshmen.

Rachel Strait, Project Chair, Generation Rx, and Kelsey Stephens, ASP Chapter President, attended the 2014 Generation Rx University Conference at The Ohio State University to collect best practices in order to further develop local programming for the fall semester. Based on what they learned, the chapter developed and provided a presentation and discussion with incoming college freshman enrolled in the “First Year Experiences” course. This course is designed as an introduction to campus life as a means to ensure student success. The presentation focused on focused statistics, intervention strategies, and explained common myths regarding medication use. A survey was provided to the students before and after the presentation to assess the student’s knowledge and perception of prescription medication misuse. Students’ belief that prescription medications are safer than “street” drugs significantly decreased and student agreement in understanding proper medication disposal significantly increased. Of particular interest, student understanding of where to find resources to help others significantly increased after providing Generation Rx programming. Based on the success of these efforts, ASP was asked to update the textbook used for this course.

Stickers were provided to middle- and high school students after a Generation Rx presentation. (Photo courtesy of R. Strait and K. C. Stephens)

Stickers were provided to middle- and high school students after a Generation Rx presentation. (Photo courtesy of R. Strait and K. C. Stephens)

During the spring semester, the chapter provided presentations to local middle school and high school students focused on a pharmacist’s role as part of the healthcare team, prescription drug abuse statistics and dangers of abuse, media coverage on the topic, and the difference between over-the-counter (OTC) and prescription medications. As a treat for their attention and participation, chapter members provided students with stickers, pens, and seven-day pill planners purchased with The Cardinal Health Foundation Generation Rx Grant.

The chapter is currently working with The Ohio State University, Cardinal Health, and SockKids to develop interactive videos targeting young individuals in helping promote healthy medication habits. Our chapter has improved and developed our Generation Rx program due to the help and support of The Ohio State University, Generation Rx Tool-kits, Cardinal Health, and other APhA-ASP chapters. We look forward to continuing to enhance our Generation Rx program and impact more individuals.

Members of University of Mississippi's Generation Rx provide presentations to middle school and high school students and are expanding to create presentations for younger individuals. (Photo courtesy of R. Strait and K. C. Stephens)

Members of University of Mississippi’s Generation Rx provide presentations to middle school and high school students and are expanding to create presentations for younger individuals. (Photo courtesy of R. Strait and K. C. Stephens)

If you are a member of an APhA-ASP chapter looking to implement or enhance your Generation Rx program, our chapter recommends first selecting a target age group for your program. Next, we recommend beginning with the Generation Rx tool-kits located at generationrx.org. Pre-made Powerpoint presentations, handouts, speaker notes, and more can be found on this website. Once you select the information for a specific age group, it is essential to gain interest of volunteers, develop a committee, and select a location to give the presentation. Training sessions for the speakers may be held before the Generation Rx program begins in order to encourage unity between all of the presentations. Lastly, obtain feedback from presenters, participants, and other chapters to enhance your program for the next year. By following these steps, our chapter was able to develop, implement, and expand our Generation Rx program exponentially in the past two years and hope to continue our efforts in improving our program.

Rachel Strait is from Hazlehurst, MS, and is currently pursuing her PharmD from the University of Mississippi. She is the secretary of American Pharmacists Association – Academy of Student Pharmacists (APhA-ASP) and the president of the student chapter of the Academy of Managed Care Pharmacy (AMCP). She served as the project chair for Generation Rx program during the ‘14-‘15 academic year.  She can be reached for questions at rachelcstrait@gmail.com.

 

Kelsey Carol StephensKelsey Carol Stephens is from Greenwood, MS, and is a second year student pharmacist and the President of APhA-ASP (American Pharmacists Association – Academy of Student Pharmacists) at the University of Mississippi School of Pharmacy. She initiated development of the Generation Rx program impacting freshman college students and middle- and high school students in the community. She can be reached for questions at kcstephe15@gmail.com.