The Importance of Drug Take Back Days

By Dr. Candace Haugtvedt

The OSU Student Health Services Pharmacy had a very successful Medication Disposal Day on Thursday, April 21, 2016 under the direction of Candace Haugtvedt, R.Ph., Ph.D. who coordinated the event. We reached 80 people who turned in 131.5 pounds of unused medications!  This included 1118 CII tablets or capsules and 370ml of CII liquids that are now off the streets and safely disposed of in an environmentally friendly way.  The OSU Police took 11 boxes for destruction by the Environmental Health & Safety Department in Facilities Operations and Development.  We handed out two adult Generation Rx educational handouts about how to Take Action to prevent drug misuse at home to each of the 80 people who dropped off unneeded drugs.  We had a steady flow of people and collected almost double the amount of drugs as we did the year before and reached almost double the amount of people as well.

OSU Police Officer Dave Ferimer, and P3 Pharm.D. students Andrea Haugtvedt and Lena Wu with boxes of unneeded drugs for destruction at the conclusion of our latest event. Photo courtesy of Candance Haugtvedt.

OSU Police Officer Dave Ferimer, and P3 Pharm.D. students Andrea Haugtvedt and Lena Wu with boxes of unneeded drugs for destruction at the conclusion of the latest event. Photo courtesy of Candace Haugtvedt.

The OSU SHS Pharmacy has been having Drug Take Back Days since 2011. This event was staffed by Generation Rx initiative pharmacy volunteers and coordinated by volunteers from SSHP and student health services. 10TV News even featured a story on our Drug Take Back Day event at noon and 5pm.We will have another Drug Take Back Day here at the OSU Student Health Services Pharmacy on Thursday, October 27, 2016 from 9am to 2pm to coincide with the NOPE (Narcotics Overdose Prevention and Education) Candlelight Vigil in memory of those lost to and those suffering from substance abuse.

We are also working on having a permanent Drug Take Back Box installed at the OSU Police Station on campus. A group from the OSU Police Dept., Environmental Health & Safety in Facilities Operations & Development, the Council of Graduate Students and the OSU Student Health Services Pharmacy is working out the policy and procedure details and all of the logistics.  There will be an ongoing need for Generation Rx volunteer students to separate out the controlled from non-controlled drugs and provide an inventory for the disposal vendor on a weekly or bi-weekly basis throughout the year.  The ongoing costs of drug disposal are also an issue we have to work on finding a funding source for.  Hopefully we can work these and other issues out over the next several months to have the permanent Drug Take Back Box in place on campus by next May.

Guidelines for hosting a Medication Disposal Day are found at:

Medication disposal days are extremely important to prevent the diversion of unneeded medications and to dispose of them in a safe, legal and environmentally friendly manner. Most teenagers who misuse prescription drugs obtain them from a friend or family member. It is very important to safely store medications, keeping them locked up and out of the reach of children. Safe disposal keeps toxic medications out of the groundwater and protects wildlife from harm. Medication disposal days are key to promoting public health and safety on campus and throughout the community.

CandanceCandace Haugtvedt is a pharmacist at OSU Student Health Services Pharmacy. She has a Ph.D. is in Pharmaceutical Administration/Preventive Medicine from Ohio State in 1998. Areas of expertise include health behavior/health promotion, public health advocacy and health care management. Professional experience includes 16 years as a decentralized Hospital Pharmacist at the University of Missouri-Columbia and Mount Carmel Health West in Columbus, and then 19 years as an Ambulatory Care Pharmacist in College Health at the Ohio State University Student Health Services Pharmacy.

Collegiate Recovery Community partnerships and activities allow for drug misuse education

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

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.




  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. Published 2013. Updated 2014. Accessed December 20, 2015.
  4. NCCA student-athlete substance use study: executive summary august 2014. National Collegiate Athletic Association. 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

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

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

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

by Ann Quinn-Zobeck

Image courtesy of

Image courtesy of

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

Image courtesy of

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 To find out how to start a peer education group and for other peer education resources, visit

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

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.


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.