October is Talk about Your Medicines Month, giving us the opportunity to recognize the importance of addressing prescription drug abuse. The National Council on Patient Information and Education (NCPIE) has long been about addressing prescription drug abuse and the role of treatment and a recovery-oriented system of care – as well as developing educational resources to support engagement at the community level.  We’ve learned that it’s not enough to say, “Don’t abuse these medicines,” which marginalizes consumers, not giving them the credit they deserve. 

HBCU Campus Dialogue on Prescription Drug Abuse Prevention, Treatment & Recovery

In March 2014, NCPIE convened the Historically Black College and University (HBCU) Campus Dialogue on Prescription Drug Abuse Prevention, Treatment & Recovery, an opportunity to gain a better understanding of this issue from faculty, staff and students. With support from the Substance Abuse and Mental Health Services Administration, we convened over 40 participants for this two-day meeting. Attendees affirmed that the abuse of certain prescription medications has been normalized on some college campuses.

While the Campus Dialogue represented a microcosm of colleges and universities, we suspect that you may likely find similar findings on your campus. See if you observe yourself nodding, “yes” to the following cycles of influence that participants attributed to prescription drug abuse and addiction.

• Misaligned Economic Incentives: When young adults enter college they are keenly aware of our country’s challenging financial conditions. There is a perception of a financial gain to selling medications. “A pill can sell for $30-$40, and a bottle of Promethazine with codeine can go for $400-500.00. Money now trumps problems later.”
• Availability or Overprescribing: “There’s a pill for every ill. We’ll give you something to fix you, and we’ll fix you from the inside out.”
• Misinformation: The integration of images and words, portraying drug abuse as “big fun,” can give students the mistaken impression that, “Everyone is doing it; why not try it; how could these medicines be so bad?”
• Peer pressure: “When students find themselves at parties, and everyone is getting high, some may think that they are outside of the loop if they are not using.”
• Transitional stress: Parental and personal pressure of making good grades, being independent, fear of the unknown, being in a fast-paced environment and absence of treatment and recovery services can make medication abuse a “go-to solution.”
• Racial disparity: Drug abuse and addiction are taboo. “Families are closed about drug abuse and addiction, and there are perceptions of denial.”

Bring Prescription Drug Abuse and Addiction Out of the Shadows

What began as a discussion about prescription drug abuse on HBCU campuses provided a platform for students, staff and faculty to address much bigger challenges including transitional stress, cultural disparity, poor economy, the role of social media and institutional bias. These academic and social pressures are reinforced by the perception that prescription medications can help some students get through the day, from studying and sleeping to socializing. The two days of discussion generated strategies for creating on-campus change – recommendations that could be implemented today and in the future, including the following:

• Monthly seminars
• Comprehensive RA training and integration of mentors
• Instituting the practice of forming smaller classes
• Launching an “unplugged day” twice a year
• Investing more research dollars into alternative medicines

Raise the Level of Awareness on Your Campus 

Dialogue participants concluded that we should begin by picking one provocative possibility and then exploit conditions to “viralize” change. So this October, make a commitment to raise the level of awareness about prescription drug abuse, treatment and recovery among students, faculty, staff and parents. Check out the following resources as you build and enhance your prevention and intervention efforts:

• Taking Action to Prevent and Address Prescription Drug Abuse
• Recoveropensdoors.org
• Prescription Drug Abuse Prevention: Resources for Community Action
• The Generation Rx Initiative
• Prevent Rx Abuse: A CADCA Toolkit

To learn more about the HBCU Dialogue and safe medicine use, contact Ray Bullman at NCPIE, 301.340.3940, bullman@ncpie.info, or check out www.talkaboutrx.org.

Photos courtesy of Ray Bullman.

The National Council on Patient Information and Education (NCPIE) has been working toward advancing the safe and appropriate use of medicines since 1992. This October marks NCPIE’s 29^th annual “Talk About Your Medicines” month (originally called “Talk About Prescriptions” Month). This year’s theme is “Let’s Get in Sync.” NCPIE will be in partnership with the American Pharmacists Association Foundation to launch a consumer education campaign encouraging more communication between pharmacists and patients and/or caregivers. The campaign will be looking at areas where there can be more interaction – including pharmacists providing medication counseling and medication synchronization services (in which multiple medicine refills would be available at the same time each month). Synchronization works by utilizing the Appointment Based Model (ABM) and is designed to improve patient adherence. Utilizing this tool allows pharmacists and pharmacy staff members to do medication reviews every month to be aware of therapeutic and adherence issues patients may be facing. This model can help patients achieve better health outcomes – particularly those who have multiple health conditions, are taking multiple medications, and are seeing multiple health care providers. Research has shown better patient adherence with this model, and this model allows the patient to be at the center of the healthcare team.​

A post regarding this topic will be coming later this month!

(Adapted from the National Council on Patient Information and Education, talkaboutrx.org)

These days it is not uncommon to hear about professional athletes getting caught up abusing pain pills, as these stories have almost become commonplace in sports.  Some athletes will do whatever necessary to stay on the field, and pain pills are becoming more widely used to mitigate sports injury discomfort. Unfortunately, while pain pills might work in the short run by allowing athletes to quickly play again, they are also highly addictive and can lead to future problems much bigger than the original injury.

Pain pills in sports

While it may be understandable why professional athletes turn to pain pills (since their careers depend on being healthy enough to play), it is more troubling to see youth athletes using these drugs.  In fact, in too many cases today young athletes who are originally prescribed pain pills from their physician later turn to the streets to buy black market pain pills when their scripts expire.  If black market pain pills become too difficult to find, or cost-prohibitive, heroin then becomes the drug of choice since it is more widely available and cheaper.  Ironically, young athletes who become addicted to pain pills (or heroin) almost always start out by using simply to get back on the field, only later do they become addicted to the drugs due to lacking medical oversight and/or relatively fast physiological addiction.

Possible reasons for this paradigm shift pertaining to more pain pill usage in sports include new norms in sports when it comes to pain management, group dynamics (pressures from teammates to quickly play again), fear of loss of starting position, or fears associated with missing future college athletic opportunities because of injuries that otherwise could be controlled for by using pain pills.  These new pressures, group dynamics, and future sport goals sometimes converge to create a “perfect storm” where otherwise healthy, level-headed kids uncharacteristically consider using dangerous pain pill drugs.

The race for athletic scholarships

Many young athletes (and their parents) begin the journey very early on when it comes to the pursuit of a full-ride DI athletic scholarship.  Though only about 3-4% of all high school student athletes will ever earn a full-ride, hundreds of thousands more will try their best with the hope of being one of the lucky few.  Along the way, it is almost inevitable that injuries will occur, and in some cases the injuries will be so severe that they jeopardize the chances of earning a full-ride.  It is in these instances where some kids (sometimes with parental influence) elect to do whatever is necessary so that the injury is quickly addressed — even if this means abusing pain pills.

Coincidentally, even young athletes with little to no hope of ever earning a full-ride scholarship are also at-risk for unforeseen drug abuse and dependence, mostly because prescription pain pills have almost become commonplace for rehabilitation recovery protocols.    Ironically, this new wave of drug addicts are very different than the traditional recreational drug addict who voluntarily chose to use street drugs to get high — in the case of the addicted athlete, the addiction occurs not because the athlete wants to get high, but instead because of the perceived value in these drugs as they apply to quickly getting back on the field again. 

Train healthy & allow time to heal

Healthy training and injury recovery methodologies in sports need to be closely examined and scrutinized, especially at the youth sport level.  Please check with your physician about the many ways to control for pain aside from prescription pain pills, including relaxation techniques, imagery, physical therapy, and proper rest.  Coming back from sports injuries too soon may cause bigger problems with pain pills and addiction, and might also send an athlete back on to the field too soon (which, ironically, may lead to more permanent long-term damage).

For more information about healthy training in youth sports please visit www.drstankovich.com or follow me on Twitter @Drstankovich.

Photos courtesy of Chris Stankovich.

I believe that colleges and universities have an obligation to educate students about medication safety. We live in a culture in which medications are used at an unprecedented rate (approximately 4 billion prescriptions per year). We see advertisements for prescription drugs on television (one of only two countries in the world to allow this) and in other media communications. We expect quick fixes to life’s myriad problems, and we often use a medication as that “fix.” This “pharmaceuticalization” has become normalized in our society, a phenomenon which is both good and bad. Modern medicines have provided many benefits, as we are living longer and healthier lives because of them. Many diseases that were once fatal are being prevented, converted to chronic conditions, or cured. But there is a dark side to this drug-taking culture as well. Adverse drug events (e.g., side effects, adverse drug reactions, medication errors) now consume more of our healthcare resources than the cost of the drug products. And the misuse and abuse of prescription medications has become a serious public health problem. The abuse of pharmaceuticals now exceeds that of all other substances except marijuana, and those first abusing a prescription medication (painkillers, sedatives and stimulants combined) far exceed those who first use marijuana. This has produced an epidemic in which emergency department visits and drug treatment center admissions relating to prescription drug abuse are escalating, and drug overdoses are now the leading cause of accidental death in the United States. On average, over 100 people die each day or one person every 15 minutes!

According to the National Survey on Drug Use and Health, the average age when prescription drug abuse starts is around 22, so there is a dire need to help college students adopt safe medication-taking habits. As healthcare consumers, they will be exposed to pharmaceuticals throughout their lives. We need to help them use these medications in a safe and effective way. The Generation Rx Initiative and the Higher Education Center for Alcohol and Drug Abuse Prevention & Recovery at the Ohio State University have been implemented to do just that, and this blog is being launched to give a “Voice” to those who seek to prevent the misuse and abuse of prescription medications in our colleges and universities. We encourage you to use the resources provided in the Generation Rx University toolkit which are provided free-of-charge due to the generous support of the Cardinal Health Foundation and share your efforts to prevent prescription drug abuse with others. Margaret Mead once said, “Never doubt that a small group of thoughtful, committed citizens can change the word; indeed, it’s the only thing that ever has.” We implore you to “change the world” on your campus by implementing educational strategies to prevent the misuse and abuse of prescription medications. In the process, we will save lives and help our students get the best results from prescription and non-prescription medicines.

We all need to hear your “Voice” as you help prevent the misuse and abuse of medications among college students. To get us started over the next few weeks, students from the American Pharmacists Association’s Academy of Student Pharmacists chapters at East Tennessee State University, the University of New Mexico, and the University of North Carolina who have received national Generation Rx awards will describe their amazing work. But we want to hear from YOU! Please send stories, photos, videos, etc. to me at hale.3@osu.edu – we would love to share some of these in future “GenRxU Voices” blog posts!

Many thanks to Julia Lawrence, a student at the University of Kentucky, for helping us launch this new initiative!

Dr. Kenneth M. Hale

Dr. Kenneth Hale

Clinical Professor, Pharmacy Practice and Administration

Co-Director, the Generation Rx Initiative

Associate Director, Higher Education Center for Alcohol and Drug Abuse Prevention & Recovery

The Ohio State University College of Pharmacy