1. Barry County Substance Abuse Task Force: Increasing Amounts of Prescription Use Within the Community 2007 - 2011 Prepared By: Shreenath Shah and Michael Spence Pharm D. Candidates 2013 Ferris State University College of Pharmacy

2. Objectives Substance Abuse in the USA Introduction to the commonly abused prescription medications View of Barry counties prescription medication use (Then and Now) How you can help

3. Substance Abuse in the United States Three types of drugs are abused most often: 1.Opioids- Pain Relievers 2.CNS Depressants- Stress, Seizures, Sleep 3. Stimulants- ADHD and Narcolepsy

4. Opioid Prescription Trends in the United States

5. Stimulant Prescription Trends in the United States

6. Prescriptions (Rx) Schedule II Substances: MUST be written or typed and manually signed by a practitioner with valid DEA # Provide a valid reason for medication MAX of 30 day supply NO Refills Schedule III Substances: May be ordered by practitioner orally, in writing, or by fax to the pharmacist. May be refilled if so authorized on the prescription or by call-in. Can be refilled up to five times within six months

7. Commonly Abused Rx’s 1.Stimulants: Amphetamines(Adderall), Methylphenidate (Concerta, Ritalin) – Schedule II – RX – ADHD – Excessive sleepiness – Depression Methamphetamines, MDMA (Ecstasy), Cocaine – Illegal substances Concerta

8. Commonly Abused Rx’s 1.Stimulants Continued… – Intoxication Effects Increased energy, alertness, feelings of exhilaration – How are they abused Crushed and Injected, Smoked or Snorted – Side Effects Faster heartbeat, seizures, insomnia, nervousness, paranoia aggressive behavior, hallucinations and heart attacks – Street Names: Methylphenidate : Rits, Vitamin R and West Coast Amphetamine: Speed, bennies, black beauties, crosses, hearts, uppers and truck drivers

9. Commonly Abused Rx’s 2. Opioids I.Oxycodone containing products - CII - Oxycodone + Ibuprofen ( Combunox) - Oxycodone + Acetaminophen (Percocet, Oxycontin, Endocet, Oxceta, Tylox) - Street Names: Roxys, Percs, Roxicotten, 512s, O’s, Hillbilly heroin

10. Commonly Abused Rx’s 2. Opioids Continued… I. Hydrocodone containing products – CIII -Hydrocodone + Acetaminophen (Vicodin, Norco, Lortab) - Street Names: Viko, Vikes or Hydro II. Methadone – CII -Brand Names: Dolophine, Methadose, Methadone diskets -Street Names: Juice, Meth, Fizzies, Amidone Vicodin Methadone

11. Commonly Abused Rx’s 2. Opioids Continued… – Use: Moderate to severe pain – Side Effects: Lowered heartbeat and breathing, coma, addiction, – How are they abused Crushed and smoked, snorted or injected – Intoxication Effects Pain relief, euphoria, impaired coordination, drowsiness

12. Population Size 2010 Census Cloverdale – N/A Delton -872 Dowling -374 Hastings – 7,308 Woodland - 425 Bellevue -1,282 Freeport – 483 Middleville – 3,319 Wayland -4,709 Hickory Corners - 322 Nashville – 1,628 Plainwell – 3804

13. Stimulant Use 2007 and 2011 in Barry County

14. Oxycodone Use 2007 and 2011 in Barry County

15. Hydrocodone Use 2007 and 2011 in Barry County

16. Methadone Use 2007 and 2011 in Barry County

17. Summary/Conclusions Prescription drug use rising in the USA Oxycodone, Hydrocodone and Stimulant use are most prescribed and dispensed medications in Barry County – Plainwell, Hastings and Delton all show significant increases in amounts of pain medication dispensed – Middleville and Wayland show similar increases in prescription medication use

18. Teenagers and Substance Abuse: National Statistics 1 out of 10 teens have abused stimulants (Adderall or Ritalin) 1 out of 5 teens have abused a prescription pain reliever – Hydrocodone, Oxycodone, Methadone

19. Teenagers and Substance Abuse: Barry County

20. What Can I Do ? Communication Encourage Positive Behavior Calmly set limits regarding drug abuse, ensuring child understands and is on the same page Lead by example Returning expired medications: – Medications, uncontrolled and controlled that are not disposed of properly can be stolen and misused

21. Medication Return: Barry County

22. More Information/ Helpful Resources Barry County Substance Abuse Task Force: – http://www.barrycountysatf.com Substance Abuse Guide Prescription and OTC Drug Abuse Guides The Partnership at DrugFree.org – http://www.drugfree.org/ National Institute for Drug Abuse: – http://teens.drugabuse.gov/ Family Checkup: Positive Parenting Prevents Drug Abuse – http://www.drugabuse.gov/family-checkup

23. Questions?

24. References 1. National Institute on Drug Abuse [Internet].Maryland: NIH [Updated 2013 Jan] Commonly Abused Prescription Drugs Chart; [Cited on Feb 19 3013] Available from: http://www.drugabuse.gov/drugs-abuse/commonly-abused- drugs/commonly-abused-prescription-drugs-charthttp://www.drugabuse.gov/drugs-abuse/commonly-abused- drugs/commonly-abused-prescription-drugs-chart 2. National Institute on Drug Abuse [Internet].Maryland: NIH [Updated 2013 Jan] Family Checkup: Positive Parenting Prevents Drugs; [Cited on Feb 19 th 2013] Available From: http://www.drugabuse.gov/family-checkuphttp://www.drugabuse.gov/family-checkup 3. National Institute on Drug Abuse for Teens [Internet]. Maryland: NIH for Teens [Updated Feb 19 th 2013] Facts on Drugs [Cited on Feb 19 2013] Available from: http://teens.drugabuse.gov/drug-facts http://teens.drugabuse.gov/drug-facts 4. Barry County Substance Abuse Task Force [Internet] Michigan (Barry); [Updated February 2013] Program Material [Cited on Feb 20 2013] Available from: http://www.barrycountysatf.com/program-materials.html http://www.barrycountysatf.com/program-materials.html 5. The partnership at drugfree.org [Internet]: [Updated February 2013] Prescription drug Abuse in the United States [Cited on Feb 19 2013] Available from: http://www.drugfree.org/drug-guide