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What an 1864 Epidemic and Today’s Substance Abuse Prevention Have In Common

By Nathan Grounds

Substance Abuse Prevention Month

This October marks the 10^th annual National Substance Abuse Prevention Month, a designation designed to honor those who have lost their lives to substance abuse and to highlight the significance of prevention efforts nationwide.

Substance misuse is not something foreign to East Texans. According to the Texas Regional Needs Assessment, the average age of first use for alcohol in East Texas is 12.9, slightly younger than the state average of 13.1. This is important for folks who work in prevention, because age of first use is a significant factor in predicting future alcohol dependence. In fact, a young person whose first drink comes at age 15 is six times more likely to become alcohol dependent than adults who begin drinking at age 21, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Obviously, the goal of prevention is to see these numbers reversed, but how exactly is this accomplished?

Something In the Water

In 1864 a physician named John Snow was sent to London to attend to those who had contracted Cholera, an epidemic that was raging through the city. In an effort to discover the source of the disease, Snow began to map the housing locations of those who’d fallen ill. It wasn’t long before he made an alarming discovery: the vast majority of those diagnosed had drawn their water from a single source, the Broad Street pump. By simply removing the handle of the pump, thus closing its access, the spread of cholera was essentially eliminated.

One of the more significant acknowledgements in the prevention field today is the significance the environment plays in substance misuse. Like John Snow, substance abuse coalitions all across the country seek to analyze environmental factors within their communities that lead to substance abuse; things like easy access, low perceived risk, and social norms. Once these factors have been identified, coalition members plan and implement strategies to change the environment in such a way that young people are less likely to turn to substances .

East Texas Prevention and the Part You Play

Locally, the Northeast Texas Coalition Against Substance Abuse (NETCASA) is hard at work to make the environmental changes necessary to reduce prescription drug abuse. According to SAMSHA, two-thirds of teens who obtain pills not prescribed to them get them from familiar places like friends, family, or home medicine cabinets. Unfortunately, many adults do not properly dispose of their unneeded prescriptions, making it far too easy for teens to get a hold of.

To combat this trend, NETCASA has partnered with local law enforcement to host the Drug Enforcement Administration’s (DEA) Takeback Event. This fall’s event will take place on October 24 from 10 to 2. Simply round up your unwanted prescriptions and drop them off at any of the participating drop sites. You can find a drop site near you on the DEA website or our Rx prevention website.

Can’t make it to the event? You can drop off your meds at one of the 30+ Rx drop boxes across East Texas. Click here to find an Rx drop box near you. Simply drop your medications in the box. No questions asked.

With your help, we can take a major step in preventing youth prescription drug abuse in East Texas.

NOTE: Due to the ongoing pandemic, the DEA Takeback is a drive-thru event only with no gatherings allowed. To ensure everyone’s safety, please wear a mask and maintain social distance protocols.

2019 National Prevention Week – Preventing Prescription and Opioid Drug Misuse

Opioid abuse and overdose has become the defining public health crisis of our time. On average, 130 Americans die every day of opioid overdose, according to the National Institute on Drug Abuse.

This week is the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Prevention Week. Today’s focus is on Preventing Prescription and Opioid Drug Misuse.

The Centers for Disease Control and Prevention estimates that the cost of the crisis is $78.5 billion a year, including the costs of healthcare, lost productivity, treatment, and criminal justice involvement.

There are some solutions that prevention experts are working on. One is drop boxes for leftover prescription drug at law enforcement agencies and pharmacies. When teens abuse prescription drugs, more than half of the time they get the drugs from friends and family, sometimes stealing drugs out of a medicine cabinets. To see drop box locations in the East Texas area, check out our Rx Drop Box map.

Another strategy is encouraging doctors to adhere to the CDC prescribing guidelines. These include things like talking to the patient about the risks, keeping the prescription short anywhere from 3-14 days depending on the situation) and checking a database of opioid prescriptions, the Prescription Drug Monitoring Program, to cut down on doctor shopping.

In East Texas, there are 209 controlled substance prescriptions written for every 100 people.

Unfortunately, “roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them,” according to the National Institute on Drug Abuse, and “about 80 percent of people who use heroin first misused prescription opioids.” By educating the public on the risk of addiction when opioids are misused, hopefully that percentage will decrease.

If you have leftover prescription drugs at home, it’s important that you dispose of the ones you no longer need, and to monitor the ones that you are still currently taking. By working together, we can all do our part to help reduce the impact of the opioid crisis.

National Rx Drug Take Back Day: October 27, 2018

Think about your medicine cabinet at home for a minute. Do you have prescription drugs left over, maybe pushed toward the back of the cabinet and forgotten?

A great way to get rid of them is coming up on Oct. 27 from 10 a.m. to 2 p.m., the semi-annual Drug Enforcement Administration (DEA) Take Back. Your disposing of your prescription drugs at this event ensures they can’t fall into the wrong hands.

The DEA Take Back is one of our prevention coalitions’ favorite activities. This event happens in communities all over East Texas and the rest of the country. Local law enforcement set up come-and-go collection sites where residents can drop off their leftover prescription medication, no questions asked.

Residents who come to drop off their drugs almost always thank the law enforcement for holding this event, and often say they wanted to dispose of their leftover prescription drugs but weren’t sure how.

To see Takeback locations in your area, check out the DEA Take Back site.

How did the opioid crisis get started?

According to the Centers for Disease Control and Prevention (CDC), 72,000 people died of drug overdoses in 2017, and the number of deaths has climbed every year since opioids started to be prescribed in the 90s, with the total deaths now more than 600,000.

According to Vox News, “The opioid epidemic began in the 1990s, when doctors became increasingly aware of the burdens of pain. Pharmaceutical companies saw an opportunity, and pushed doctors — with misleading marketing about the safety and efficacy of the drugs — to prescribe opioids to treat all sorts of pain. Doctors, many exhausted by dealing with difficult-to-treat pain patients, complied — in some states, writing enough prescriptions to fill a bottle of pills for each resident.”

What is the scope of the problem in East Texas?

According to the Regional Needs Assessment, controlled substances (prescriptions that have a higher potential for abuse) are prescribed at a higher rate in East Texas than the rest of the state, and that access contributes to the fact that teens in East Texas abuse prescription drugs at a higher rate than their peers across Texas.

How does having leftover pills in your cabinet contribute to the crisis?

The opioid crisis has been in the news a lot lately, and Americans are beginning to understand the impact of leftover drugs sitting in their medicine cabinet. Whenever teens who abuse prescription drugs are surveyed, the majority say they get them for free from friends and family — and sometimes take them from a loved one without their knowledge. Not to mention that prescription drugs are sometimes taken when a burglary occurs to either be consumed or sold for a big profit.

When you dispose of your prescription drugs responsibly with law enforcement, you are not only protecting your teen or another loved one from potential misuse, but also protecting the community. If you can’t make it out to the National Rx Drug Tack Back event from 10 a.m. to 2 p.m. on October 27, check out our How To Dispose page for other ways to safely get rid of your medications.

Faith In Action: Healing The Opioid Crisis Together

If you’re a person of faith, how would you say you put that faith into action?

One way you might put your faith into action is by disposing of your leftover prescription drugs.

We are partnering with faith congregations across East Texas next week to spread the message that you can help your community by disposing of your leftover prescription drugs that would otherwise sit in your medicine cabinet. We are encouraging congregations to put the message in their bulletins, talk about it in their small group classes, post it in the halls of their facilities. A large percentage of people in East Texas are part of a community of faith, so this is a great way to spread the message. To find a prescription drug drop box location near you with your local law enforcement, or to learn about other ways to dispose, visit our How To Dispose page.

The opioid crisis has decimated families across this country. The CDC estimates that 72,000 people died of a drug overdose in 2017, and about 50,000 of those were opiate overdoses. Experts say we have a long way to go before those numbers start to trend downward.

Some people might say they like to save their prescriptions for a friend or family member who might need them down the line, but did you know it’s actually illegal to share your prescription drugs?

It’s illegal because 1) If you’re not a medical professional, you haven’t been trained in how someone else’s body may respond to your medication, and 2) It can create or worsen addiction. Most people, including youth, who abuse prescription drugs say they get them for free from friends and family.

And, although it happens less often, there are cases of people stealing leftover prescription drugs from someone without their knowledge. If you responsibly dispose of your leftover prescription drugs, that can’t happen.

So how is disposing of your prescription drugs an example of faith in action? What does it have to do with your spiritual life? Simple: It’s an answer to many people’s prayers.

People have been praying someone will do something to end this crisis. By disposing of your prescription drugs, you can be the hands and feet of many prayers across East Texas. In fact, according to the Regional Needs Assessment, teens have abused opioid at a higher rate in East Texas than their peers across the state.

Disposing of your prescription drugs is an answer to prayer and an act of compassion. It can help prevent addiction from starting, or even a deadly overdose. If you would like to get your faith community involved, give one of our coordinators a call at 903-939-9010.

What You Should Know If Your Child Is Prescribed Opioids

With opioid overdoses being so frequent across the country (115 Americans die every day, according to the CDC) and in the news lately, parents may be concerned if their child receives an opioid prescription. Here’s some tips on how to ensure that your child gets the pain relief they need while avoiding opioid misuse and addiction.

First, what is an opioid?

There are several opioids that are on the market now. The most common are Hydrocodone (Zohydro); Hydrocodone with Acetaminophen (Vicodin); Oxycodone (Oxycontin, Roxicodone); Oxycodone + Acetaminophen (Percocet); Codeine, Morphine, Fentanyl, and Tylenol with codeine.

These are distinct from opiates; opiates are drugs like morphine and heroin that are derived from the poppy plant, whereas opioids are synthetic, but they create a similar high. This is why 4 out of 5 heroin users say that their addiction began when they started abusing prescription drugs.

Why are opioids so addictive?

According to the National Institute on Drug Abuse, “Opioids activate several brain systems, including one that motivates a person to take more of the drug. At the same time, opioids cause changes in another part of the brain that limits a person’s ability to stop taking them. When these two brain processes work in combination, the effect is like hitting the accelerator in a car—without having any brakes. A person addicted to opioids feels an intense urge to take the drug again, and also has a hard time resisting that urge.”

On top of that, teens have a brain that is not fully developed. The part of the brain that assesses risk isn’t fully finished developing until about the mid-twenties, which means that teens are more susceptible to trying substances.

What should you ask your child’s doctor?

The Partnership for Drug-Free Kids recommends asking these questions if your child’s doctor prescribes an opioid:

1) “Is a prescription opioid necessary to treat my child’s pain? Might an over the counter (OTC) pain reliever such as acetaminophen (e.g., Tylenol), in combination with a non-steroidal anti-inflammatory drug (NSAID) be just as effective? For chronic pain, can we explore alternative treatments such as physical therapy, acupuncture, biofeedback or massage?”

2) “How many pills are being prescribed, and over how long a period? Is it necessary to prescribe this quantity of pills?”

3) “What are the risks of misuse? (The prescriber should be able to answer this question for the specific drug being prescribed.)”

4) “Should my child be screened to determine his/her risk of substance use disorder (SUD) before this medication is prescribed? If not, why not? (Common risk factors include co-occurring mental health disorders such as depression or ADHD, as well as a family history of addiction or a recent trauma such as a death in the family or a divorce.)”

What other steps can you take if an opioid is prescribed?

First and foremost, be sure and talk to your kids about the dangers of taking a medication in any way other than the way it’s prescribed. Medication, especially opioids, should never be taken at a higher dose or more frequently than prescribed.

As with any medication, especially ones that have a high risk of being misused, consider securing it behind a lock. If that’s not possible, keep track of how much medication you have.

Once your child is feeling better, dispose of any leftover medication right away. There are several ways to properly dispose of leftover medication, such as attending a DEA Takeback event that happens twice a year, dropping the medication in a secure drop box at a participating law enforcement agency or pharmacy, using a drug deactivation pouch, or mailing in your medication to an agency that will incinerate it for you.

Opioid addiction can be a scary thought, but following these steps will go a long way to keeping your family safe.

Free Envelopes to Reduce Opioid Risk from The National Safety Council

The National Safety Council is providing a new way for residents to dispose of their prescription drugs for free.

At this website, you can order a special envelope to mail your leftover prescription drugs to a company that is approved by the Drug Enforcement Agency and specializes in destroying drugs.

This is a great initiative that targets one of the main reasons our country is seeing so many people get addicted and overdose on prescription opioids: there are simply too many of these drugs sitting in medicine cabinets.

“Research indicates people who take opioid painkillers can quickly develop a dependence on this class of drug,” according to the National Safety Council’s informational website. “Yet, 70% of doctors prescribe highly addictive opioids for longer than the CDC recommends, according to a National Safety Council survey.

The envelopes are 8”x12” and DEA-compliant, and are designed to hold up to 8 oz. of medication, of which 4 oz. may be liquid in a sealed container. The company, Stericycle, will destroy the medication using a process that is secure and safe for the environment. Envelopes are U.S. postage-paid, pre-addressed and include complete instructions.

These envelopes are just one of a few options for disposing of prescription drugs—other ways to dispose are through a prescription drug dropbox in your area, a DEA Takeback event, or disposal pouches that destroy the drugs immediately. If you have leftover medications at home, properly dispose of them and do your part to make sure they can’t fall into the wrong hands.

National Prevention Week, Day Three: Prescription & Opioid Drug Misuse

Maybe you’ve heard about “The Opioid Crisis” in the news. It is one of the biggest public health epidemics of our time.

According to the CDC, from 1999 to 2016, more than 630,000 people have died from a drug overdose. Around 66 percent of the more than 63,600 drug overdose deaths in 2016 involved an opioid. In 2016, the number of overdose deaths involving opioids (including prescription opioids and illegal opioids like heroin and illicitly manufactured fentanyl) was 5 times higher than in 1999, and on average, 115 Americans die every day from an opioid overdose.

Unfortunately, according to the Region 4 Needs Assessment for the 23 counties that make up this part of Texas, “compared to the state and to the other regions, Regions 4 & 5 have the highest reported rate of non‐medical current (30‐day) use, school year use, and lifetime use for all grades and for the 12th grade of prescription drugs (Texas School Survey, 2016). When looking at lifetime use of selected prescription drugs among Grades 7‐12, Region 4 & 5 students have the highest reported rate in the state for the two opioid categories.”

How did we get here?

“The opioid epidemic began in the 1990s, when doctors became increasingly aware of the burdens of pain,” according to an article from news website Vox.com. “Pharmaceutical companies saw an opportunity, and pushed doctors — with misleading marketing about the safety and efficacy of the drugs — to prescribe opioids to treat all sorts of pain. Doctors, many exhausted by dealing with difficult-to-treat pain patients, complied — in some states, writing enough prescriptions to fill a bottle of pills for each resident. The drugs proliferated, making America the world’s leader in opioid prescriptions.”

Because there are so many drugs out there, part of how to prevent the problem from getting worse is to properly dispose of leftover prescription drugs that are no longer needed, and not saving them for a rainy day.

There are several ways you can dispose of your prescription medications and keep them from falling into the wrong hands. One, use a prescription drug drop box if one is available in your community. These are a great option because the drugs are incinerated by law enforcement, keeping them out of landfills and the water supply. Here is our list of those boxes in East Texas.

Two, participate in the twice-annual DEA Takeback event. The event is typically held in April and October every year.

Three, use a prescription drug pouch that will deactivate the drugs if one is available to you. Ask your pharmacist about other good ways to dispose of your prescription drugs.

Proper Disposal of Prescription Drugs Now Easier With New Partnerships

One of the best ways to combat the opioid crisis and prescription drug abuse is to ensure that prescription drugs aren’t easily accessible.

People are coming up with new ways to do that every day, and now even Google is getting involved.

“We’re deeply concerned by the opioid crisis that has impacted families in every corner of the United States,” reads Google’s blog post announcing their efforts to combat the crisis. “We started by thinking about how to bring Google’s technical expertise to help families combat the epidemic.

“Research by the federal government has shown that prescription drug abuse is a large driver of opioid addiction, and that the majority of abused prescription drugs are obtained from family or friends, often from a home medicine cabinet. The U.S. Drug Enforcement Administration (DEA) has found that one way that Americans can help prevent drug abuse and addiction is to properly dispose of unneeded or expired prescription drugs. Yet many people aren’t aware of, or can’t easily find, prescription drug disposal programs in their communities.”

Google used their search engine to help people locate DEA Takeback events this past Saturday, and are working with individual states to locate more permanent drug takeback options, such as drop boxes at participating local law enforcement agencies and pharmacies. Until then, here is our list of locations in the East Texas area.

We are thrilled that such a large corporation that millions of people use every day is joining the fight against the opioid crisis. According to the Centers for Disease Control, “more than 630,000 people died from a drug overdose from 1999 to 2016, and about 66 percent of the more than 63,600 drug overdose deaths in 2016 involved an opioid. In 2016, the number of overdose deaths involving opioids (including prescription opioids and illegal opioids like heroin and illicitly manufactured fentanyl) was five times higher than in 1999. On average, 115 Americans die every day from an opioid overdose.”

In addition, Blue Cross and Blue Shield of Texas is partnering with Walgreens to provide prescription drug drop boxes in Walgreens locations across Texas.

These are wonderful initiatives, but the essential part of the equation is you: If you have leftover prescription drugs, please make sure you do your part and dispose of them properly.

What is a prescription drug disposal pouch?

It’s a simple idea: When there are fewer drugs in medicine cabinets, people are less likely to abuse them.

That’s the thought behind prescription drug disposal tactics such as disposal boxes (click here for a list of locations in East Texas where you can dispose of your leftover prescription drugs, no questions asked) and prescription drug disposal pouches being distributed in communities in our 3 coalitions 13-county coverage area.

The East Texas Substance Abuse Coalition covers Smith, Rusk, Cherokee, Henderson, and Van Zandt counties.

The Piney Woods Substance Abuse Coalition covers Gregg, Harrison, and Marion counties.

The Northeast Texas Coalition Against Substance Abuse covers Franklin, Titus, Morris, Cass and Bowie counties.

The prescription drug pouches were awarded to the coalitions from the Texas Targeted Opioid Response grant. The opioid crisis has been in the news a ton lately, and for good reason. According to the Centers for Disease Control, 115 people die every day from opioid overdose.

There is a massive amount of these drugs out in the community, making them readily available for would-be abusers. More opioids are prescribed in East Texas than the average rate for the state, and the rate of calls to poison control for opioid exposures is higher in East Texas than the rest of the state, according to the Regional Needs Assessment by the Longview-based Prevention Resource Center.

In 2015, doctors prescribed “enough painkillers in the U.S. to keep every American doped up around the clock for three weeks straight,” according to NY Daily News.

Our coalitions are encouraging residents to dispose of these drugs once they are no longer needed. Enter: the disposal pouch.

There are a few options on the market, but the pouch the coalition is distributing are very easy to use. Simply drop the drugs into the pouch, fill it up halfway with warm water, reseal it and throw it in the trash. The charcoal inside the pouch makes the drugs inert and the pouches are landfill safe. This is a much safer, more effective option than simply throwing drugs directly into the trash or flushing them down the toilet.

Whether you use a prescription drug drop box or a disposal pouch, you are doing a service to your community when you dispose of your prescription drugs properly.

If you are a Brookshire’s pharmacy patient, specific Brookshire’s pharmacies are giving out these pouches. Click here for that list. And if you are a Walmart patient, any Walmart pharmacist will happily provide you with their own disposal pouch.