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Vision Session: Community Anti-Drug Coalitions of America (CADCA): Using the 7 Strategies of Community Change - CADCA's Comprehensive Coalition Approach to Preventing Rx Abuse - Mary Elizabeth Elliott and Sue Thau
Citation preview
Coali&ons At Work: Implemen&ng the Seven Behavior
Change Strategies at the Community Level ________________________
Sue Thau, Public Policy Consultant Mary Elizabeth Ellio9, VP, Communica<ons, Membership & IT
CADCA
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Community an<-‐drug coali<ons play a unique role that involves:
• Reducing access and availability;
• Enforcing consequences;
• Changing aMtudes and percep<ons;
• Changing social norms;
• Raising awareness about costs and consequences; and
• Building skills in youth, parents and communi<es to deal with these issues effec<vely
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What is a coali&on? A coali<on is a formal arrangement for
coopera<on and collabora<on between groups or sectors of the community, in which each group retains its iden<ty but all agree to work together towards a common goal of building a safe, healthy and drug-‐free community.
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Coali<ons convene and combine talent and resources to address local substance abuse issues:
Key Sectors
• Law enforcement • Youth • Parents • Businesses • Media • Schools • Youth serving organiza<ons
• Faith based community • Civic and volunteer groups • Health care professionals • State, local or tribal agencies • Other organiza<ons involved in reducing substance abuse
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Environmental and Popula&on Level Strategies Are Effec&ve
Effec<ve substance abuse preven<on is comprehensive, community-‐wide and includes environmental and popula<on level strategies designed to change or strengthen norms against alcohol and drug use.
Environmental strategies involve changes in legisla<on, policy and enforcement throughout an en<re community.
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The community coali&on model, specifically the Drug Free Communi&es program, has proven successful in reducing substance use/abuse,
including the misuse and abuse of prescrip&on drugs
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DFC Program
• Na<onal program, created by Congress in 1997
• Reauthorized in 2001 and again in 2006 • Recognizes the importance of mul<sector comunity
coali<ons in reducing substance abuse
• Establishes funding for local community coali<ons – (local coali<ons can apply for up to $125,000 dollars per year for a period of up to five years -‐ renewable)
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DFC Program Requirements To be eligible to compete for a DFC grant, a coali&on must:
• Have the reduc<on of substance abuse among youth as its principal mission, and must target mul<ple drugs
• Have been in existence for at least 6 months • Have representa<on from the each of the 12 sectors • Be able to demonstrate through its mee<ng minutes that it func<ons as a unique en<ty and is more than a group of agency and organiza<on representa<ves or a board of directors of a direct service delivery organiza<on
• Coali<ons are only eligible to receive as much federal funding as they can match, dollar for dollar, with non-‐ Federal support, up to $125,000
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Na&onal Drug Free Communi&es (DFC) Program Evalua&on Findings
• Past 30-‐day use of alcohol, tobacco, and marijuana have declined significantly and in all grade levels between DFC coali<ons’ first and most recent data report.
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These results are being mirrored at the local level in communi&es throughout the
country.
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In this DFC community, past 30 day use of marijuana use among 10th graders decreased to 10.6% in 2010, a 47.3% decrease since 2002. During this same <me frame, according to Monitoring the Future (MTF), the na<onal rate decreased to 16.7%, a 6.2% decrease since
2002.
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• Partnering with schools to implement zero tolerance policies related to any substance that is illegal or the abuse of legal drugs (over the counter drug or prescrip<on drugs);
• Providing youth leadership training and parent educa<on workshops; and
• Partnering with local newspapers to raise awareness about the risks/harms associated with illegal drugs and alcohol
Strategies Implemented To Achieve Reduc&ons
13
In this DFC community, past 30 day use of marijuana use among 12th graders decreased to 14% in 2012, a 36.4% decrease since 2004. During this same <me frame,
according to Monitoring the Future (MTF), the na<onal rate actually increased to 22.9%, a 15.1% increase since 2004.
2004 2012 Na<onal MTF Rate (2004) Na<onal MTF Rate (2012)
19.9 22
14
0
5
10
15
20
25
30
35
40
2004 2012
Past 30 Day Use of Marijuana Among 12th Graders
Carter County Drug Task Force
Ashland, KY
22.9
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• Developing and implemen<ng public awareness and media campaigns;
• Increasing parent training and educa<on; and
• Promo<ng meaningful opportuni<es for youth par<cipa<on.
Strategies Implemented To Achieve Reduc&ons
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DFC coali&ons are singularly situated to deal with emerging drug trends, such as the misuse and abuse of prescrip&on drugs because they have the necessary infrastructure in place
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Keys To Pushing Back Against The Misuse and Abuse of Rx Drugs
• Taking a comprehensive, data driven approach that appropriately mobilizes each of the key sectors and actors who have a role in reducing access to and availability of prescrip<on drugs
• Changing social norms about the harm that misuse and abuse of these substances can cause is also cri<cal
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Seven Strategies To Affect Community Change:
Based on local data and condi<ons, coali<ons implement mutually reinforcing combina<ons of seven strategies to
achieve popula<on level reduc<ons in the misuse and abuse of prescrip<on drugs
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Strategy 1: Providing informa&on
• This strategy involves raising awareness within the community-‐at-‐large -‐ to include youth, parents, police officers, healthcare providers and educators, etc. – with educa<onal presenta<ons, workshops or seminars and data or media presenta<ons.
• The goal is to increase the knowledge base of the community and raise general awareness around prescrip<on drug abuse.
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Strategy 1 In Ac&on
• The Woonsocket Preven<on Coali<on implemented media campaigns to raise widespread awareness about the dangers of prescrip<on drug abuse in their communi<es.
• The Carter County Drug Task Force in Ashland, Kentucky distributed 35,000 Push Cards on “Preven<ng Abuse of Prescrip<on and Over-‐the-‐Counter Medica<ons” and 35,000 Push cards distributed on “Guidelines for Proper Disposal of Prescrip<on Drugs”.
• Coali<ons oren launch these types of campaigns during Na<onal Medicine Abuse Awareness Month, held every October.
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Strategy 2: Enhancing Skills
• This strategy provides workshops, seminars or other ac<vi<es designed to increase the skills of those who can prevent, iden<fy and treat prescrip<on drug abuse, including:
• Healthcare and dental providers;
• Pharmacists;
• Parents and adult care givers;
• Educators;
• Law enforcement;
• Businesses; and
• Youth
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Strategy 2 In Ac&on
• NCADD of Middlesex County delivered community educa<on presenta<ons to enhance the skills of community members who can prevent and iden<fy prescrip<on drug abuse, such as law enforcement, youth, parents and the medical community
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Strategy 3: Providing Support
• This strategy provides reinforcement and encouragement for par<cipa<on in ac<vi<es that prevent prescrip<on drug abuse
• The goal is to stop prescrip<on drug abuse before it ever starts
23
Strategy 3 In Ac&on
• The Shelby County Drug Free Coali<on partnered with local pharmacies to distribute prescrip<on drug warnings to raise awareness about the dangers of abuse.
24
Strategy 4: Enhancing or Reducing Access and Barriers
• This strategy u<lizes the systems and services that reduce illegal access to prescrip<on medica<ons while protec<ng access for those who legi<mately need medica<ons to relieve pain.
• It targets healthcare providers, pharmacists, law enforcement officials, educators and public health officials and encourages en<re communi<es to take ac<on.
25
Strategy 4 In Ac&on
• The Delaware Coordina<ng Council to Prevent Alcohol and Other Drug Abuse reduced barriers to proper medicine disposal by partnering with the Delaware County TRIAD program, a community based organiza<on sponsored by the Delaware County Sheriff’s office, which provides proper disposal of unused and expired medica<on.
26
Strategy 5: Changing Consequences
This strategy focuses on increasing or decreasing the probability of a specific behavior by changing the consequences (e.g., increasing public recogni<on for deserved behavior, individual and business rewards, taxes, cita<ons, fines, revoca<ons and loss of privileges).
27
Strategy 5 In Ac&on
• Coali<ons can recognize den<sts who have received training on prescribing protocols and subsequently prescribe less than the full 30 day supply of pain medicine when trea<ng adolescents who have their wisdom teeth removed.
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Strategy 6: Changing Physical Design
• This strategy focuses on safeguarding prescrip<on medicines to ensure that they will not be misused and abused, and targets everyone in the community.
• It involves changing the physical design or structure of the environment to reduce access and availability.
29
Strategy 6 In Ac&on
• The Cherokee Na<on installed a permanent medicine drop off box in the lobby of their police sta<on
• It also partnered with local homebuilders to ensure that the installa<on of one locking medicine cabinet is standard in every new home that is built.
• The Jackson County An<-‐Drug Coali<on purchased an incinerator to dispose of all returned medicines in their community.
30
Strategy 7: Modifying and Changing Policies
• This strategy is aimed at changing policies, laws and procedures to prevent current and future prescrip<on drug abuse.
• The target audience includes lawmakers, state and local public officials, employers and others involved in seMng rules and regula<ons.
31
Strategy 7 In Ac&on
• In carrying out this strategy, coali<ons oren support the passage and u<liza<on of prescrip<on drug monitoring programs, drug take-‐back and disposal legisla<on, statutes that support increased penal<es against doctors who prac<ce unscrupulous prescribing procedures, those who par<cipate in doctor shopping, etc.
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Strategy 7 In Ac&on
• The Metropolitan Drug Commission submi9ed an applica<on through the State of Tennessee for a planning grant to:
1) Develop a statewide prescrip<on drug task force to assist in the early detec<on, interven<on and preven<on of prescrip<on drug abuse and addic<on;
2) Educate both the health care community and the public; and
3) Assist law enforcement with access to the developing state Prescrip<on Drug Program created through the Controlled Substance Monitoring Act of 2002.
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DFC coali&ons have achieved major results
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In this DFC community, past 30 day non-‐medical use of prescrip<on drugs decreased at a rate of 88.9% among 10th graders; 83.3% among 12th graders.
9
12
3 3 1
2
0
2
4
6
8
10
12
14
10th Grade 12th Grade
Carter County Drug Task Force Grayson, KY
Past 30 day Non-‐Medical Use of Prescrip&on Drugs Among 10th and 12th Graders
2004 2010 2012
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• Partnered with local law enforcement to implement take back events and increase DUI/drug suppression checks;
• Provided funding for law enforcement agencies to receive drug suppression training;
• Implemented a social norms media campaign;
• Provided educa<on to parents, teachers, youth and healthcare professionals; and
• Convened a key leader community forum to educate elected officials about the growing prescrip<on drug problem
Strategies Implemented To Achieve Reduc&ons
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7 0
5
10
15
20
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Barrington Prevention Coalition (BAY TEAM)
Barrington, RI
Past 30 Day Non-Medical Use of Prescription Drugs
Among 12th Graders
In this DFC community, past 30 day non-‐medical use of prescrip<on drugs decreased at a rate of 61.1%, from 18% in 2009 to 7% in 2011.
■2009 ■2011
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• Partnered with local law enforcement to: 1) implement three take back events; and 2) distribute “you should know” le9ers to the peers of any youth arrested for a substance abuse related offense
• Provided parent educa<on
• Developed and disseminated a brochure on the dangers associated with the misuse and abuse of prescrip<on drugs
Strategies Implemented To Achieve Reduc&ons
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CADCA’s OTC and Rx Drug Abuse Recommenda<ons and Resources
39
OTC and Rx Drug Abuse is a Concern for CADCA Coali<ons
In our 2013-‐2013 Annual Survey of Coali<ons we asked… Does your coali<on collect data on any of the following substances? • Cough medicine – 25.31% • Hydrocodone – 39.17% • Oxycodone – 47.24% • Prescrip&on drugs (not Hydro/Oxy) – 74.54%
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OTC and Rx Abuse A Concern, Cont.
Rank of the top 5 substances that are causing the most problems in your community?
• Cough medicine – 3.1%
• Hydrocodone – 17.36% • Oxycodone – 28.43% • Prescrip&on drugs (not Hydro/Oxy) – 66.05%
41
OTC and Rx Abuse A Concern, Cont.
Which of the following substances is your coali<on currently addressing?
• Cough medicine – 11.31%
• Hydrocodone – 24.32% • Oxycodone – 30.41% • Prescrip&on drugs (not Hydro/Oxy) – 58.7%
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1. Expand effec<ve Prescrip&on Drug Monitoring Programs to ensure adequate coverage in every state and interoperability to share data where appropriate.
2. Enhance educa<on and training of medical and dental professionals in proper prescribing protocols.
3. Raise the general public’s awareness about the dangers of prescrip<on drug abuse as well as the proper ways to store and dispose of them.
4. Enhance opportuni<es for prescrip<on take back and other large scale disposal programs.
CADCA Recommendations
43 43
Recommenda&ons, Cont.
5. Support increased law enforcement and legal remedies to close down “pill mills.”
6. Require manufacturers to create abuse deterrent formula&ons for commonly-‐abused prescrip&on painkillers.
7. Expand the number of DFC funded communi&es and train more communi&es to implement comprehensive, data driven strategies to effec<vely address their local prescrip<on drug abuse problems.
11 44
CADCA Supports the Office of Na4onal Drug Control Policy (ONDCP) Plan
and the Na4onal Governor’s Issue Brief “Six Strategies for Reducing Prescrip4on
Drug Abuse”
45 45
CADCA’s Resources and Ac&on Published first Rx abuse preven<on toolkit in 2002
Dose of Preven<on Toolkit on cough medicine abuse in 2006
Town hall mee<ngs
Stopmedicineabuse.org with partner CHPA
Informa<onal video developed for communi<es
5 CADCA TV shows
Strategizer publica<on with ONDCP in 2008
Rx Abuse Preven<on Toolkit: From Awareness to Ac<on in 2010Na<onal Medicine Abuse Awareness Month
General Dean tes<fies before Congress
Hosted two half-‐day Rx specific trainings at the 2012 Mid-‐Year
New online course launched October 2012
28 46
No-‐Cost Online Medicine Abuse Preven&on Course for Coali&ons
47
• hkp://learning.cadca.org/
• 10 modules – es<mated 6 hours to complete
• Cer<ficate upon comple<on, con<nuing educa<on credits.
• Take the course at no cost –and give us feedback at [email protected].
47
Na&onal Medicine Abuse Awareness Month
• CADCA’s partner is the Consumer Healthcare Products Associa<on
• Annual CADCA 50 Challenge encourages coali<ons to host educa<onal events in October.
• 56 coali<ons, represen<ng 35 states par<cipated
• Our Dose of Preven<on Award recognizes best coali<on outreach on OTC and Rx Medicine Abuse Preven<on each year at the CADCA Forum.
• CADCA hosts town hall mee<ngs, Twi9er chats, and webinars each October to raise awareness.
30 48
New Partnerships in Rx Drug Abuse Preven<on a focus at CADCA’s Mid-‐Year
Training Ins<tute • An in-‐depth and unique coali<on
training experience, featuring 1, 2 and 4-‐day courses.
• Average a9endance is 1800. • July 21-‐24, 2014 in Orlando, Fla. • Rx courses will focus on unique
partnerships; statewide ini<a<ves/plans and new places coali<ons can have an impact
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Visit us on the Web at www.cadca.org
Call us at 1-‐800-‐54-‐CADCA
Email Membership: [email protected]
Email Training and TA: [email protected]
Join us via Social Media: Facebook: facebook.com/CADCA
Twi9er: @cadca
Connected Communi<es Network: h9p://connectedcommuni<es.ning.com
YouTube: youtube.com/cadca09
Flickr: flickr.com/photos/cadca
Linkedin: Linkedin/company/cadca
Stay Connected with CADCA
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