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Eric R. Wright, PhD

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Nonmedical Prescription Drug (Rx) Use in Indiana 2011 Eric R. Wright, PhD Chair, Indiana SEOW Director, Center for Health Policy * * * * * Schedule I drugs are not ... – PowerPoint PPT presentation

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Title: Eric R. Wright, PhD


1
Nonmedical Prescription Drug (Rx) Use in
Indiana2011
  • Eric R. Wright, PhD
  • Chair, Indiana SEOW
  • Director, Center for Health Policy

2
SEOW
  • In 2005, Indiana received a SPF SIG grant from
    SAMHSA to help build a solid foundation for
    delivering and sustaining effective substance
    abuse prevention services
  • Requirement of grant Establishment of SEOW
  • In 2009, Indianas DMHA switched SEOW funding
    from SPF SIG to SAPT block grant to ensure
    continuation of workgroup beyond SPF SIG

3
State Epidemiological Profiles
  • Annual publications (2006-2010) currently
    working on 2011 report
  • Companion documents (fact sheets and chart pack)
  • Available at www.healthpolicy.iupui.edu
  • Review of alcohol, tobacco, marijuana, cocaine,
    heroin, meth, Rx drugs, and polysubstance abuse
  • Supplements to the 2011 Report
  • Returning vets
  • LGTB
  • Ex-offenders
  • Dual diagnosis/co-occurring disorder

4
Most Recent ATOD Issue Briefs
  • Whats Cooking? Meth Use in Indiana (2010)
  • An Epidemiological Overview of Alcohol, Tobacco,
    and Other Drug Use in Indiana (2010)
  • Injection Drug Use In Indiana (2010)
  • Economic Impact of Substance Abuse and Misuse in
    Indiana (2010)
  • Underage Drinking A Culture of Drinking on
    Indianas College Campuses? (2009)
  • Prescription Drug Abuse Is a Growing Problem in
    Indiana (2008)
  • Fatal Drug Overdoses A Growing Concern in
    Indiana (2008)

5
Most Commonly Abused Rx Drugs
  • Pain relievers (opioids, narcotics)
  • Oxycodone (e.g., OxyContin, Percocet),
    hydrocodone, codeine, and morphine
  • Central nervous system depressants (sedatives,
    tranquilizers, hypnotics)
  • Barbiturates (e.g., Mebaral, Nembutal) and
    benzodiazepines (e.g., Valium, Xanax)
  • Stimulants (used to treat attention deficit
    disorders, narcolepsy, and weight loss)
  • Dextroamphetamine (e.g., Dexedrine, Adderall) and
    methylphenidate (e.g., Ritalin, Concerta)
  • NIDA, October 2011

6
The INSPECT Program
  • Indiana Scheduled Prescription Electronic
    Collection Tracking Program
  • Indianas Rx drug monitoring program
  • Collects information on all controlled substances
    (schedules II-V) dispensed in Indiana
  • Mandatory reporting
  • Maintained by the Indiana Professional Licensing
    Agency/Board of Pharmacy
  • Doesnt distinguish between legitimate and
    illegitimate (nonmedical) use
  • Indiana Board of Pharmacy, n.d.

7
Controlled Rx Drugs Dispensed in Indiana
2008 2009 2010 Overall Trend
Opioids 5,849,460 (50.3) 6,376,664 (50.2) 5,591,679 (49.3) ?
CNS Depressants 3,558,007 (30.6) 3,902,414 (30.7) 3,514,361 (31.0)
Stimulants 1,149,939 (9.9) 1,353,939 (10.6) 1,309,265 (11.5) ?
Others 1,077,686 (9.3) 1,080,914 (8.5) 926,234 (8.2) ?
Total 11,635,092 (100.0) 12,713,931 (100.0) 11,341,539 (100.0)
Source Indiana Board of Pharmacy, 2011
8
Rx Drugs Dispensed, by Gender
2008 2008 2009 2009 2010 2010
Male Female Male Female Male Female
Opioids 2,347,332 (51.4) 3,502,128 (49.5) 2,572,006 (51.3) 3,751,214 (49.6) 2,269,731 (50.5) 3,280,122 (48.7)
CNS Depressants 1,167,603 (25.6) 2,390,404 (33.8) 1,287,691 (25.7) 2,564,953 (33.9) 11,64,349 (25.9) 2,309,314 (34.3)
Stimulants 624,472 (13.7) 525,467 (7.4) 705,179 (14.1) 624,503 (8.3) 666,755 (14.8) 622,647 (9.2)
Others 426,712 (9.3) 650,974 (9.2) 450,047 (9.0) 618,273 (8.2) 393,286 (8.8) 524,121 (7.8)
Note All gender differences were significant, P
lt .001. Source Indiana Board of Pharmacy, 2011
9
The Growing Problem of Rx Abuse
  • Abuse of Rx drugs is a serious and growing public
    health problem in Indiana and the U.S.
  • Almost 52 million Americans (20.4) ages 12 have
    used Rx drugs nonmedically at least once in their
    life this includes pain relievers, sedatives,
    tranquilizers, and stimulants (2010).
  • In Indiana, over a million Hoosiers (20.7)
    reported that they misused Rx drugs at least once
    in their life (2002-2004)
  • Substance Abuse and Mental Health Services
    Administration, Office of Applied Studies, n.d

10
Lifetime, Past Year, and Current Nonmedical Rx
Drug Use, Indiana and U.S. (National Survey on
Drug Use and Health)
Lifetime Use Lifetime Use Past Year Use Past Year Use Past Month Use Past Month Use
Indiana U.S. Indiana U.S. Indiana U.S.
All Psycho-therapeutics 20.7 20.4 7.6 6.3 2.7 2.7
Pain Relievers 15.0 13.7 6.1 4.8 2.0 2.0
OxyContin 2.5 2.4 0.8 0.7 0.3 0.2
Tranquilizers 9.1 8.7 2.8 2.2 0.8 0.9
Sedatives 3.9 3.0 0.4 0.4 0.1 0.1
Stimulants 8.3 8.5 1.7 1.1 0.8 0.4
Note Indiana data based on NSDUH averages from
2002-2004 (most recent estimates) U.S. data
based on 2010 results. Source Substance Abuse
and Mental Health Services Administration, Office
of Applied Studies, n.d
11
Nonmedical Pain Reliever Use in the Past Year,
Indiana and U.S., by Age Group (NSDUH, 2009)
Note The differences between Indiana and U.S.
were NOT statistically significant. Source
Substance Abuse and Mental Health Services
Administration, Office of Applied Studies, n.d.
12
Percentage of College Students Reporting Rx
Misuse in the Past Six Months in Indiana, 2011
Rx Drug Prevalence
Adderall 9.9
Vicodin 4.3
Xanax 3.0
Codeine 3.0
Ritalin 1.5
Lortab 1.1
Percocet 1.1
Oxycontin 1.0
Morphine 0.6
Methadone 0.3
Steroids 0.2
Key Opioid Stimulant CNS Depressant Other
Source Indiana Collegiate Action Network, 2011
13
What is Driving the Prevalence of Nonmedical Rx
Use?
  • NIDA (October 2011) suggests three main drivers
  • Misperceptions about their safety
  • Increasing environmental availability
  • Varied motivations for their abuse

14
Sources of Rx Drugs
  • Among the U.S. population ages 12 and older who
    used pain relievers nonmedically in the past
    year
  • 55.0 got the pain relievers they most recently
    used from a friend or relative for free
  • 17.3 got the pain relievers they most recently
    used through a prescription from one doctor
  • 11.4 bought them from a friend or relative
  • 4.8 took them from a friend or relative without
    asking
  • 4.4 got them from a drug dealer or other
    stranger
  • 0.4 bought them on the Internet
  • Substance Abuse and Mental Health Services
    Administration, Office of Applied Studies, n.d.

15
Consequences of Rx Abuse
  • The consequences of Rx abuse are similar to those
    of illicit drug use and include
  • Legal consequences
  • Health consequences (abuse and dependence/addictio
    n)

16
Number of Arrests for Possession and Sale/
Manufacture of Other Drugs (Barbiturates and
Benzedrine) in Indiana (UCR, 19992008)
Source National Archive of Criminal Justice
Data, Inter-university Consortium for Political
and Social Research, University of Michigan, n.d.

17
Arrest Rates, per 1,000 Population, for
Possession and Sale/Manufacture of Other Drugs
(Barbiturates and Benzedrine), Indiana and U.S.
(UCR, 19992008)
Source National Archive of Criminal Justice
Data, Inter-university Consortium for Political
and Social Research, University of Michigan, n.d.
18
Percentage of Indiana and U.S. Treatment Episodes
with Nonmedical Rx Drug Use (TEDS, 2009)
ALL RX USE
Source Substance Abuse and Mental Health Data
Archive, n.d.
19
Percentage of Indiana and U.S. Treatment Episodes
with Nonmedical Rx Drug Dependence (TEDS, 2009)
ALL RX DEPENDENCE
Source Substance Abuse and Mental Health Data
Archive, n.d.
20
Nonmedical Rx Use Reported at Admission, Rate per
1,000 Population (TEDS, 2010)
Indiana Family and Social Services
Administration, Revenue Enhancement and Data,
20106
21
Final Thoughts
  • Abuse of Rx drugs is a serious and growing public
    health problem in Indiana and the U.S.
  • Opioid-based pain medications (e.g., oxycodone)
    are the most frequently abused Rx drug
  • Pain meds are most frequently abused by females,
    whites, and young adults (18-25)

22
Center for Health Policy
  • The Center for Health Policy collaborates with
    state and local government, as well as public and
    private healthcare organizations in health policy
    and program development to conduct high quality
    program evaluation and applied research on
    critical health policy-related issues.
  • Eric R. Wright, PhD
  • Director, Center for Health Policy
  • Professor and Interim Chair
  • Department of Public Health, IU School of
    Medicine
  • Indiana University-Purdue University Indianapolis
    (IUPUI)
  • 714 N Senate Ave, Suite 220
  • Indianapolis, IN 46202
  • 317-274-3161
  • ewright_at_iupui.edu
  • www.healthpolicy.iupui.edu

23
References
  • Indiana Board of Pharmacy. (2011). INSPECT
    datasets for 2009 and 2010. Received May 26,
    2011, from Joshua Klatte, Program Director,
    INSPECT Prescription Monitoring Program, Indiana
    Board of Pharmacy.
  • Indiana Board of Pharmacy. (n.d.). INSPECT.
    Retrieved December 7, 2011, from
    http//www.in.gov/pla/inspect.htm
  • Indiana Collegiate Action Network. (2011).
    Results of the Indiana College Substance Use
    Survey 2011. Received October 12, 2011, from Lisa
    Hutcheson, Director of ICRUD and ICAN.
  • Indiana Family and Social Services
    Administration, Revenue Enhancement and Data.
    (2011). TEDS County Data, 2010. Indianapolis, IN
    Indiana Family and Social Services Administration
  • National Archive of Criminal Justice Data,
    Inter-university Consortium for Political and
    Social Research, University of Michigan. (n.d.).
    Uniform Crime Reporting (UCR) Program. Available
    from http//www.icpsr.umich.edu/NACJD
  • National Institute on Drug Abuse. (May 2011).
    Prescription Drug Abuse. Retrieved December 7,
    2011, from http//www.nida.nih.gov/tib/prescriptio
    n.html
  • National Institute on Drug Abuse. (October 2011).
    Prescription Drugs Abuse and Addiction.
    Retrieved December 7, 2011, from
    http//www.nida.nih.gov/ResearchReports/Prescripti
    on/Prescription.html
  • Substance Abuse and Mental Health Data Archive.
    (n.d.). Treatment Episode Data Set - Admissions
    (TEDS-A), 2009. Available from http//webapp.icpsr
    .umich.edu/cocoon/SAMHDA/STUDY/24280.xml
  • Substance Abuse and Mental Health Services
    Administration, Office of Applied Studies.
    (n.d.). National Survey on Drug Use and Health
    (NSDUH). Retrieved December 7, 2011, from
    https//nsduhweb.rti.org/
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