SAMHSA’s CAPT Helps States Address Non-Medical Use of Prescription Drugs

Prescription painkillers, stimulants, tranquilizers, and sedatives fill medicine cabinets in homes across America. Because of their easy availability and perceived harmlessness, these highly addictive drugs are increasingly being abused. Consequences of abuse range from drug dependence to death by overdose. To address this growing public health problem, states are urgently seeking effective measures to prevent the non-medical use of prescription drugs.

Over the past year, SAMHSA’s Center for the Application of Prevention Technologies’ (CAPT) Northeast Resource Team has been working closely with states to develop an array of products and services that shed light on the consequences of non-medical use of prescription drugs, as well as on strategies for reducing their misuse. These products – including literature reviews, a three-part webinar series, and a face-to-face training – provide states with the information they need to do effective prevention planning.

Non-medical use of prescription drugs became the focus of the Northeast Team’s work when four of the states that it serves  – Massachusetts, Delaware, New Hampshire, and Rhode Island – ranked among the top highest in the country for non-medical pain reliever use among individuals 18 years and older[1]. Two other states in its catchment area, New York and Connecticut, have also designated the issue as a priority, according to Linda Barovier, coordinator for the CAPT’s Northeast Resource Team.

While there is no standard definition of non-medical use of prescription drugs, it has come to mean the use of a prescription drug without a doctor’s prescription, simply for the experience or feeling the drugs cause[2]. A similar term, misuse of prescription drugs, is the intentional or unintentional use of a prescribed medication in a manner contrary to directions[3].

“The Northeast Resource Team had been tracking national and regional data on the non-medical use of prescription drugs, and we anticipated this would become a priority with states in our service area,” Barovier says. “The message we received from states was: ‘We want our prevention workforce to understand the risk and protective factors involved in non-medical use of prescription drugs, and to know which strategies or interventions would be most effective.’ That is what the literature reviews and webinars are designed to do.”

As a first step, the CAPT thoroughly investigated the published research to date, including academic and scholarly articles, on the non-medical use of prescription drugs. The literature review included a detailed analysis of risk and protective factors, as well as strategies and interventions. “The literature review appeals to high-level state policymakers because it helps them see which interventions may be most useful for preventing prescription drug abuse,” says Barovier.

As a second step, the CAPT developed three webinars based on the literature review findings. The team delivered these webinars to prevention professionals in New Hampshire and New York. “Webinars capture major themes. They’re like bullet points from the lit reviews – a quick synopsis designed to increase awareness of key issues and guide decision making,” Barovier explained.

The first webinar, Understanding the Consequences of Non-Medical Use of Prescription Drugs, introduced prevention professionals to the dangers posed by non-medical use of prescription drugs. The webinar focused on increasing knowledge about the harmful physical and behavioral effects of misusing these potent drugs and explained key terminology, including the four categories of drugs that are commonly misused and the conditions for which they are generally prescribed: opioids (for pain relief), tranquilizers (for anxiety), sedatives (for sleep disorders), and stimulants (For attention-deficit hyperactivity disorder).

The second webinar, Risk and Protective Factors for Non-Medical Use of Prescription Drugs, informed prevention practitioners about the risk factors that play a role in individuals’ abuse of prescription drugs. These risk factors include a high degree of access and availability and a low perception of harm. Protective factors for prescription drug misuse among adolescents include strong parental disapproval of non-medical use of prescription drugs, as well as parental monitoring and overall involvement in the adolescent’s life.

Strategies to Prevent the Non-Medical Use of Prescription Drugs, the third webinar, examined strategies that have the strongest evidence of effectiveness according to the literature review’s analysis. These include state prescription monitoring programs, which enlist the help of pharmacists and doctors to reduce the number of prescriptions written in order to curtail the flow of commonly abused prescription drugs into the community.

In several states, the Northeast Resource Team has coupled the webinar series with face-to-face trainings. “Face-to-face trainings are more interactive than webinars and allow us to engage participants on a deeper level. By using case studies, for example, practitioners are able to work through how they might apply information gleaned from literature reviews and webinars to their own states,” says Barovier. 

According to Katy Shea, program manager of the New Hampshire Bureau of Drug and Alcohol Service’s Center for Excellence, the CAPT’s work with her state has been invaluable. “The literature reviews were hugely beneficial to us. We don’t have the resources to do the kind of in-depth research that SAMHSA’s CAPT does. Knowing that we were receiving the most up-to-date research gave us confidence in making decisions about which interventions to choose.”

“The goal of these products and services is to meet states where they are in their prevention work,” Barovier says. “We want states to have the tools to begin bringing down these elevated rates of prescription drug use.

For more information on this topic, contact Linda Barovier [1], Coordinator, SAMHSA’s CAPT, Northeast Resource Team.