West Virginia Department of Health and Human Resources
Bureau for Behavioral Health and Health Facilities
Behavioral Health is Essential to Health
Prevention Works
Treatment is Effective
People Recover
Improving the quality of life for West Virginians with behavioral health needs
Funded by:
This training is funded by a grant from the U.S. Department of Health
and Human Services, Substance Abuse and Mental Health Services
Administration, Center for Substance Abuse Prevention, and the
West Virginia Department of Health and Human Resources,
Bureau for Behavioral Health and Health Facilities.
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create awareness about the impact of
prescription drug abuse in WV
discuss the appeal of using depressants,
stimulants, and / or opioids
identify the dangers of such abuse
provide you with prevention tips and help you
safely store and discard your medications.
explore local resources for treatment
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651 people died from prescription drug overdoses in
2011 (preliminary data), compared to 164 in 2001. This is
almost a 300% increase.
The rate of prescription drug overdoses in WV has risen
from 12.0 in 2002 to 33.9 in 2011 (preliminary data).
Per capita, WV has an average of 19.3 prescriptions
(that is, for each person)
Nationally, 7.1% of treatment admissions in 2009 was
for Opioids, compared to 28.2% in West Virginia
In 2010, drug overdoses killed more
West Virginians than car accidents. .
It is the leading cause of accidental deaths in WV.
WV
40
36.5
Percent Reporting Use
35
30.7
30
26.6
25
26.6
24.8
21.5
18.3
20
15
10
26.7
12.0
13.8
9.2
5
0
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Source: WV Health Statistics Center
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Treatment admissions for opiates (other than
heroin) rose from 19,941 in 1998 to 161,805 in 2010.
 That’s an Increase of over 700%
Source: Treatment Episode Data Set (TEDS) wwwdasis.samhsa.gov/dasis2/teds.htm
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In 2009, 1.2 million persons visited Emergency
Rooms for the nonmedical use of pharmaceuticals
or dietary supplements the most common drug for
these visits were opiate/opioid (50%)
 Hydrocodone (alone or in combination) in 175,949
 Methadone in 70,637
Source: 2009 DAWN Report (www.samhsa.gov/data/DAWN.aspx
Between 6 and 7 million Americans have abused
prescription medications in the past month.
 Nearly 7,000 Americans initiate medication misuse
or abuse every day.
 Everyday, approximately 2,500 young people
between 12 and 17 years of age abuse a prescription
painkiller for the first time.
 Four out of the top five drugs abused by
12th graders are prescription or non-prescription
medications.
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25
20
15
18.8
14.9
12.0
10
19.3
18.5
12.0
12.1
9.5
5
0
2008
2009
Source: Kaiser State Health Facts
2010
2011
WV
US
Prescription Sedatives & Tranquilizers
Valium
Klonopin
Ativan
Halcion
ProSom
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Slow brain activity
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Prescribed for anxiety, tension, panic attacks,
acute stress reactions, sleep disorders, and
can be used for anesthesia (high doses)
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Morphine
 “Morpheus”
 Discovered in 1803
 Treats moderate to severe pain
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Codeine
 “Poppy Head”
 Discovered in 1832
 mild to moderate pain
 cough (Tylenol with Codeine)
Michael Palladini, RPh MBA CADC, Pennsylvania Certification Board Webinar, June 27 2012
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Moderate to severe pain
Oral and IV
IR=active in 30 min
ER=active in 90 min
George Albert (George V)
Hank Williams, Sr.
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Mild to moderate pain
Cough suppression
Oral
IR=active in 30 min
APAP
Howard Hughes
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Diacetylmorphine
Hydromorphone
Oxycodone
Oxymorphone
Hydorcodone
Bupreorphine
(Heroin)
(Dilaudid)
(Oxycontin, Roxicodone)
(Opana)
(Vicodin, Lortab)
(Suboxone, Subutex)
Michael Palladini, RPh MBA CADC, Pennsylvania Certification Board Webinar, June 27 2012
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Oral not recommended
IV best
Metabolizes to morphine once in CNS
Provides ‘rush’ by entering brain quickly
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Severe pain
Oral and IV
Highly water soluble
IR and ER
Catya Sassoon-Model
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Moderate to severe pain
Oral
IR=30 min (Roxicodone)
ER=90 min (Oxycontin)
APAP
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Severe pain
Oral
IR generics
ER (Opana)
Opana
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Mild to moderate pain
Oral
IR=30 min
APAP
Brittany Murphy-Actress
Gerald Levert-R&B Singer
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Moderate to severe pain
Used to combat opiate dependence
High lipid solubility
Long acting
Subutex
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Meperidine
Fentanyl
Methadone
Tramadol*
(Demerol)
(Duragesic)
(Dolophine)
(Ultram)
*Tramadol considered a “non-typical opioid”
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Chemical structures are not related to
morphine or codeine.
Michael Palladini, RPh MBA CADC, Pennsylvania Certification Board Webinar, June 27 2012
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Moderate to severe pain
First synthetic opiate
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Severe pain
Full synthetic
Most potent opioid
Fast acting
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Moderate to severe pain
Opiate dependence treatment
Full synthetic
Andy IronsFamous Surfer
Anna Nicole SmithActress/Model
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Atypical opioid
Chemical analogue of codeine
IR and ER (extended release)
Oral
Moderate to severe pain
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Knowing the difference between:
 Pharmacology:
Effects, symptoms, produced by the drug
 Pharmacokinetics:
How the drug works: absorption, distribution,
metabolism, and elimination
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Analgesia
Euphoria
Sedation
Nausea/vomiting
Depress cough reflex
Effects on mood
Respiratory depression
Nausea, vomiting
Seizures
 Dizziness
 Weakness
 Loss of
consciousness
 Blood disorders
 Slow heartbeat
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Coma
Confusion
 Tiredness
 Cold and clammy
skin
 Small pupils
 Low blood
pressure
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Muscle spasticity
Difficulty breathing
Slow, shallow and
labored breathing
 Periods of Stopped
breathing (can be fatal
within 2-4 hours)
 Pinpoint pupils
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Bluish skin
Bluish fingernails and
lips
 Spasms of the stomach
and/or intestinal tract
 Constipation
 Weak pulse
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Be a pro-active consumer by:
 Asking your doctor if your medication is addictive-
explore alternatives
 Maintaining medication compliance
 Protecting your medications
 Discarding all unused medications properly
Source of Pain Relievers for Nonmedical Use
Among Past Year Users (2010 Nationally)
Source: SAMHSA. (2011). 2010 National Survey on Drug Use and Health.
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Changing your own behavior to adapt,
ignore, struggle or otherwise cope with
another person’s substance abuse problem.
Some of the behaviors that families, friends
and co-workers adopt are called “enabling”.
Enabling is action that you take to protect the
person with the problem from the
consequences of their actions. Unfortunately,
enabling actually helps him or her to not deal
with the problem.
Embarrassment: “They’ll say things about our family”
 Fear: “He/She will really blow up if I …”
 Insecurity: “If I quit giving him/her my pills, I will not
get visited”
 Friendship: “If I confront him/her, this problem could
end our friendship”
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DO NOT share your medications with family
members--- it is illegal to give scheduled
medications to others.
SECURE your medications so they are not taken.
WV Drug
Abuse Quitline
1-866-987-8488
www.wvrxabuse.org
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Treatment is available within the county and
state
Doctors/psychiatrists can help with
medications to support recovery
Therapists can assist those with addictions
learn healthy alternative behaviors to recover
from their CHRONIC disease.
12 Step programs– support groups are good;
N/A, A/A, etc.
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National Institute of Drug Abuse, National Institutes of Health, Research
Report Series, 2008, www.nida.nih.gov
The Partnership for a Drug-Free America, Partnership Attitude Tracking
Study, 2008, www.drugfree.org
Street Drugs, www.streetdrugs.org
SAMHSA, Stimulant Use in 2003, February, 4 ,2005; www.samhsa.gov
Teacher Scholastic, May 12, 2008,
teacher.scholastic.com/scholasticnews/indepth/headsup/support/prescri
ption_teacher.pdf
Charleston Daily Mail, dailymailcom/News/statenews/200802060592
Charleston Gazette,
wvgazette.com/News/201101151175?page=2&build=cache
Parents. The Anti-Drug, www.theantidrug.com/drug_info/
Facts About Drugs Website, www.factsaboutdrugs.com/
The National Youth Anti-Media Campaign, www.theantidrug.com/
Ohio State University School of Pharmacy, www.pharmacy.ohiostate.edu/generation-rx
Cathy Coontz, MA, MS, PSII, NPN
Prevention Lead for WV and
National Prevention Network for WV
Division on Alcoholism and Drug Abuse
Bureau for Behavioral Health and Health Facilities
350 Capitol Street, Room 350
Charleston, WV 25301
Cathy.E.Coontz@wv.gov