0
Association Report
The prescription drug misuse and abuse epidemic
J Am Pharm Assoc (2003) 2012;52:564-568. doi:10.1331/JAPhA.2012.12532
APhA–APPM Megan E. Thompson
APhA–APRS Anthony Tommasello
APhA–ASP Brigid Long
A.B. is a 66-year-old grandmother of three who has just undergone a routine root canal. She is prescribed 20 tablets of oxycodone. She only needs one-half tablet before she feels better, but saves the rest for a rainy day.
C.W. is 18 years old and actively involved in high school sports. Yesterday, he had a severe muscle strain during a game and took a bottle of old pain pills from his grandmother's medicine cabinet so he could “sleep off” the pain.
G.W. is 16 years old and on her way out to a friend's party with her brother. While getting ready in the bathroom, she finds a prescription bottle with their grandmother's name on it. The prescription is for oxycodone. She grabs the bottle and takes it to the party to experiment with her friends.
These scenarios occur on a much-too-frequent basis. The number of prescriptions written for opiates is on the rise, and the amount of prescription narcotics being consumed by Americans is staggering. All too often we hear about adolescents rummaging through their own medicine cabinets in search of prescription narcotics to get high and subsequently falling prey to addiction. We hear of patients, adolescents, and adults who knowingly share their prescription medications with friends or family.
Failure to discard unused or expired medication is common in households everywhere. Increased availability, lack of education about addictions, new pain management standards, and a drug-taking culture help to explain prescription drug misuse and abuse. The issue affects all demographics. The reasons are multifactorial. This problem is real. What is the pharmacist's role in combating prescription drug abuse, and are we making a difference?
According to the Office of National Drug Control Policy, the prescription drug misuse and abuse issue needs to be addressed at several levels: (1) education/prevention, (2) prescription monitoring programs, (3) proper medication disposal, and (4) enforcement. Pharmacists are in a unique position to help lead this charge at all levels. As medication experts, specialists, educators, patient advocates, and providers with prescriptive authority (in select states), we are equipped with the tools to address this concern. We all understand that it is our professional responsibility to educate every patient, every time, on every prescription. “Patient Counseling 101” trains us to state the medication's purpose, how to take it, what to expect from the medication, and who to contact if they have questions. In terms of opiates and other narcotic prescriptions, however, it is quickly becoming imperative that pharmacists in all settings take patient counseling a step further. These steps might include discussions like educating on warning signs of addiction, proper disposal of any unused medication, not sharing the medications with others, keeping medications in a secure and locked location, and providing addiction resources. But is this even enough?
Pharmacists are patient educators. We are leaders in our communities. We are grandparents, parents, children, sisters, brothers, aunts, and uncles. The education about the dangers of prescription drug misuse and abuse does not have to end when our patients leave the pharmacy. Multiple education and prevention tools exist that are free and suited for individuals or communities with limited knowledge of prescription drug abuse. Ideal settings for presenting the information include schools, colleges, universities, faith-based organizations, rotary clubs, law enforcement entities, parent–teacher association meetings, athletic teams, and community centers. Arrange drug take-back events at your local grocery stores. Organize an event to promote the awareness and passage of prescription drug abuse prevention legislation. The possibilities are endless.
Prescription drug misuse and abuse will not disappear entirely, but pharmacists are key players in the effort to combat the issue. Take action, not just as a pharmacist in your practice setting but also as a member in your community. We can slow the rate, even if it is just one patient, loved one, or coworker at a time.
Megan E. Thompson, PharmD
Director of APPE, Associate Professor of Pharmacy Practice, and Generation Rx Faculty Chair
College of Pharmacy
University of New Mexico
Albuquerque
methompson@salud.unm.edu
Prescription opioid abuse has supplanted heroin abuse as the major cause of opioid-related problems in the United States. Databases that track patterns of substance use in America have documented a major change in our experience with opioids. Several observations define this recent shift. Heroin purity at the street buyer level increased dramatically starting from the mid-1980s, fueling an upsurge in heroin use and recruiting new opioid abusers who snorted rather than injected the drug. +1 Recently, prescription opioid diversion made national headlines, +2 and illicit use of opioid analgesics among college students increased considerably. +3 Associated with these trends in the illicit markets of opioid trade are increases in emergency department visits +4 and overdose deaths. +5 In the period between January 2003 and June 2006, poison centers across the United States recorded 9,240 exposures to opioid medications in children younger than 6 years. +6
Prescription drug diversion played a major role in this shift. As the legal custodians of the nation's drug supply, pharmacists have a corresponding responsibility in the legitimate dispensing of controlled substances. +7 Failure to exercise independent judgment in this regard may result in the dispensing of illegitimate prescriptions. If pharmacy is not a part of the solution, then it could very well be part of the problem.
Prescription opioid diversion is big business. +8 Physicians and pharmacists who ignore this are or will become prime targets of those who seek to obtain controlled substances fraudulently. Despite attempts by third-party payers to reduce fraud and abuse through the prior authorization process, those who intend to divert controlled dangerous substances (CDSs) are willing to pay cash for both the physician's office visit and the prescription. These transactions have not been recorded in insurance carrier databases and therefore have gone untracked. However, the advent of prescription drug monitoring programs (PDMPs) promises to capture these cash transactions and give physicians and pharmacists the ability to view a patient's previous CDS acquisitions before prescribing or dispensing a medication.
Missouri is the only state that has not passed legislation authorizing a PDMP. +9 The policy is not self-implementing and requires the active and wise use of PDMP data by pharmacists and physicians to reduce the amount of opioids available for diversion while ensuring adequate access for patients with legitimate needs. PDMPs hold promise for reducing, not eliminating, prescription opioid diversion, and the nation must look to multiple approaches for balancing the problems associated with diversion and abuse while acknowledging and protecting the tremendous societal benefit of legitimate CDS prescribing.
A nagging issue is the means by which America manages the population of opioid-dependent individuals. Cost-effectiveness studies have clearly demonstrated the monetary benefit of opioid dependence treatment. +10 However, we have failed to adequately train the nation's health professionals to recognize and treat all addictions, particularly opioid addiction. +11 One consequence of this is the continued stigmatization of opioid-dependent patients and an ongoing tension as to their appropriate management, be it in the courts or in clinics.
Access to treatment for opioid dependence has waxed and waned during the past 100 years. +12 Treatment access in the United States is currently expanding due in large part to the passage of the Drug Addiction Treatment Act of 2000 (DATA 2000). +13 DATA 2000 permits qualified physicians “to treat opioid addiction with Schedule III, IV, and V opioid medications or combinations of such medications that have been specifically approved by the FDA for that indication.” Presently, buprenorphine is the only molecule that fits this description, and it is available in several formulations. The law authorizes the issuance of an “X” designation on the Drug Enforcement Administration registration number of the roughly 18,000 active prescribers to indicate their certification to prescribe these medications from an office-based practice.
Before DATA 2000 was passed, the National Institute on Drug Abuse estimated the presence of 850,000 opioid-dependent individuals in the United States and a national capacity to treat 280,000 in closely regulated methadone treatment clinics. +14 Currently, 304,656 patients are receiving medication for opioid dependence treatment in outpatient treatment clinics and 432,482 are receiving buprenorphine formulations in office-based practices (personal communication, R. Johnson, Reckitt Benckiser Pharmaceuticals, Inc., August 2012). A national survey in 2006 found that more than 12 million Americans reported nonmedical use of prescription opioids. +15 Further analysis revealed that 1.6 million of these individuals met criteria for opioid abuse or dependence. +16 Thus, treatment availability is expanding but so is the magnitude of the problem.
Clinical and policy challenges remain in the national effort to address opioid drug diversion. Some opioid-dependent patients earnestly seek treatment, and access to compassionate quality care should be available on demand. Others, unfortunately, are ill prepared to engage in treatment and, even worse, may be gaming the clinical system to acquire opioids with intent to divert. Adverse patient selection is likely if physicians and pharmacists are unfamiliar with the characteristics of individuals with symptomatic untreated opioid addiction and lack the clinical skills and wisdom to detect and deflect their demands.
Fortunately, the country is awaking to the tremendous social, economic, and emotional burden of untreated or poorly treated addiction. DATA 2000 provides the framework for office-based treatment of opioid addiction, PDMPs offer an opportunity to reduce opioid diversion, health profession schools can implement recommendations for education and training in addictions, addiction research is advancing at a rapid pace, and the media are bringing the issue to public attention.
Pharmacists can contribute to solutions and avoid becoming part of the problem. We are particularly well positioned to actively engage patients. +17 Patients can be questioned sensitively about alcohol, tobacco, and other drug use during a drug history. In the process of medication therapy management, one can discuss concerns about prescription drug interactions with alcohol and other substances. When CDSs are dispensed, elements of the risk evaluation and mitigation strategy should be reinforced, particularly the need to prevent access to the medication by others.
Whether prescription opioid diversion is a consequence or a cause of the rise in opioid addiction is an issue for debate. Nevertheless, concerted efforts and interprofessional cooperation among health care providers can go a long way toward bringing addiction disorders out of the shadows of stigma into the light of medical awareness and treatment. Accessible and successful treatment will result in less demand for illicit supplies of opioids.
Anthony Tommasello, BSPharm, PhD, FAPHA
Field Medical Advisor
Reckitt Benckiser Pharmaceuticals, Inc.
Richmond, VA
Member
Clinical Sciences Section
APhA–APRS
anthony.tommasello@reckittbenckiser.com
Executive Office of the President, Office of National Drug Control Policy.  Technical report for the price and purity of illicit drugs: 1981 through the second quarter of 2003. Accessed at www.ncjrs.gov/ondcppubs/publications/pdf/price_purity_tech_rpt.pdf,  August 16, 2012.
 
Kluger J.  The new drug crisis: addiction by prescription.  Time.  2010; 176( 11): 46– 9. [PubMed]
 
McCabe SE, Teter CJ, Boyd CJ.  Illicit use of prescription pain medication among college students.  Drug Alcohol Depend.  2005; 77: 37– 47. [PubMed]
 
Center for Substance Abuse Research.  Estimated number of buprenorphine- and hydromorphone-related ED visits more than doubles from 2006 to 2010. Accessed at www.cesar.umd.edu/cesar/cesarfax/vol21/21-31.pdf,  August 16, 2012.
 
Centers for Disease Control and Prevention.  Vital signs: overdoses of prescription opioid pain reliever: United States, 1999–2008.  MMWR Morb Mortal Wkly Rep.  2011; 60: 1487– 92. [PubMed]
 
RADARS System.  RADARS System presents to the FDA. Accessed at www.radars.org/LinkClick.aspx?fileticket=Zar9u31aDz4%3D&tabid=594&mid=4327,  August 16, 2012.
 
Brushwood DB.  Corresponding responsibility under DEA regulations.  Pharmacy Today.  2011; 17( 2): 23.
 
Gillette F.  American pain: the largest U.S. pill mill's rise and fall. Accessed at http://www.businessweek.com/articles/2012-06-06/american-pain-the-largest-u-dot-s-dot-pill-mills-rise-and-fall,  August 16, 2012.
 
Hancock J.  Drug czar will push Missouri to track prescription medicines. Accessed at www.kansascitystar.com/2012/08/14/3762592/drug-czar-to-push-for-prescription.html,  August 14, 2012.
 
Cartwright WS.  Cost-benefit analysis of drug treatment services: review of the literature.  J Ment Health Policy Econ.  2000; 3: 11– 26. [PubMed]
 
Dole EJ, Tommasello AC.  Recommendations for implementing effective substance abuse education in pharmacy practice. In: Haack MR, Hoover A, Eds. Strategic planning for interdisciplinary faculty development: arming the national health professional workforce for a new approach to substance use disorders. Providence, RI:   Association for Medical Research in Substance Abuse; 2002:263–71.
 
Jaffe JH, C O’Keeffe.  From morphine clinics to buprenorphine: regulating opioid agonist treatment of addiction in the United States.  Drug Alcohol Depend.  2003; 70( 2 suppl): S3– 11. [PubMed]
 
Substance Abuse and Mental Health Services Administration.  Drug Addiction Treatment Act of 2000: title XXXV, section 3502 of the Children's Health Act of 2000. Accessed at http://buprenorphine.samhsa.gov/titlexxxv.html,  August 6, 2012.
 
Office of National Drug Control Policy.  The President's national drug control strategy.  Washington, DC:  Office of National Drug control Policy;  2003.
 
Substance Abuse and Mental Health Services Administration.  Results from the 2006 National Survey on Drug Use and Health: national findings.  Rockville, MD:  Department of Health & Human Services;  2007.
 
Becker WC, Sullivan LE, Tetrault JM, et al.  Non-medical use, abuse and dependence on prescription opioids among U.S. adults: psychiatric, medical and substance use correlates.  Drug Alcohol Depend.  2008; 94: 38– 47. [PubMed]
 
Tommasello AC.  Substance abuse and pharmacy practice: what the community pharmacist needs to know about drug abuse and dependence. Accessed at www.harmreductionjournal.com/content/1/1/3,  August 6, 2012.
 
+

APhA–ASP

What do Elvis Presley, Michael Jackson, and Whitney Houston have in common? They all suffered untimely deaths due to overdoses, lethal combinations, or abuse of prescription drugs. Prescription drug abuse is intentionally taking a prescription medication for different reasons, dosages, or methods to experience the feeling it causes (i.e., to “get high”). +1 Sadly, prescription drug abuse has reached epidemic levels in the United States.
According to the National Survey on Drug Use and Health, an estimated 2.4 million Americans abused prescription drugs for a nonmedical, nonprescribed purpose for the first time in 2010. One-third of these abusers were between the ages of 12 and 17 years. The Centers for Disease Control and Prevention has reported that unintentional drug poisonings/overdoses are the leading cause of accidental death, with 37,485 people dying in 2009 (or 1 person every 14 minutes). This now exceeds deaths resulting from motor vehicle accidents.
Ohio has been dealing with this issue for many years. As a result, individuals at the Ohio State University (OSU) College of Pharmacy started the Generation Rx initiative, which is a learning community devoted to education outreach for medication safety and prescription drug abuse prevention. Generation Rx began locally to provide tools and resources to educate elementary- through college-aged students about the dangers of the misuse and abuse of prescription drugs. Through initiatives by OSU, APhA, and Cardinal Health, it has now expanded to involve community members of all ages.
Generation Rx is truly a collaborative college-wide effort at OSU. The OSU APhA–ASP chapter partners with pharmacists from a local pharmacy organization to share the Generation Rx toolkit presentation at local community organization functions. OSU's Student Society of Health-System Pharmacy chapter and Student National Pharmaceutical Association chapter provide interactive and engaging seminars to first-year undergraduate students regarding safe use of medications. In addition, OSU has partnered with the Center of Science and Industry in Columbus, OH, to create the Generation Rx lab for attendees to learn in a hands-on fashion about the science of drugs.
Many resources are available, including the Generation Rx toolkits (created in collaborative effort by Cardinal Health and OSU), that are geared toward community members, teens, and seniors. Two brand-new toolkits will be launched this year. The first is a collegiate toolkit called Generation Rx University and the second is specific for elementary schools called Medication Safety Patrol. All of these resources are available online for free download at go.osu.edu/generationrx.
In 2010, members of OSU's APhA–ASP chapter attended the University of Utah School on Alcoholism and Other Drug Dependencies, where they educated other pharmacists and student pharmacists on the scope, reasons, and consequences of prescription drug abuse. They provided attendees with resources for implementing prescription drug abuse prevention programs in their local communities. After participating in this session, many student attendees applied the resulting knowledge and resources to initiate programs in their communities across the nation.
In fall 2010, Generation Rx was launched as a national APhA–ASP community outreach program with support from the Cardinal Health Foundation. OSU worked closely with APhA and Cardinal Health staff to create and implement this community outreach project. Chapter members across the country were encouraged to implement new programs in their communities and share the awareness presentation using the readily available Generation Rx toolkits.
Since this partnership began, APhA–ASP chapters across the nation have developed new programs and truly increased awareness of this national epidemic. In 2010, 190 Generation Rx presentations were given by 18 chapters, educating 11,105 students and community members. In just 1 year, growth of the program by APhA–ASP chapters nationwide has been substantial. In 2011, 54 chapters gave 397 presentations to educate 148,535 individuals. The public relation efforts of the chapters reached nearly 2 million individuals.
With the nationwide effort of APhA–ASP chapters and pharmacists in the community, prescription drug abuse awareness is on the rise. Student pharmacists and pharmacists have the tools through Generation Rx to make students and community members understand the dangers of abusing prescription drugs. Through efforts of the pharmacy community along with others across the nation, the increase in community awareness may help to decrease the national epidemic of prescription drug abuse.
Brigid Long, PharmD
Ambulatory/Community Care Pharmacy Practice MS-Resident
College of Pharmacy
Ohio State University
Columbus
2010–11 Ohio State University Chapter President
APhA–ASP
brigid.long@gmail.com
doi: 10.1331/JAPhA.2012.12532
Volkow ND.  Prescription drugs: abuse and addiction.  Bethesda, MD:  National Institute on Drug Abuse, National Institutes of Health;  2011.
 
The Association Report column in JAPhA reports on activities of APhA's three academies and topics of interest to members of those groups.
The APhA Academy of Pharmacy Practice and Management (APhA–APPM) is dedicated to assisting members in enhancing the profession of pharmacy, improving medication use, and advancing patient care. Through the six APhA–APPM sections (Administrative Practice, Community and Ambulatory Practice, Clinical/Pharmacotherapeutic Practice, Hospital and Institutional Practice, Nuclear Pharmacy Practice, and Specialized Pharmacy Practice), Academy members practice in every pharmacy setting.
The mission of the APhA Academy of Pharmaceutical Research and Science (APhA–APRS) is to stimulate the discovery, dissemination, and application of research to improve patient health. Academy members are a source of authoritative information on key scientific issues and work to advance the pharmaceutical sciences and improve the quality of pharmacy practice. Through the three APhA–APRS sections (Clinical Sciences, Basic Pharmaceutical Sciences, and Economic, Social, and Administrative Sciences), the Academy provides a mechanism for experts in all areas of the pharmaceutical sciences to influence APhA's policymaking process.
The mission of the APhA Academy of Student Pharmacists (APhA–ASP) is to be the collective voice of student pharmacists, to provide opportunities for professional growth, and to envision and actively promote the future of pharmacy. Since 1969, APhA–ASP and its predecessor organizations have played a key role in helping students navigate pharmacy school, explore careers in pharmacy, and connect with others in the profession.
The Association Report column is written by Academy and section officers and coordinated by JAPhA Contributing Editor Joe Sheffer of the APhA staff. Suggestions for future content may be sent to jsheffer@aphanet.org.
Executive Office of the President, Office of National Drug Control Policy.  Technical report for the price and purity of illicit drugs: 1981 through the second quarter of 2003. Accessed at www.ncjrs.gov/ondcppubs/publications/pdf/price_purity_tech_rpt.pdf,  August 16, 2012.
 
Kluger J.  The new drug crisis: addiction by prescription.  Time.  2010; 176( 11): 46– 9. [PubMed]
 
McCabe SE, Teter CJ, Boyd CJ.  Illicit use of prescription pain medication among college students.  Drug Alcohol Depend.  2005; 77: 37– 47. [PubMed]
 
Center for Substance Abuse Research.  Estimated number of buprenorphine- and hydromorphone-related ED visits more than doubles from 2006 to 2010. Accessed at www.cesar.umd.edu/cesar/cesarfax/vol21/21-31.pdf,  August 16, 2012.
 
Centers for Disease Control and Prevention.  Vital signs: overdoses of prescription opioid pain reliever: United States, 1999–2008.  MMWR Morb Mortal Wkly Rep.  2011; 60: 1487– 92. [PubMed]
 
RADARS System.  RADARS System presents to the FDA. Accessed at www.radars.org/LinkClick.aspx?fileticket=Zar9u31aDz4%3D&tabid=594&mid=4327,  August 16, 2012.
 
Brushwood DB.  Corresponding responsibility under DEA regulations.  Pharmacy Today.  2011; 17( 2): 23.
 
Gillette F.  American pain: the largest U.S. pill mill's rise and fall. Accessed at http://www.businessweek.com/articles/2012-06-06/american-pain-the-largest-u-dot-s-dot-pill-mills-rise-and-fall,  August 16, 2012.
 
Hancock J.  Drug czar will push Missouri to track prescription medicines. Accessed at www.kansascitystar.com/2012/08/14/3762592/drug-czar-to-push-for-prescription.html,  August 14, 2012.
 
Cartwright WS.  Cost-benefit analysis of drug treatment services: review of the literature.  J Ment Health Policy Econ.  2000; 3: 11– 26. [PubMed]
 
Dole EJ, Tommasello AC.  Recommendations for implementing effective substance abuse education in pharmacy practice. In: Haack MR, Hoover A, Eds. Strategic planning for interdisciplinary faculty development: arming the national health professional workforce for a new approach to substance use disorders. Providence, RI:   Association for Medical Research in Substance Abuse; 2002:263–71.
 
Jaffe JH, C O’Keeffe.  From morphine clinics to buprenorphine: regulating opioid agonist treatment of addiction in the United States.  Drug Alcohol Depend.  2003; 70( 2 suppl): S3– 11. [PubMed]
 
Substance Abuse and Mental Health Services Administration.  Drug Addiction Treatment Act of 2000: title XXXV, section 3502 of the Children's Health Act of 2000. Accessed at http://buprenorphine.samhsa.gov/titlexxxv.html,  August 6, 2012.
 
Office of National Drug Control Policy.  The President's national drug control strategy.  Washington, DC:  Office of National Drug control Policy;  2003.
 
Substance Abuse and Mental Health Services Administration.  Results from the 2006 National Survey on Drug Use and Health: national findings.  Rockville, MD:  Department of Health & Human Services;  2007.
 
Becker WC, Sullivan LE, Tetrault JM, et al.  Non-medical use, abuse and dependence on prescription opioids among U.S. adults: psychiatric, medical and substance use correlates.  Drug Alcohol Depend.  2008; 94: 38– 47. [PubMed]
 
Tommasello AC.  Substance abuse and pharmacy practice: what the community pharmacist needs to know about drug abuse and dependence. Accessed at www.harmreductionjournal.com/content/1/1/3,  August 6, 2012.
 
+

APhA–ASP

What do Elvis Presley, Michael Jackson, and Whitney Houston have in common? They all suffered untimely deaths due to overdoses, lethal combinations, or abuse of prescription drugs. Prescription drug abuse is intentionally taking a prescription medication for different reasons, dosages, or methods to experience the feeling it causes (i.e., to “get high”). +1 Sadly, prescription drug abuse has reached epidemic levels in the United States.
According to the National Survey on Drug Use and Health, an estimated 2.4 million Americans abused prescription drugs for a nonmedical, nonprescribed purpose for the first time in 2010. One-third of these abusers were between the ages of 12 and 17 years. The Centers for Disease Control and Prevention has reported that unintentional drug poisonings/overdoses are the leading cause of accidental death, with 37,485 people dying in 2009 (or 1 person every 14 minutes). This now exceeds deaths resulting from motor vehicle accidents.
Ohio has been dealing with this issue for many years. As a result, individuals at the Ohio State University (OSU) College of Pharmacy started the Generation Rx initiative, which is a learning community devoted to education outreach for medication safety and prescription drug abuse prevention. Generation Rx began locally to provide tools and resources to educate elementary- through college-aged students about the dangers of the misuse and abuse of prescription drugs. Through initiatives by OSU, APhA, and Cardinal Health, it has now expanded to involve community members of all ages.
Generation Rx is truly a collaborative college-wide effort at OSU. The OSU APhA–ASP chapter partners with pharmacists from a local pharmacy organization to share the Generation Rx toolkit presentation at local community organization functions. OSU's Student Society of Health-System Pharmacy chapter and Student National Pharmaceutical Association chapter provide interactive and engaging seminars to first-year undergraduate students regarding safe use of medications. In addition, OSU has partnered with the Center of Science and Industry in Columbus, OH, to create the Generation Rx lab for attendees to learn in a hands-on fashion about the science of drugs.
Many resources are available, including the Generation Rx toolkits (created in collaborative effort by Cardinal Health and OSU), that are geared toward community members, teens, and seniors. Two brand-new toolkits will be launched this year. The first is a collegiate toolkit called Generation Rx University and the second is specific for elementary schools called Medication Safety Patrol. All of these resources are available online for free download at go.osu.edu/generationrx.
In 2010, members of OSU's APhA–ASP chapter attended the University of Utah School on Alcoholism and Other Drug Dependencies, where they educated other pharmacists and student pharmacists on the scope, reasons, and consequences of prescription drug abuse. They provided attendees with resources for implementing prescription drug abuse prevention programs in their local communities. After participating in this session, many student attendees applied the resulting knowledge and resources to initiate programs in their communities across the nation.
In fall 2010, Generation Rx was launched as a national APhA–ASP community outreach program with support from the Cardinal Health Foundation. OSU worked closely with APhA and Cardinal Health staff to create and implement this community outreach project. Chapter members across the country were encouraged to implement new programs in their communities and share the awareness presentation using the readily available Generation Rx toolkits.
Since this partnership began, APhA–ASP chapters across the nation have developed new programs and truly increased awareness of this national epidemic. In 2010, 190 Generation Rx presentations were given by 18 chapters, educating 11,105 students and community members. In just 1 year, growth of the program by APhA–ASP chapters nationwide has been substantial. In 2011, 54 chapters gave 397 presentations to educate 148,535 individuals. The public relation efforts of the chapters reached nearly 2 million individuals.
With the nationwide effort of APhA–ASP chapters and pharmacists in the community, prescription drug abuse awareness is on the rise. Student pharmacists and pharmacists have the tools through Generation Rx to make students and community members understand the dangers of abusing prescription drugs. Through efforts of the pharmacy community along with others across the nation, the increase in community awareness may help to decrease the national epidemic of prescription drug abuse.
Brigid Long, PharmD
Ambulatory/Community Care Pharmacy Practice MS-Resident
College of Pharmacy
Ohio State University
Columbus
2010–11 Ohio State University Chapter President
APhA–ASP
brigid.long@gmail.com
doi: 10.1331/JAPhA.2012.12532
Volkow ND.  Prescription drugs: abuse and addiction.  Bethesda, MD:  National Institute on Drug Abuse, National Institutes of Health;  2011.
 
The Association Report column in JAPhA reports on activities of APhA's three academies and topics of interest to members of those groups.
The APhA Academy of Pharmacy Practice and Management (APhA–APPM) is dedicated to assisting members in enhancing the profession of pharmacy, improving medication use, and advancing patient care. Through the six APhA–APPM sections (Administrative Practice, Community and Ambulatory Practice, Clinical/Pharmacotherapeutic Practice, Hospital and Institutional Practice, Nuclear Pharmacy Practice, and Specialized Pharmacy Practice), Academy members practice in every pharmacy setting.
The mission of the APhA Academy of Pharmaceutical Research and Science (APhA–APRS) is to stimulate the discovery, dissemination, and application of research to improve patient health. Academy members are a source of authoritative information on key scientific issues and work to advance the pharmaceutical sciences and improve the quality of pharmacy practice. Through the three APhA–APRS sections (Clinical Sciences, Basic Pharmaceutical Sciences, and Economic, Social, and Administrative Sciences), the Academy provides a mechanism for experts in all areas of the pharmaceutical sciences to influence APhA's policymaking process.
The mission of the APhA Academy of Student Pharmacists (APhA–ASP) is to be the collective voice of student pharmacists, to provide opportunities for professional growth, and to envision and actively promote the future of pharmacy. Since 1969, APhA–ASP and its predecessor organizations have played a key role in helping students navigate pharmacy school, explore careers in pharmacy, and connect with others in the profession.
The Association Report column is written by Academy and section officers and coordinated by JAPhA Contributing Editor Joe Sheffer of the APhA staff. Suggestions for future content may be sent to jsheffer@aphanet.org.

References

Executive Office of the President, Office of National Drug Control Policy.  Technical report for the price and purity of illicit drugs: 1981 through the second quarter of 2003. Accessed at www.ncjrs.gov/ondcppubs/publications/pdf/price_purity_tech_rpt.pdf,  August 16, 2012.
 
Kluger J.  The new drug crisis: addiction by prescription.  Time.  2010; 176( 11): 46– 9. [PubMed]
 
McCabe SE, Teter CJ, Boyd CJ.  Illicit use of prescription pain medication among college students.  Drug Alcohol Depend.  2005; 77: 37– 47. [PubMed]
 
Center for Substance Abuse Research.  Estimated number of buprenorphine- and hydromorphone-related ED visits more than doubles from 2006 to 2010. Accessed at www.cesar.umd.edu/cesar/cesarfax/vol21/21-31.pdf,  August 16, 2012.
 
Centers for Disease Control and Prevention.  Vital signs: overdoses of prescription opioid pain reliever: United States, 1999–2008.  MMWR Morb Mortal Wkly Rep.  2011; 60: 1487– 92. [PubMed]
 
RADARS System.  RADARS System presents to the FDA. Accessed at www.radars.org/LinkClick.aspx?fileticket=Zar9u31aDz4%3D&tabid=594&mid=4327,  August 16, 2012.
 
Brushwood DB.  Corresponding responsibility under DEA regulations.  Pharmacy Today.  2011; 17( 2): 23.
 
Gillette F.  American pain: the largest U.S. pill mill's rise and fall. Accessed at http://www.businessweek.com/articles/2012-06-06/american-pain-the-largest-u-dot-s-dot-pill-mills-rise-and-fall,  August 16, 2012.
 
Hancock J.  Drug czar will push Missouri to track prescription medicines. Accessed at www.kansascitystar.com/2012/08/14/3762592/drug-czar-to-push-for-prescription.html,  August 14, 2012.
 
Cartwright WS.  Cost-benefit analysis of drug treatment services: review of the literature.  J Ment Health Policy Econ.  2000; 3: 11– 26. [PubMed]
 
Dole EJ, Tommasello AC.  Recommendations for implementing effective substance abuse education in pharmacy practice. In: Haack MR, Hoover A, Eds. Strategic planning for interdisciplinary faculty development: arming the national health professional workforce for a new approach to substance use disorders. Providence, RI:   Association for Medical Research in Substance Abuse; 2002:263–71.
 
Jaffe JH, C O’Keeffe.  From morphine clinics to buprenorphine: regulating opioid agonist treatment of addiction in the United States.  Drug Alcohol Depend.  2003; 70( 2 suppl): S3– 11. [PubMed]
 
Substance Abuse and Mental Health Services Administration.  Drug Addiction Treatment Act of 2000: title XXXV, section 3502 of the Children's Health Act of 2000. Accessed at http://buprenorphine.samhsa.gov/titlexxxv.html,  August 6, 2012.
 
Office of National Drug Control Policy.  The President's national drug control strategy.  Washington, DC:  Office of National Drug control Policy;  2003.
 
Substance Abuse and Mental Health Services Administration.  Results from the 2006 National Survey on Drug Use and Health: national findings.  Rockville, MD:  Department of Health & Human Services;  2007.
 
Becker WC, Sullivan LE, Tetrault JM, et al.  Non-medical use, abuse and dependence on prescription opioids among U.S. adults: psychiatric, medical and substance use correlates.  Drug Alcohol Depend.  2008; 94: 38– 47. [PubMed]
 
Tommasello AC.  Substance abuse and pharmacy practice: what the community pharmacist needs to know about drug abuse and dependence. Accessed at www.harmreductionjournal.com/content/1/1/3,  August 6, 2012.
 
Volkow ND.  Prescription drugs: abuse and addiction.  Bethesda, MD:  National Institute on Drug Abuse, National Institutes of Health;  2011.
 
Executive Office of the President, Office of National Drug Control Policy.  Technical report for the price and purity of illicit drugs: 1981 through the second quarter of 2003. Accessed at www.ncjrs.gov/ondcppubs/publications/pdf/price_purity_tech_rpt.pdf,  August 16, 2012.
 
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Jaffe JH, C O’Keeffe.  From morphine clinics to buprenorphine: regulating opioid agonist treatment of addiction in the United States.  Drug Alcohol Depend.  2003; 70( 2 suppl): S3– 11. [PubMed]
 
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Office of National Drug Control Policy.  The President's national drug control strategy.  Washington, DC:  Office of National Drug control Policy;  2003.
 
Substance Abuse and Mental Health Services Administration.  Results from the 2006 National Survey on Drug Use and Health: national findings.  Rockville, MD:  Department of Health & Human Services;  2007.
 
Becker WC, Sullivan LE, Tetrault JM, et al.  Non-medical use, abuse and dependence on prescription opioids among U.S. adults: psychiatric, medical and substance use correlates.  Drug Alcohol Depend.  2008; 94: 38– 47. [PubMed]
 
Tommasello AC.  Substance abuse and pharmacy practice: what the community pharmacist needs to know about drug abuse and dependence. Accessed at www.harmreductionjournal.com/content/1/1/3,  August 6, 2012.
 
Volkow ND.  Prescription drugs: abuse and addiction.  Bethesda, MD:  National Institute on Drug Abuse, National Institutes of Health;  2011.
 
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