Coalition Launches Program to Prevent Doctor Shopping

While nearly every state (49) has a Prescription Drug Monitoring Program to help identify "doctor shoppers," problem prescribers and individuals in need of treatment, these programs vary dramatically in funding, use and capabilities. In the latest addition to CADCA’s Coalition Ideas Exchange, the Weymouth Youth Coalition Substance Abuse Prevention Team discusses how it launched the Preventing Doctor Shopping and Pharmacy Hopping campaign to help local pharmacists and physicians reduce misuse and access to prescription drugs.

After experiencing growing rates of non-medical prescription drug use, hospitalization and overdose in Weymouth, Mass., key informant interviews revealed that incidents of doctor shopping and pharmacy hopping significantly contributed to the problem. In response to the issue, the coalition led a collaborative effort to increase local pharmacists’ use of the state’s Prescription Monitoring Program (PMP). The program creates barriers for individuals looking to access large amounts of prescription medications for non-medical purposes. The Preventing Doctor Shopping and Pharmacy Hopping Campaign, led by the coalition, included educating and enrolling pharmacists in the PMP, as well as supporting statewide legislation to ensure proper prescription monitoring practices among Massachusetts physicians.

CADCA’s Coalition Ideas Exchange provides coalitions access the latest information from other organizations across the country that are implementing innovative strategies and interventions to address substance abuse in their communities. The information comes directly from coalitions with the goal of providing resources, actionable steps and recommendations for applying these ideas to work in other communities. To learn more about the Weymouth Youth Coalition Substance Abuse Prevention Team and the Coalition Ideas Exchange, visit www.cadca.org/ideasexchange.

Study Examines Teen Attitudes About Drug Use

High school seniors who frown upon the use of drugs are most likely to be female, nonsmokers or hold strong religious beliefs, according to a study by Joseph Palamar of New York University. The study examines how teenagers’ attitudes toward marijuana influenced their thoughts on the further use of other illicit drugs. The work appears online in the journal Prevention Science, published by Springer.

Although previous research has shown that people who disapprove of a particular drug will in all likelihood not use it, little is known about how the use of one drug affects people’s attitudes toward using other drugs. 

Palamar examined how demographics and a lifetime use of various drugs – marijuana use in particular – can predict if a person will become partial to using “harder” and more dangerous drugs, such as powder cocaine, crack, LSD, heroin, amphetamine and ecstasy, also known as “Molly.” Data was obtained from 29,054 high school seniors who took part in the Monitoring the Future annual cross-sectional survey of approximately 130 public and private schools in 48 states between 2007 and 2011.

Palamar found that youths who smoked cigarettes or used more than one “hard” drug were consistently less critical of other drug use. The lifetime use of alcohol had no impact on people’s attitudes. Those who used only marijuana tended to be less judgmental of further using such so-called “socially acceptable” drugs as LSD, amphetamine and ecstasy. They did not approve of cocaine, crack or heroin, however, most likely because of their perceived dangers and addictive qualities.

Unsurprisingly, female high school seniors consistently disapproved of using cocaine, crack, LSD and ecstasy. Compared to their male counterparts, females are generally less likely to use most drugs. Palamar was also not surprised by the finding that religiosity robustly increased attitudes against drug use, as it is a major force in societal values.

Youths from more advantaged socio-economic backgrounds with highly educated parents as well as those living in urban areas were much less disapproving of the use of the so-called “less dangerous” drugs. Palamar believes that the higher prevalence of illicit drug use in urban areas may be helping to normalize drug use in cities.

“Public health and policy experts need to ensure that the use of other drugs does not increase in light of the growing prevalence of marijuana use and more lenient policies surrounding it,” Palamar explains. 
 

U.S. Attorneys General Urge FDA to Regulate E-cigarettes

Reuters reports that top U.S. law enforcement officials urged the Food and Drug Administration this week to quickly issue a promised set of rules governing the sale of e-cigarettes.

In 2009, the FDA was given authority to regulate cigarettes, cigarette tobacco and roll-your-own tobacco, although not pipe tobacco, cigars or e-cigarettes. The law allows the FDA to expand its authority over all tobacco products, but it must first issue new regulations. The FDA has said they are in development.

In a letter to FDA Commissioner Margaret Hamburg, Attorneys General from 41 states asked the agency to "take all available measures" to issue the rules by the end of October.

"We ask the FDA to move quickly to ensure that all tobacco products are tested and regulated to ensure that companies do not continue to sell or advertise to our nation's youth," they wrote.

The FDA did not immediately respond to a request for comment.

The letter comes less than a week after the American Academy of Pediatrics and 14 other public health organizations, including the American Lung Association and American Heart Association, sent a letter to President Barack Obama asking him to pressure the FDA into issuing the rules.

In July, the FDA said it might place restrictions on menthol cigarettes following a review that showed the products are likely to be more addictive than regular cigarettes. The agency is seeking public comment.

In their letter, the Attorneys General noted that sales of e-cigarettes have doubled every year since 2008 and are projected to reach $1.7 billion in 2013. The cost, meanwhile, has fallen, making them more affordable and attractive to youth, they said.

Moreover, there are no restrictions on advertising e-cigarettes.

"Consumers are led to believe that e-cigarettes are a safe alternative to cigarettes, despite the fact that they are addictive, and there is no regulatory oversight ensuring the safety of the ingredients in e-cigarettes."

To learn more about e-cigarettes, read CADCA’s latest blog post about how some jails are using e-cigarettes as a way to raise funds for their facilities regardless of the health consequences. CADCA also published a blog post in July about e-cigarettes, entitled “E-cigarettes: Do I Smell a Rat?” which you can find on CADCA’s website.