This webinar will describe East Tennessee State University’s efforts to curb the opioid epidemic along the continuum of addiction. ETSU’s Academic Health Science Center has engaged multiple constituents to conduct federally funded research, community based practice and more importantly, to foster cross-sector engagement and education. The team hosts monthly meetings to facilitate partnerships across sectors with multiple aims. These aims include regional health improvement, research capacity development and community outreach. By the end of this webinar, participants will be able to: Describe multiple evidence-based approaches for the prevention and treatment of opioid use disorder. Describe techniques for engagement in community and cross-sector collaboration to address the opioid use disorder crisis.

Prescription ADHD medication has been shown to be on the rise as a drug of abuse among young people. Unlike other drugs that serve only the purpose of achieving a high, this particular substance can also be perceived as useful and beneficial by those who abuse it. It is these positive attributes given to the illicit use of these drugs that make them so dangerous, especially in the hands of youths. To date extant research has made little effort to contextualize this type of drug use within theories of deviance. This study looks to fill that void as well as bridge the gap between current epidemiological studies on this topic and future etiological studies looking to assess causation within a theoretical context. Examining a national sample of 12th grade students (N=2,384), this study looks at what risk factors and predictors exist for the illicit use of ADHD medication. By testing aspects of social bonding and social learning theories, the goal is to assess which theory can best predict this type of drug use. Due to the low proportion of users, a rare events logistic regression is utilized in the analysis. While social learning items were able to account for the greatest level of variance in use, many of the findings contradict the theory, and therefore no theoretically based conclusions can be made at this time. Overall, more research needed on this topic using better fitting data tailored for theoretical interpretation. Considerations for future studies are also discussed.

Numerous consequences of sexual assault have been identified, including psychological consequences such as posttraumatic stress disorder (PTSD) and health-risk behaviors such as substance misuse. Previous research has indicated that survivors of sexual assault may engage in substance misuse (i.e. alcohol and other illicit and prescription drug use) in attempt to suppress negative thoughts, memories, and flashbacks of the assault. The present study seeks to expand on and examine health-risk behaviors among undergraduate college women after the experience of sexual assault. Although many researchers have focused on the use of alcohol following sexual assault, less have studied non-medical use of prescription drugs (NMUPD) as an alternative method of maladaptive coping. NMUPD has recently been identified as the fastest rising recreational substance among college populations. With NMUPD becoming a norm among college students in recreational settings, exploring NMUPD for alternative uses seems like the next logical step in research. This study views sexual assault on a continuum starting from unwanted sexual contact and ending in completed rape. This study aims to bridge the gap in research by attempting to connect the risky behavior of NMUPD to coping with any experience on the sexual assault continuum among college undergraduate women. Participants with and without a history of sexual assault were recruited for the present study. Participants completed a measure of sexual assault history and severity, along with questionnaires assessing current alcohol, marijuana, and NMUPD use

Pharmaceutical drugs are one of the most socially important heath care products. They are part of many individuals' everyday lives, from the eradicating of diseases at birth to treating patients at the end of life. However, for many patients access is prevented due to expensive cost. This study explored cost-related non-adherence (CRN) and researched if reimportation of pharmaceutical drugs from other countries could increase patient drug adherence. The perceptions of 10 patients and 10 providers in Maine were assessed. Maine is the only state that allowed its citizens to purchase prescription drugs from abroad. The research questions addressed (a) how reimportation drugs could contribute to drug adherence, (b) the perceptions of patients, and (c) the perceptions of key providers of reimportation. This study was guided by a theoretical framework utilizing Kurt Lewin's theory of organizational change. Participants answered 15 open-ended questions. The study utilized a qualitative grounded theory approach; data were analyzed inductively. The research demonstrated that patients and healthcare providers had positive perceptions for a reimportation policy. Future research of other regions for this topic should prevail. Member checking was used to validate the emerging theories of increased long term drug adherence incentivized by affordable drug cost, which contributes to perception of competence, better management of current disease, and decreased safety concerns. Positive social change implications can be achieved through savings to the health-care industry by creating a pathway to affordable drugs that will bring more drugs to market and create a competitive structure that can drive down pricing.

Syfte: Syftet är att undersöka följderna av konkurrensutsättningen på apoteksmarknaden ur ett logistiskt flödesperspektiv. Metod: Abduktiv ansats och en kvalitativ datainsamlingsmetod i form av semistrukturerade och ostrukturerade intervjuer. Teori: Logistiska målmixen, Du Pont-schemat, 80–20-regeln, byta lager mot information, logistik som konkurrensmedel Marknadsteorier, konsumenttrygghet, drivkrafter för innovation, Porters fem krafter Resultat: De största volymerna av receptbelagda läkemedel går, likt under monopol-tiden, fortfarande via de största distributörerna Tamro och Oriola. Apoteks-aktörerna tycks överlag vilja gå mot lägre kapitalbindning, med något högre logistikkostnader och servicegrad. Främst vill aktörerna styra varuförsörj-ningen i egen regi för att anpassa den till de egna affärsmodellerna. Service-graden tycks inte ha försämrats sedan omregleringen. Trots detta önskar apoteken en förändring av varuförsörjningen, men detta har i dagsläget inte förverkligats. Den främsta orsaken tycks vara leverantörernas makt och bristen på substitut. För att utmana det obalanserade maktförhållandet tar apoteken till parallellimport, vilken tycks ha ökat, som förhandlingsmedel. Slutsatser: Komplexiteten tycks ligga i att marknaden i sin helhet måste behålla vissa öar av monopol. Ett läkemedel kan nämligen behäftas med mycket höga forsknings- och utvecklingskostnader, varpå utvecklarens patentskydd mot andra läkemedelsleverantörer är nödvändigt. Detta skapar dock en sämre förhandlingsställning för apoteksaktörerna. En annan bidragande faktor till komplexiteten kan vara statens inblandning som tredje part på marknaden. Den nya marknaden har dock lett till en innovationsutveckling på varuförsörjningsplanet, där aktörerna skapar sina egna logistiklösningar. / Purpose: The aim is to examine the impact of competition on the Swedish pharmacy market from a logistical flow perspective. Method: Abductive base and qualitative data collection method in the form of semi-structured and unstructured interviews. Theory Logistical Goal Mix, Du Pont chart, 80–20 rule, replacing stock with information, logistics as a competitive tool Market theories, consumer protection, innovation drivers, Porters five forces Result: The largest volumes of prescription drugs are still handled the same way as before the re-regulation by the largest distributors Tamro and Oriola. Pharmacy stakeholders in general seem to aim for lower tied up capital, with slightly higher logistics costs and service levels. Mainly, the pharmacies want to control the supply chain in-house to suit their own business models. The level of service seems to have remained stable since the re-regulation. Despite the same level of service, pharmacies desire a change in the supply chain. No change has been implemented which mainly seems to depend on the power of suppliers and lack of substitutes. In order to challenge the unbalanced power relationship pharmacies use parallel imports, which seem to have increased, as negotiation means. Conclusion: The complexity seems to lie in that the market as a whole must maintain certain islands of monopoly. A drug may be connected with very high research and development costs, which mean developer's patent protection of drugs against other vendor’s become necessary. However, this creates a weaker negotiating position for pharmacy operators. Another contributing factor to the complexity can be state involvement, as a third party, in the market. Despite this, the new market has led to an innovation development on the supply chain level where players create their own logistics.

Background Drug use has increased over recent decades, and is especially great among women and among people with mental health problems. To take advantage of the full potential of drugs and to avoid drug-related problems, drug prescription needs to be correct and the drugs need to be taken according to the prescribed regimens. Research on drug utilization is thus important to the public health. Aim To study the influence of gender and depression on drug utilization, prescription of drugs and self-reported use of drugs, i.e. adherence. Methods The thesis included two population-based questionnaires and data from the Swedish Prescribed Drug Register (SPDR) covering Swedish citizens 18-84 years. The questionnaire in Study I and II included items on prescription drug use and adherence to treatment regimens; Study II also included the Hospital Anxiety and Depression Scale (HADS) for self-estimation of anxiety/depression. The questionnaire in Study III included the HADS and data from the SPDR on prescribed antidepressants. Study IV included data from the SPDR on all types of prescribed drugs. Results Men and women differed in non-adherent behaviours and reasons for non-adherence, for example, men were more likely to report forgetting to take the drug, while women were more likely to report adverse drug reactions (ADRs) as a reason for non-adherence. Further, both anxiety and depression were associated with non-adherence and with ADRs as a reason for non-adherence. In addition, men reported depression to a greater extent than women did but used antidepressants to a lesser extent, while women used antidepressants without reporting depression more often than men did, which may be a sign of under-treatment among men and over-treatment among women. Moreover, the associations between antidepressants and other types of drugs differed by gender; they were often specific, or stronger, in women than in men, which may be a sign of a gender difference in comorbidity between depression and other conditions. Conclusions Although the cross-sectional study design prevented confirmation of causality, the thesis found that gender and depression influence both prescription of drugs and adherence, and are thus important to pay attention to in clinical practice as well as research.

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Background: Sedatives and hypnotics are substances to calm or relieve anxiety and to induce sleep. Long term prescription of benzodiazepines/Z-drugs may lead to the development of tolerance and the need to increase the dose. It is important to be aware of the risks of uncontrolled use of these drugs, such as harmful interactions with other substances, side effects and potential for abuse or addiction. Aim: The aim of this research was to describe abuse of sedatives and hypnotics from the user's perspective, to focus on circumstances leading to drug abuse, to describe beginning and course of the use of these drugs and self-awareness of the problem. The aim was also to describe the current state of users and their needs. Sample: The research sample consisted of 6 participants, of which 4 women and 2 men currently or recently using sedatives and hypnotics (specifically benzodiazepines/Z-drugs). Methods: Data were collected through a qualitative approach using a semi-structured interview. Interviews were conducted, rewritten into protocol summary, further analysed using thematic analysis, modified using open and axial coding and categorization methods. Results: Respondents may have misused sedatives and hypnotics to self-medicate symptoms. These drugs were prescribed for the first time with...

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The purpose of this study was to examine prescription drug abuse among the adolescent population and analyze factors that may contribute to or influence adolescent drug abuse. This study examined 3 waves of a secondary data set from the Substance Abuse and Mental Health Services Administration (SAMSHA) entitled the National Survey on Drug Use and Health (NSDUH). The data from these surveys are nationally representative and include data on several types of drug use and mental health conditions. Results from the current study indicate that there were significant relationships among age, gender, race, previous alcohol use, school enrollment, general health, mental health treatment, and the use of prescription drugs in the adolescent populations. Future research should be conducted to investigate the severity of the impact adolescent prescription drug abuse will have on society and to investigate possible solutions to this problem.