Advertisement

Primary Prevention of Prescription Drug Misuse Among Culturally and Linguistically Diverse Suburban Communities

  • Matthew Kearney
  • Leslie Reynolds
  • Sandy Blitzstein
  • Kristin Chapin
  • Philip Massey
Article
  • 63 Downloads

Abstract

Comprehensive strategies for prescription drug misuse must reach culturally and linguistically diverse suburban populations to effectively combat the ongoing opioid epidemic. The purpose of this study was to conduct a community needs assessment and inform the development and implementation of culturally appropriate primary prevention strategies for community-based interventions, specifically related to medication disposal practices. Three data collection techniques were utilized: key informant interviews (n = 4), intercept surveys (n = 71), and focus group discussions (n = 8; 61 participants). To accommodate linguistically diverse subpopulations, surveys and focus groups were available in English, Spanish, Arabic, Russian, and Hindi. Participants were overwhelmingly female (survey: 70%/FGD: 84%), ethnic minorities (survey: 61%/FGD: 66%), and, on average, middle-aged [survey: 52 years (SD: 19)/FGD: 54 (15)]. Approximately one in three survey respondents (30%) had heard of drug-take back events, and one in ten (10%) had participated. Non-English speakers were less likely to both perceive a community problem with prescription drugs (β = − .35; p < .001) and be aware of take-back opportunities (β = − .23; p = .038). Focus group participants expressed confusion about appropriate medication disposal methods, identifying potential sources of conflicting information. Recent media coverage and political events have heightened stigma towards non-English speaking and non-native peoples, increasing their fear of law enforcement and other perceived threats. To encourage community engagement in take-back events, we identified multiple ways, such as multilingual materials and marketing campaigns, which may help marginalized suburban subpopulations feel less threatened and more included in prescription drug misuse prevention activities.

Keywords

Prescription drug misuse prevention Culturally diverse populations Drug take-back 

Notes

Acknowledgements

This work would not have been possible without the YWCA Bucks County community site coordinators and our volunteer participants from Bucks County, we are very thankful for their collaboration and support. From Drexel University, we would also like to thank Kristine Alarcon, who supported the planning, development and implementation of this study, and Nguyen Tran, who provided invaluable feedback during the analysis process.

Funding

This work was supported by the Bucks County Drug & Alcohol Commission, Inc. and the Substance Abuse and Mental Health Services Administration under Grant No. SP-14-004.

Compliance with Ethical Standards

Conflict of interest

The authors report no conflict of interest.

References

  1. 1.
    Compton, W. M., Jones, C. M., & Baldwin, G. T. (2016). Relationship between nonmedical prescription-opioid use and heroin use. The New England Journal of Medicine, 374(2), 154–163.  https://doi.org/10.1056/NEJMra1508490.CrossRefPubMedGoogle Scholar
  2. 2.
    U.S. Drug Enforcement Administration (DEA), Department of Justice. (2017). Analysis of Overdose Deaths in Pennsylvania, 2016. Arlington: U.S. Drug Enforcement Administration (DEA), Department of JusticeGoogle Scholar
  3. 3.
    U.S. Centers for Disease Control (CDC). (2018). Drug Overdose Death Data | Drug Overdose. Retrieved September 4, 2018, from https://www.cdc.gov/drugoverdose/data/statedeaths.html.
  4. 4.
    Rudd, R. A., Seth, P., David, F., & Scholl, L. (2016). Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. MMWR. Morbidity and Mortality Weekly Report, 65(5051), 1445–1452.  https://doi.org/10.15585/mmwr.mm655051e1.CrossRefPubMedGoogle Scholar
  5. 5.
    Mars, S. G., Bourgois, P., Karandinos, G., Montero, F., & Ciccarone, D. (2014). “Every ‘never’ I ever said came true”: Transitions from opioid pills to heroin injecting. The International Journal on Drug Policy, 25(2), 257–266.  https://doi.org/10.1016/j.drugpo.2013.10.004.CrossRefPubMedGoogle Scholar
  6. 6.
    Becker, W. C., Sullivan, L. E., Tetrault, J. M., Desai, R. A., & Fiellin, D. A. (2008). Non-medical use, abuse and dependence on prescription opioids among U.S. adults: Psychiatric, medical and substance use correlates. Drug and Alcohol Dependence, 94(1–3), 38–47.  https://doi.org/10.1016/j.drugalcdep.2007.09.018.CrossRefPubMedGoogle Scholar
  7. 7.
    Grau, L. E., Dasgupta, N., Harvey, A. P., Irwin, K., Givens, A., Kinzly, M. L., & Heimer, R. (2007). Illicit use of opioids: Is OxyContin a “gateway drug”? The American Journal on Addictions, 16(3), 166–173.  https://doi.org/10.1080/10550490701375293.CrossRefPubMedGoogle Scholar
  8. 8.
    Compton, W. M., Boyle, M., & Wargo, E. (2015). Prescription opioid abuse: Problems and responses. Preventive Medicine, 80, 5–9.  https://doi.org/10.1016/j.ypmed.2015.04.003.CrossRefPubMedGoogle Scholar
  9. 9.
    Cicero, T. J., Ellis, M. S., Surratt, H. L., & Kurtz, S. P. (2014). The changing face of heroin use in the United States: A retrospective analysis of the past 50 years. JAMA Psychiatry, 71(7), 821–826.  https://doi.org/10.1001/jamapsychiatry.2014.366.CrossRefGoogle Scholar
  10. 10.
    Diarrassouba, N., & Johnson, S. (2014). Responding to demographic change: What do suburban district leaders need to know? International Journal of Educational Leadership Preparation, 9(1), 1Google Scholar
  11. 11.
    Farrell, C. R. (2016). Immigrant suburbanisation and the shifting geographic structure of metropolitan segregation in the United States. Urban Studies, 53(1), 57–76.  https://doi.org/10.1177/0042098014558537.CrossRefGoogle Scholar
  12. 12.
    Fleming, E., Proescholdbell, S., Sachdeva, N., Alexandridis, A. A., Margolis, L., & Ransdell, K. (2016). North Carolina’s operation medicine drop results from one of the Nation’s Largest Drug Disposal Programs. North Carolina Medical Journal, 77(1), 59–62.  https://doi.org/10.18043/ncm.77.1.59.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Ma, C. S., Batz, F., Juarez, D. T., & Ladao, L. C. (2014). Drug Take Back in Hawai‘i: Partnership Between the University of Hawai‘i Hilo College of Pharmacy and the Narcotics Enforcement Division. Hawai’i Journal of Medicine & Public Health, 73(1), 26–31.Google Scholar
  14. 14.
    Stewart, H., Malinowski, A., Ochs, L., Jaramillo, J., McCall, K., & Sullivan, M. (2014). Inside Maine’s Medicine Cabinet: Findings From the Drug Enforcement Administration’s Medication Take-Back Events. American Journal of Public Health, 105(1), e65–e71.  https://doi.org/10.2105/AJPH.2014.302207.CrossRefGoogle Scholar
  15. 15.
    Gray, J. A., & Hagemeier, N. E. (2012). Prescription drug abuse and DEA-sanctioned drug take-back events: Characteristics and outcomes in rural appalachia. Archives of Internal Medicine, 172(15), 1186–1187.  https://doi.org/10.1001/archinternmed.2012.2374.CrossRefPubMedGoogle Scholar
  16. 16.
    Gutierrez, J., Negrón, J., & García-Fragoso, L. (2011). Parental practices for prevention of home poisoning in children 1–6 years of age. Journal of Community Health, 36(5), 845–848.  https://doi.org/10.1007/s10900-011-9384-4.CrossRefPubMedGoogle Scholar
  17. 17.
    Glassmeyer, S. T., Hinchey, E. K., Boehme, S. E., Daughton, C. G., Ruhoy, I. S., Conerly, O., et al. (2009). Disposal practices for unwanted residential medications in the United States. Environment International, 35(3), 566–572.  https://doi.org/10.1016/j.envint.2008.10.007.CrossRefPubMedGoogle Scholar
  18. 18.
    Thach, A. V., Brown, C. M., & Pope, N. (2013). Consumer perceptions about a community pharmacy-based medication take back program. Journal of Environmental Management, 127, 23–27.  https://doi.org/10.1016/j.jenvman.2013.04.025.CrossRefPubMedGoogle Scholar
  19. 19.
    Lystlund, S., Stevens, E., Planas, L. G., & Marcy, T. R. (2014). Patient participation in a clinic-based community pharmacy medication take-back program. Journal of the American Pharmacists Association, 54(3), 280–284.  https://doi.org/10.1331/JAPhA.2014.13132.CrossRefPubMedGoogle Scholar
  20. 20.
    Lewis, E. T., Cucciare, M. A., & Trafton, J. A. (2014). What do patients do with unused opioid medications? The Clinical Journal of Pain, 30(8), 654–662.  https://doi.org/10.1097/01.ajp.0000435447.96642.f4.CrossRefPubMedGoogle Scholar
  21. 21.
    State of Pennsylvania. (2016). Pennsylvania Youth Survey: 2015 State Report.Google Scholar
  22. 22.
    U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). Strategic prevention framework, partnerships for success—community-level instrument.Google Scholar
  23. 23.
    Coker, A. L., Watkins, K. W., Smith, P. H., & Brandt, H. M. (2003). Social support reduces the impact of partner violence on health: Application of structural equation models. Preventive Medicine, 37(3), 259–267.  https://doi.org/10.1016/S0091-7435(03)00122-1.CrossRefPubMedGoogle Scholar
  24. 24.
    Bollen, K. A. (1989). Structural equations with latent variables. New York: Wiley.CrossRefGoogle Scholar
  25. 25.
    Hoyle, R. (1995). The structural equation modeling approach basic concepts and fundamental issues. In R. H. Hoyle (Ed.), Structural equation modeling, concepts, issues, and applications (pp. 1–13). Newbury Park: Sage Publications.Google Scholar
  26. 26.
    Gold, K., & Schumann, J. (2007). Dangers of used sharps in household trash. Implications for Home Care.  https://doi.org/10.1097/01.NHH.0000296119.71814.f7.CrossRefGoogle Scholar
  27. 27.
    Food, U. S. & Drug Administration (FDA). (2018). Safe disposal of medicines—disposal of unused medicines: What you should know [WebContent]. Retrieved September 4, 2018, from https://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm.
  28. 28.
    Fass, J. A. (2011). Prescription drug take-back programs. American Journal of Health-System Pharmacy, 68(7), 567–570.  https://doi.org/10.2146/ajhp100559.CrossRefPubMedGoogle Scholar
  29. 29.
    U.S. Environmental Protection Agency (EPA). (2018). Collecting and disposing of unwanted medicine. Washington DC: U.S. Environmental Protection Agency (EPA)Google Scholar
  30. 30.
    Velleman, R. D., Templeton, L. J., & Copello, A. G. (2005). The role of the family in preventing and intervening with substance use and misuse: A comprehensive review of family interventions, with a focus on young people. Drug and Alcohol Review, 24(2), 93–109.  https://doi.org/10.1080/09595230500167478.CrossRefPubMedGoogle Scholar
  31. 31.
    Coatsworth, J. D., Pantin, H., & Szapocznik, J. (2002). Familias unidas: A family-centered ecodevelopmental intervention to reduce risk for problem behavior among hispanic adolescents. Clinical Child and Family Psychology Review, 5(2), 113–132.  https://doi.org/10.1023/A:1015420503275.CrossRefPubMedGoogle Scholar
  32. 32.
    Raber, M., Huynh, T. N., Crawford, K., Kim, S., & Chandra, J. (2018). Development and feasibility of a community-based, culturally flexible colorectal cancer prevention program. Journal of Community Health, 43(5), 882–885.  https://doi.org/10.1007/s10900-018-0497-x.CrossRefPubMedGoogle Scholar
  33. 33.
    Watanabe-Galloway, S., Alnaji, N., Grimm, B., & Leypoldt, M. (2018). Cancer community education in Somali Refugees in Nebraska. Journal of Community Health, 43(5), 929–936.  https://doi.org/10.1007/s10900-018-0507-z.CrossRefPubMedGoogle Scholar
  34. 34.
    Kumpfer, K. L., Magalhães, C., & Kanse, S. A. (2016). Impact of family structure, functioning, culture, and family-based interventions on children’s health. In M. R. Korin (Ed.), Health Promotion for Children and Adolescents (pp. 57–81). Boston: Springer.  https://doi.org/10.1007/978-1-4899-7711-3_4.CrossRefGoogle Scholar
  35. 35.
    Kumpfer, K., Magalhães, C., & Xie, J. (2017). Cultural adaptation and implementation of family evidence-based interventions with diverse populations. Prevention Science, 18(6), 649–659.  https://doi.org/10.1007/s11121-016-0719-3.CrossRefPubMedGoogle Scholar
  36. 36.
    Allen, M. L., Garcia-Huidobro, D., Porta, C., Curran, D., Patel, R., Miller, J., & Borowsky, I. (2016). Effective parenting interventions to reduce youth substance use: A systematic review. Pediatrics.  https://doi.org/10.1542/peds.2015-4425.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    City of Philadelphia Department of Behavioral Health and Intellectual Disability Services (DBHIDS). (2017). The Mayor’s Task Force to Combat the Opioid Epidemic in Philadelphia: Final Report & recommendations. City of Philadelphia.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Drexel University Dornsife School of Public HealthPhiladelphiaUSA
  2. 2.YWCA Bucks CountyTrevoseUSA
  3. 3.Drexel University Dornsife School of Public HealthPhiladelphiaUSA

Personalised recommendations