SAMHSA provides information, evidence-based practices, and treatment locators to prevent, treat, and promote recovery from prescription drug misuse and abuse.
SAMHSA’s efforts inform, alert, and educate the public, patients and their family members, and health care practitioners of the dangers of prescription drug misuse and abuse. SAMHSA also:
- Helps individuals find appropriate treatment
- Provides evidence-based practices to improve treatment
- Regulates treatment to safeguard the public
- Promotes the recovery of individuals from prescription drug misuse and abuse
Health care practitioners, communities and workplaces, patients, and families all can contribute to preventing prescription drug abuse. SAMHSA’s 2014 National Prevention Week Toolkit contains many valuable ideas. SAMHSA’s 2014 Opioid Overdose Prevention Toolkit describes strategies to prevent opioid overdose for all these groups.
Physicians play a critical role in prescription drug misuse and abuse prevention. They can screen their patients to identify signs of prescription drug abuse or dependence, and talk with patients about the negative effects of misusing prescription drugs. Physicians also can note rapid increases in amounts of medication needed and requests for frequent refills, which may signal “doctor shopping.” The Prescription Drug Monitoring Program Training and Technical Assistance Center provides assistance in identifying these behaviors among patients.
In 2011, SAMHSA operationalized the Action Plan for Improving Access to Prescription Drug Monitoring Program through Health Information Technology by funding the Enhancing Access to Prescription Drug Monitoring Programs using Health Information Technology Project, which is managed by the Office of the National Coordinator for Health Information Technology (ONC), in collaboration with SAMHSA, the Centers for Disease Control & Prevention (CDC), and the White House Office of National Drug Control Policy (ONDCP). The project explored opportunities to use health information technology (HIT) to integrate critical prescription drug history information from prescription drug monitoring programs into provider and pharmacy systems to empower more informed decision making at the point of care.
According to the CDC, prescribers may contribute to opioid abuse and overdose because of a lack of education and awareness about appropriate opioid prescribing practices. Most opioid analgesics in the United States are prescribed by primary care physicians and internists; most have little training in pain management or addiction. SAMHSA offers an in-person continuing education course, Clinical Challenges in Prescribing Controlled Drugs: Prescribing Opioids for Chronic Pain. The course, targeted to primary care providers, provides specific knowledge and skills associated with safely prescribing opioids for chronic pain, and clinical strategies for managing challenging patient situations. In addition, SAMHSA supports Providers’ Clinical Support System for Opioid Therapies (PCSS-O), which provides training and mentoring services to a variety of health care providers on the safe and appropriate prescribing of opioids.
Communities and workplaces can access a number of SAMHSA’s initiatives and resources to prevent prescription drug misuse and abuse:
- The Drug Free Communities Support Program is a collaborative effort between the ONDCP and SAMHSA to strengthen collaboration among community coalitions to prevent and reduce substance use, including prescription drug misuse and abuse.
- The 2014 National Drug Control Strategy serves as the Obama Administration’s blueprint for reducing drug use and its consequences, including a national framework for reducing prescription drug diversion and abuse.
- The 2011 Prescription Drug Abuse Prevention Plan (PDF | 306 KB) expands upon the Obama Administration’s National Drug Control Strategy and includes action in four major areas to reduce prescription drug abuse: education, monitoring, proper medication disposal, and enforcement.
- The Division of Workplace Programs (DWP) provides oversight for the Federal Drug-Free Workplace Program and for the National Laboratory Certification Program.
- The Center for the Application of Prevention Technologies (CAPT) is a nationwide substance abuse prevention training and technical assistance system. It works with states, tribes, jurisdictions, and communities to develop and implement strategies to prevent the misuse and abuse of prescription drugs.
- SAMHSA’s Opioid Overdose Prevention Toolkit equips communities and local governments with material to develop policies and practices to help prevent opioid-related overdoses and deaths. It addresses issues for first responders, treatment providers, and those recovering from opioid overdose.
- In collaboration with SAMHSA, the National Council on Patient Information and Education works to improve communication of information to consumers and health care providers on the appropriate use of medications.
- National Prevention Week, a SAMHSA-supported annual health observance dedicated to increasing public awareness of, and action around, mental and/or substance use disorders, included a day in 2014 devoted to prescription drug abuse prevention.
Patients need to ensure they use prescription drugs appropriately, store them securely, and dispose of them safely. SAMHSA participates in the Drug Enforcement Administration’s National Take-Back Initiative, which aims to provide a safe, secure, and environmentally responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse and trafficking of medications. The Food and Drug Administration (FDA) and ONDCP have also developed guidelines on disposal for unused medicines.
Parents can discuss the risks of misusing or abusing prescription drugs with their children and be familiar with the warning signs, such as missing prescription drugs, changes in friends, increased secrecy, changes in school performance, and frequent borrowing of money.
SAMHSA’s 2010 Road to Recovery webcast, Ignoring Instructions: The Importance of Using Prescription and Over-the-Counter Medications Properly, gives an overview of prescription drug abuse and discusses people who are at risk.
Treatment can incorporate several components, including withdrawal management (detoxification), counseling, and the use of FDA-approved addiction pharmacotherapies. Research has shown that a combined approach of medication, counseling, and recovery services works best. SAMHSA is a leader in Medication-Assisted Treatment (MAT)—the use of medications, in combination with counseling and behavioral therapies, to provide a whole-patient approach to the treatment of substance use disorders.
Medications available to treat opioid addiction include naltrexone (PDF | 223 KB), methadone (PDF | 245 KB), and buprenorphine/naloxone. The choice of medication depends on the patients’ needs. Since the Drug Addiction Treatment Act of 2000 (DATA 2000), physicians who meet certain qualifications may treat opioid addiction with buprenorphine/naloxone from office-based practice settings. A recent NIH-funded study demonstrated the efficacy of buprenorphine/naloxone for the treatment of prescription opioid addiction. As a result, the NIH’s NIDA-SAMHSA Blending Initiative developed the Prescription Opioid Addiction Treatment Study to help treatment providers incorporate study findings into their practice.
SAMHSA has numerous programs and resources focused on treatment for prescription drug misuse and abuse. It works to close the gap between available treatment capacity and demand; supports the adaptation and adoption of evidence-based and best practices by community-based treatment programs and services; and improves and strengthens substance abuse treatment organizations and systems.
- Federal Regulation 42 CFR Part 8, dated September 24, 2015, provides for an accreditation and certification-based system for Opioid Treatment Programs (OTPs), overseen by SAMHSA. SAMHSA’s Opioid Treatment Technical Assistance Program (OTTAP) educates and prepares opioid treatment programs nationwide to achieve certification and accreditation by SAMHSA-approved bodies. The Division of Pharmacologic Therapies within the Center for Substance Abuse Treatment manages the day-to-day regulatory oversight activities necessary to implement 42 CFR Part 8, on the use of opioid agonist medications such as methadone and buprenorphine.
- Providers’ Clinical Support Systems are available for methadone (a medication used to treat opioid addiction), buprenorphine products, and naltrexone. These sites connect health care providers with experts who provide information, mentoring, and training on the treatment of opioid use disorders and prescription drug abuse with FDA-approved medications.
- SAMHSA established the Addiction Technology Transfer Center (ATTC) Network in 1993 to improve the quality of addictions treatment and recovery services. The Network is composed of 14 Regional Centers and a National Office.
- The Substance Abuse Prevention and Treatment Block Grant Program supports states and community-based groups to improve and expand existing substance abuse treatment services. Additionally, primary prevention funds can be used for overdose prevention education/training; treatment block grant funds can be used for the purchase of naloxone and overdose kits.
Helping individuals find appropriate treatment services is key to SAMHSA’s mission. In addition to the Behavioral Health Treatment Services Locator, SAMHSA offers two locators specific to drug misuse and abuse:
- The Buprenorphine Physician & Treatment Program Locator helps you find physicians and treatment programs authorized to treat opioids, such as heroin or prescription pain relievers.
- The Opioid Treatment Program Directory helps you find treatment programs in your state that treat addiction and dependence on opioids, such as heroin or prescription pain relievers.
SAMHSA’s recovery efforts include research and practice. Learn more about these efforts at the Recovery and Recovery Support topic.