An Interview with Doug Hebert and Shelly Mowrey
What began your interest and passion in substance abuse prevention?
Doug Hebert and Shelly Mowrey:
Doug: Having worked over 26 years with the Drug Enforcement Administration; seeing firsthand the devastation and collateral damage of drug abuse, particularly when it involves children. That’s when I really took an interest in prevention and education. I often participated in presentations to community drug prevention organizations and helped organize DEA’s RED RIBBON celebration in local grade schools and middle schools. I made up my mind when I left DEA I would continue my passion in prevention and education, to educate our kids to make healthy choices in life.
Shelly: I developed a passion for preventing youth substance abuse after experiencing firsthand hand the devastation that substance abuse has on families. Over the last decade, I have seen how prevention works and leads to lower drug use, death and addiction. My focus is reaching out to parents to arm them with the knowledge and information needed to raise drug-free children.
EM: Compared to when you first began your careers in substance abuse prevention, are we in a better or worse situation?
DH and SM:
Shelly: The number of Americans using illegal drugs is now one-third the rate of what it was in the 1970’s. Where there has been an alarming trend is the abuse of pharmaceutical drugs. Every day 6,600 people in the U.S. take a prescription drug not prescribed to them by a doctor and 2,500 of those are children. Every eight minutes a child is treated in the Emergency Department for prescription drug poisonings.
Doug: Statistically we are currently seeing a drop in the “illegal” drug use rate (except marijuana); but we always have to be cognizant of what lies in the future. Drug traffickers are always one step ahead creating new ways to target our youth with “designer” drugs like Molly, Bath Salts, and other hallucinogens putting them on a destructive path. The increased availability and use of prescription drugs only compounds what the future holds. That’s why prevention, education and decreasing the access of drugs is so important.
EM: What is the reason for the drop of illegal drug use, but the rise in prescription drug abuse in America?
DH and SM:
Shelly: The perception among teens and the general public is taking prescription drugs is “safer” than abusing illegal drugs. They are prescribed by a doctor, meant for healing, and get a stamp of approval from the FDA. For many children and adults abusing pills, they believe it is a much “safer” high than abusing a street drug like heroin or cocaine. There could be nothing further from the truth. Abusing a prescription drug can be just as addictive and deadly as abusing a street drug like heroin. In addition, these prescription drugs are available and accessible in almost every household.
EM: How important is properly storing prescription medication in the household?
DH and SM:
Shelly: It is estimated that 90% of children report getting the medications they abuse right from their own medicine cabinet or from a friend. If every household properly secured their prescription medications it would virtually eliminate the opportunistic theft of those medications. If someone breaks into a secure container or a lock-box to steal prescription medications; you know there’s problem. “Available = Access = Increased Use.” It is imperative healthcare practitioners educate patients on the secure storage of prescription medications in the home.
EM: What impact does drug enforcement have on preventing drug abuse?
DH and SM:
Doug: I spent most of my DEA career targeting international and domestic drug trafficking organizations responsible for manufacturing, transportation and distribution of “illegal” drugs. I’ve witnessed tons of illegal drugs seized year after year knowing it had little impact on the supply. You come to the realization we cannot arrest ourselves out of the drug situation.
Don’t get me wrong, drug enforcement is an extremely important element. There are a lot of dangerous criminals, gangs, and terrorist organizations using drug trafficking to finance other criminal activity; and they need to be removed from society. Enforcement is one part of the equation with emphasis in education/prevention, and treatment.
EM: You mentioned DEA’s role in targeting “illegal” drug trafficking. What about DEA’s role in targeting pharmaceutical drug trafficking.
DH and SM:
Doug: Ten years ago, DEA observed an alarming trend in drug use statistics. What caught DEA’s attention was the steady decline of “illegal” drug use in the U.S., while the opposite was occurring with pharmaceutical drugs, particularly opioids. A few years later, DEA declared international drug cartels were no longer the biggest drug threat to the U.S., but rather our own domestic pharmaceutical drug industry. Pharmaceutical drug abuse is still the biggest drug threat in the U.S. today.
EM: What is DEA doing to specifically address the biggest drug threat in the U.S.?
DH and SM:
Doug: In 2009, DEA combined a section of the enforcement side of the agency with regulatory side to create Tactical Diversion Task Forces throughout the United States. Most healthcare providers are responsibly prescribing controlled substances for legitimate medical reasons. There are a few healthcare providers abusing that privilege; prescribing controlled substances for no medical reason. These DEA Diversion Task Forces specifically target those healthcare providers and pharmacies that are egregiously abusing their DEA Registration.
EM: What steps can healthcare providers take to fight prescription drug misuse, abuse and diversion?
DH and SM:
Shelly: Prescription drug abuse is a public health crisis. Never think it can’t be your patient misusing a medication. Unfortunately moms, dads, friends and neighbors are building a tolerance to these medications and becoming dependent on them. Healthcare providers can take steps to curb the prescription drug epidemic by incorporating pain contracts, having a treatment plan for their patient, providing substance abuse treatment options to those who have a high tolerance and dependence for the medication and need help.
Healthcare providers should sign up and utilize the Prescription Drug Monitoring Program (PDMP) in their state. This program allows healthcare providers to see the pharmacies and healthcare providers that have prescribed or dispensed medication to the patient. This cuts down on doctor shopping; protecting the doctor and patient. Healthcare providers must also initiate a dialogue with patients about safely storing prescription medications in a locked container.
EM: What types of activities or initiatives have you seen healthcare providers (or communities) take that has made a significant impact in decreasing drug abuse?
DH and SM:
Shelly: Most successful initiatives are those involving substance abuse prevention professionals, law enforcement, substance abuse treatment providers, and the health care community working together.
For example, the “Prescription Drug Reduction Initiative” in Arizona is a multi-systemic approach showing results. As part of the initiative, permanent prescription drug drop boxes were placed in the communities and collected nearly 6,000 pounds of unused or expired medication in one year. Parents were educated in securing their prescription medications; thus reducing the access. Parents were better prepared to talk with their children about the dangerous consequences of misusing medication. Best practice guidelines were established for prescribers and pharmacists as well as patient education.
Results show, it increased the number of practitioners using the PDMP, reduced the number of pills prescribed and reduced the number of prescriptions in the targeted communities.
EM: How urgent is this problem?
DH and SM:
Shelly: Forty lives are lost every day to a prescription pain reliever overdose. If we had 40 dolphins washing up on the shores of California, people would be outraged working night and day to figure out why so many dolphins are dying. We have to be salient when addressing this public health crisis. Too many children are dying and their deaths are 100% preventable.
Doug: DEA has already established pharmaceutical drug abuse is the biggest drug threat in our Nation. The practitioner is the first-line of defense; treating patients, educating them on the safe use of pain medications, and emphasizing the importance of safely securing prescription medications in the home.