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Running head: PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 1

Prescription Drug Abuse Among College Students

18 to 25 Years-Old in Los Angeles County, California

Czarina Muyargas

California State University, Long Beach

Prescription Drug Abuse Among College Students 18 to 25 Years-Old


PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 2

in Los Angeles County, California

Specific Aims

College students are the age population at highest risk for prescription drug abuse. This

particular group of individuals are incessantly exposed to an environment in which social events

and parties are a part of their everyday lives, and drug use and alcohol is common and

uncontrolled. Research has shown that prescription drug abuse occurs more frequently within

wealthy communities where Caucasians make up the racial majority. This educational and

awareness program has been created to address prescription drug abuse in the community setting

within this targeted population, by utilizing interactive seminars and workshops to disseminate

information that is relatable and applicable to college students residing in Los Angeles County,

California. This program aims to not only educate college students on prescription drugs, their

intended and proper use, as well as ways in which individuals misuse and abuse them, but also

provide the necessary skills to recognize particular risks in various environments and effectively

improve them. Prescription drug abuse doesnt occur in only certain individuals. It can affect

everyone regardless of their gender, age, ethnicity, and socioeconomic status, though motivations

for abusing prescription drugs may vary.

A total of 720 college students between the ages of 18 and 25 years-old, living in Los

Angeles County, California will be recruited to participate in the program. 40% of the

participants living in Manhattan Beach will be selected to become the experimental group that

will receive the program, while 40% of the participants living in Santa Monica will be part of the

comparison group that does not receive anything more than their current level of knowledge and

understanding of the issue. Univariate analysis will be conducted to measure the 30% increase in

knowledge at posttest from questions 1 through 8 using a chi-squared test. Data taken from
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 3

questions 1 through 8 will be reported as nominal data in the form of a bar graph with the

percentages and numbers of participants reporting answers on prescription drugs and level of

safety. Bivariate analysis will be conducted to measure the 5% increase in behavior change

measured at posttest through questions 9 through 15. An independent sample t-test will be used

to make a meaningful evaluation between the experimental and comparison group. In addition, a

dependent sample t-test will compare the pre/posttest results within each of the groups at a

significance level of alpha=0.05. Data will be reported as nominal data by utilizing a pie chart

and frequency table. The mean, mode, and standard deviation will be reported as well.

Background and Significance

Importance of the Topic

Prescription drug abuse has reached unprecedented epidemic percentages among young

adults in the United States. The nationwide prevalence rate amongst this subpopulation of 18 to

25 year-olds rose to 22% in 2012 with an incidence of approximately 7,900 occurring on a

regular basis (Substance Abuse and Mental Health Services Administration [SAMHSA], 2012).

Commonly abused types of prescription drugs include opioids, prescribed for pain, central

nervous system (CNS) depressants, used for anxiety and sleep disorders, and stimulants,

commonly used for attention-deficit hyperactivity disorder and narcolepsy (National Institute on

Drug Abuse [NIDA], 2012).

Increases in the abuse of prescription drugs have led to substantial increases in mortality.

Prescription drug overdose cause about 50 Americans to die every day and cause more than

16,000 deaths annually (Centers for Disease Control and Prevention [CDC], 2016). In 2014,

more than 14,000 people died in the United States from overdoses, with rates higher among non-

Hispanic whites (CDC, 2016). Whats even more alarming is that the mortality rate of accidental
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 4

drug overdose has quadrupled since 1999 (CDC, 2016). Among young adults, for every death

due to prescription drug overdose, there were 22 treatment admissions and 119 emergency room

visits (SAMHSA, 2015).

In the state of California, the occurrence of prescription drug abuse corresponds to the

nationwide trends. In the most recent National Survey on Drug Use and Health (NSDUH),

9.07% of California residents reported using prescription drugs in the past month. The national

average was 8.02% (SAMHSA, 2015). As the most populous state in the country with 38.8

million residents as of 2015, the raw number of individuals affected by improper and misuse of

prescription drugs is substantial, with rates varying significantly across counties, and even within

counties (CDADP, 2015). With the vast majority of the cities within Los Angeles County being

affluent, a wide variety of drugs become readily accessible, making it an environment where

prescription drug abuse can thrive. Each week, an estimated number of one to two individuals

under the age of 25 die as a result of prescription drug abuse in Los Angeles County (Los

Angeles County Department of Public Health, 2013). In 2014, 342 emergency room visits were

specifically related to prescription and over-the-counter drugs in those between the ages of 12

and 25 years-old. Of these emergency room visits, about 64% of the 186 who were admitted into

the hospital for treatment involved 18 to 25 year-oldsof which 42 later died from prescription

and over-the-counter drug overdose. According to the Los Angeles County Coroners Office,

mortality from prescription drug overdose have shockingly surpassed mortality resulting from

illicit drug overdose. Evidence suggests a steady increase of morbidity and mortality rates

amongst youth and young adult populations (CDADP, 2014).

Prescription drug abuse is a very serious problem that comes with a high burden of costs.

Each year, the U.S. economy is exhausted out of $190 billion in funds. This total includes $130
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 5

billion in lost productivity, $20 billion in healthcare costs, and $40 billion in legal costs Should

the prevalence and incidence rates of prescription drug abuse continue to rise substantially,

expenditures are projected to exceed $500 billion by 2016a 148% increase in just three years

(NIDA, 2012).

Critical Review on Similar Programs

At various times throughout the year, the Drug Enforcement Administration organizes

drug collection campaigns throughout thousands of sites across the country, where they collect

unused, unwanted, expired, or dangerous medications. This program enlists the assistance of

local law enforcement agencies, which often have these medication disposal sites established on

their property. It guarantees the safe disposal of medications and allows individuals to

anonymously drop off medications, while ensuring that local law enforcement upholds their civic

duty to protect the community (Drug Enforcement Administration, 2013). Informing community

members of upcoming prescription drug collection days can help reduce the number of

prescription drugs found in peoples homes and help to ensure the proper disposal of prescription

drugs.

The joint partnership of Cardinal Health and Ohio State University led to the

development of the Generation Rx University Toolkit, which guides college students, faculty,

and staff in educating others about the misconceptions, realities, and dangers of prescription drug

abuse. Upon accessing Cardinal Healths Generation Rx website, members of the general public

are provided with a supply of educational resources, including presentations and handouts, free

of costs (Cardinal Health, 2013). This program stands out because it encourages community

members of all levelsphysicians, pharmacists, law enforcement, local businesses and


PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 6

organizations, educators, and studentsto collaborate and develop partnerships in the hopes of

decreasing the prevalence and incidence of prescription drug abuse within the community.

At several colleges and universities along the East Coast, existing Good Samaritan

policies at the state level have been adopted on campus to address the consequences of alcohol

and drug consumption. These policies encourage students to call the police when they fear that

one of their peers may be in danger from consuming these dangerous substances. Additionally,

campus policies assure that any student who calls campus police or another emergency service to

help another student with a drug or alcohol-related medical issue will not face legal

consequences. This is a great program to have at all college campuses throughout the nation

because it not only recognizes the severity of the problem, but also offers a more meaningful

solution. Students are given an opportunity to help save the life of a fellow student in need

without the fear of becoming implicated in an uncompromising situation as a result of their

involvement in alcohol, drugs, and other substances.

Zero-tolerance approaches to drug and alcohol prevention have demonstrated

ineffectiveness due to their lack of flexibility and failure in considering that many adolescents

will at least experiment with substance use (Boccanfuso and Kuhfield, 2011). Although it

provides the structure necessary to address the problem as a legitimate threat, its application of

imposing harsh punishments have attributed to program failure. Reconnecting Youth, Positive

Action, Too Good for Drugs, and Skills for Adolescents are highly effective alternative

approaches to zero-tolerance amongst youth and adolescent populations in the K-12 grade level.

Such programs include the promotion of character development, academic achievement, school

bonds, healthy activities, and social-emotional skill-building. Because previous studies of these

programs have successfully demonstrated a simultaneous increase in school performance and


PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 7

decrease in drug involvement, it is believed that the positive impacts of these programs will carry

on as these individuals transition into college and become young adults (Boccanfuso and

Kuhfield, 2011). All of these components have been implemented into the National Youth Anti-

Drug Media Campaign to target a wider audience through various means of media advertising.

Information contained within these advertisements further reinforces the knowledge and skills

that individuals may have previously acquired at school or other clinical environments, such as

their physicians office or the local pharmacy (Johnson et. al, 2011).

The Brief Alcohol Screening in College Students (BASICS) is considered to be a model

program in the United States as it has reduced binge drinking and excessive drinking prevalence

amongst college students. This intervention incorporates motivational interviewing in the form

of two one-on-one interviews, which are designed to promote reduced alcohol consumption or

abstinence among high-risk drinkers (Boccanfuso and Kuhfield, 2011). These sessions provide

the individual with a greater sense of self-awareness in terms of their drinking behaviors so that

they can eventually develop a safer drinking plan (Boccanfuso and Kuhfield, 2011). Although

the BASICS model has only been used to specifically address alcohol consumption, the

motivational interviewing component offers a clinical approach that seems promising in possibly

reducing the incidence and prevalence of prescription drug abuse.

Theoretical Relevance

The framework for the proposed program will be guided by the Social Cognitive Theory

in which the continuous interactions between an individual and their environment dictate their

behavior. The Social Cognitive Theory explains how people acquire and maintain certain

behavioral patterns, while also providing the basis for intervention strategies (Bandura, 1997).

What makes prescription drugs dangerous is the perceived notion that prescription drugs are
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 8

safer because they are legally obtained from a pharmacy or through a friend or family member,

rather than illicit drugs purchased on the street (The Office of National Drug Control Policy

[ONDCP], 2011). This simple but critical misunderstanding (personal factor), consequentially

increases the likelihood of continued use (behavioral factor) amongst college students unless

measures are taken to rectify these misunderstandings (environmental factor), through continued

education and awareness efforts. This program aims to not only educate college students on

prescription drugs, their intended and proper use, as well as ways in which individuals misuse

and abuse them, but also provide the necessary skills to recognize particular risks in various

environments and effectively improve them. In doing so, the program hopes that students will

take the initiative to become more proactive about their health and the choices that they make

while in college.

To assess baseline knowledge, attitudes, and beliefs of college students regarding

prescription drugs, a pretest will be administered in the form of an internet-based survey prior to

the start of the program. This pretest serves a dual purpose, first, to serve as a means of

recruiting participants into the program, and second, to a guideline for program developers to

determine what information will be included in the educational component of the program.

Program developers expect that the participants will respond truthfully since their responses will

remain completely anonymous.

Education will take place in a series of six small seminars and workshops of thirty

minutes each, all of which will be taught by a team of college professors and other experts who

are either knowledgeable on the subject matter or have experience in dealing with college

students. In order to accommodate students on the quarter and semester system, implementation

will take place bi-weekly during the months of October and November in the fall or March and
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 9

April in the spring. The program will begin the first week of the month and alternate every other

Friday, due to the majority of college students having class Monday through Thursday.

Participants are expected to actively listen, respond to questions presented, address any of their

concerns or questions, and engage in all individual and group activities presented in the delivery

and application of skills throughout the duration of the seminars and workshops.

Program Objectives and Hypothesis to be Examined

This educational and awareness program has two objectives that will help measure

program efficiency and feasibility:

Objective 1: Upon completion of the program, participants will demonstrate at least 30%

increase in knowledge regarding prescription drugs and prescription drug abuse as measured by

questions 1 through 8 at posttest.

Objective 2: Upon completion of the program, participants will demonstrate a 5% increase in the

application of newly acquired behavioral skills, of which will be measured by questions 9

through 15 at posttest.

Methods

Description of the Population and Method of Sample Selection

Participants selected for this program will be made up of male and female college

students of all ethnic/cultural backgrounds between the ages of 18 and 25 years-old. These

individuals can be either part-time or full-time students at any college or university, however,

they must be residents of Los Angeles County, California while attending their respective college

or university. This information will be made available by the student via self-report during the

pre/posttest. College students who report themselves as living in Manhattan Beach and Santa

Monica will be asked to participate in the program, while those living in the cities of Calabasas,
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 10

and Pasadena will be asked to participate in the pilot study. Participants must be 18 years-old in

order to participate in the program. Additionally, they must report the same zip code for both

pre/posttests or they will be excluded from the sample population. Undocumented individuals

and international students may be included in the program.

Participants will be sampled using the cluster sampling method, a probability-based

sampling technique, from various locations throughout Los Angeles where college students

frequently hang out. These locations include college and university campuses, shopping centers,

as well as bars and clubs. It is critical to determine a sample size that is large enough to show

statistical significance and a sample that is small as possible that satisfies the criteria so that

resources are not wasted. 40% of the participants living in Manhattan Beach will be asked to

join the experimental group, while an additional 40% of the participants living in Santa Monica

will be assigned to the comparison group.

Based upon the criteria used to determine the sample size, the 6.3 table will be used. A

0.8 power test, 0.2 for P1, and a 0.05 significance level for alpha will be used to determine Type

1 and Type 2 error. The effect size will be determined by the 30% rate of change measured by

objective #1 of the program. A minimum sample size of 300 college students per group will be

needed at posttest for a total of 600 minimum participants. 20% (or 120 participants) will be

added to this amount to account for the estimated percentage of the participants who cannot be

located, the estimated percentage of those who drop out during the program, and the estimated

percentage of those who refuse to participate. Therefore, a total sample size of 720 college

students will be needed; 360 participants will make up the experimental group while another 360

will be part of the comparison group. Data obtained from the pilot test will be used to determine
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 11

the number of program participants. Having a sufficient staff size ensures adequate program

delivery, feasibility, and efficiency.

A gift card worth $10 to Starbucks will serve as an incentive to initially recruit program

participants. At this time, they will also receive a raffle entry for a chance to win a pair of

concert tickets to see Drake perform live at the Staples Center in Los Angeles. However, they

must report themselves as living in a Los Angeles County zip code during the pretest in order to

win both the $10 gift card and the raffle entry. Additionally, each participant must sign and

submit a letter of agreement and consent to participate. To maintain program participation

amongst those recruited, additional raffle entries will be given at the completion of every seminar

or workshop attended, making the likelihood of winning the raffle increase with participation.

The maximum number of raffle entries will be no more than seven entries per participant. To be

eligible for the concert tickets, participation in all activities is required. Individuals who opt out

at any time during the program will be placed in a separate raffle for a smaller prize of a $50 gas

card. Winners of each raffle will be contacted within 30 days after program completion.

Design of Experimental Methodology

The non-equivalent comparison group will be chosen as the experimental design method for this

program. This method eliminates history, maturation, testing, and instrumentation as threats to

internal validity because of the utilization of two groupsone of which receives the program,

while the other receives nothingand the implementation of a pre/posttest in measuring and

comparing the results directly attributed from the program. However, there is a slight chance

that participants may be able to recollect the answers that they marked in the pretest when they

fill out the posttest two months later, which may have an effect on testing.
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 12

Since there is no randomization of the participants, the chosen method cannot account for

the following threats to internal validity, regression to the means, selection, and attrition. As far

as the regression to the means effect, program staff do not expect to be concerned with it because

they have already pre-selected which cities belong to the experimental and comparison groups.

Ultimately, the experimental group will get the program and the comparison group wont.

Selection will be accounted for because, again, the program staff have already pre-selected the

cities which will and will not receive the program, so college students living in Manhattan Beach

cannot be members of the comparison group since they have already been assigned to the

experimental group. Similarly, college students living in Santa Monica cannot be assigned to the

experimental group since they are part of the comparison group. However, this does not

completely eliminate selection from occurring as college students may have friends living within

the same city as them in either groups. Because of the magnitude of the incentive thats at stake,

once participation has been completed, it is believed that the college students are less likely to

drop out, which takes the attrition effect into account. And even if they do drop out for some any

reason, their consolation prize is another raffle opportunity to compete for a $50 gas card.

Interaction can be controlled if two or more of the internal threats to validity in history,

maturation, testing, or instrumentation are used. Diffusion will be eliminated because college

students living Manhattan Beach and Santa Monica will be separated from each other by

experimental and control groups, will attend different schools, and because each participant will

sign a waiver that explicitly states they are not to discuss their involvement in the program to

their peers. Compensation and compensatory rivalry will be eliminated by the training of staff

and the programs process evaluation. It is expected that demoralization should not occur

because college students are offered incentives at each step of the wayone $10 gift card to
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 13

Starbucks and one raffle entry for the grand prize for initial participation in the survey and

program recruitment, as well as one raffle entry for every seminar and workshop attended

thereafter. The likelihood of winning the concert tickets increases with program participation.

Even if the college students do not win the concert tickets, they still get to keep their $10 gift

card in addition to the knowledge and skills that they learned from the program.

External threats to validity, including artificial environment and ethical issues, will be

eliminated by one, the presentation of real-life scenarios that detail the thoughts and experiences

of college students at various settings in which prescription drug abuse occurs during the

seminars, and two, the instruction, demonstration, and application of skills used to problem-solve

compromising situations during the interactive workshop. Guest speakers will be asked to

voluntarily participate in helping program staff deliver the necessary information during the

seminars. These individuals include current and former college students who have had

experience dealing with alcohol and prescription drug abuse in a college setting. This ensures

that the information provided will not be coming from a biased, judgmental perspective, but

rather a more realistic one. By making the program more relatable to college students, the

program experience and the information obtained will be retained in their memory for a longer

period of time. Ethical issues will be accounted for by signing a waiver that clearly states that

those that participate in the program are to maintain and adhere to the confidential policies stated

at pretest and initial program recruitment.

Operationalization of Concepts

Questions 1 through 8 of the pre/posttest includes knowledge questions that were adapted

from the Smart Moves School Toolkit Web Pre-Test and Quiz and the Drug-Related Knowledge,

Attitudes and Beliefs in Ireland Nation-Wide Survey. The questions will yield nominal data in
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 14

the form of matching, multiple choice, true/false, and choose all of the correct answers questions.

These questions will discern prescription drugs, illegal drugs, and over-the-counter drugs from

one another; identify prescription drugs that are commonly abused by college students and

sources from which they are obtained; assess judgment on whether it is okay to take medications

that are not prescribed; and determine knowledge on the severity of prescription drugs (National

Association of School Nurses, 2013). The responses to these questions will help determine the

current level of knowledge that college students have regarding prescription drug abuse and any

additional information that must be covered by the program.

To measure the beliefs of college students, questions 9 through 15 have been adapted

from a combination of resources, including the 2013 Indiana Substance Use Survey and the Core

Alcohol and Drug Survey-Long Form. These particular set of questions assess the alcohol and

substance use of college students in the form of nominal data. These include questions

regarding: alcohol use within the past six months and whether it was in combination of drugs;

specific prescription drug(s) used within the past six months and the frequency of use for each

one; location of where these substances were used; whether the college students individually

engaged in sexual intercourse; and whether these college students were intoxicated or under the

influence of alcohol and/or drugs while engaging in sexual intercourse (Jun et. al, 2013). It is a

well-known fact that college students are at high risk when it comes to prescription drug abuse

because of the environmental exposure to frequent parties and gatherings where alcohol is almost

always available. Usually when alcohol is available, the likelihood for engaging in high-risk

behaviors, including unprotected sex and combined alcohol and drug use, is heightened. The

responses to these questions will help determine whether past research is supported in this

program.
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 15

Upon the completion of the eighteen survey questions at pre and posttest, there will be an

additional ten questions pertaining to the demographics of the participants. Questions 16 through

23 were adapted from the Core Alcohol and Drug Survey, Long Form and later modified

accordingly. Nominal level data will be retrieved in the form of male/female, yes/no, self-report,

and check one that applies questionsof which gender, date of birth, race/ethnic background,

class standing, student status, employment status, student housing, geographic location, and

living arrangements can be examined. These are important things to consider as it will help

assess possible risk and protective factors at the individual level with respect to prescription drug

abuse.

Formative Evaluation Methods Pilot Testing Procedures

Pilot-testing of the program will be conducted in the form of six focus groups that will

include no more than ten students each. Participants of the pilot study will be college students,

who fit the main criteria of being 18 to 25 years-old and a Los Angeles County, California

resident. However, they must specifically live within the cities of Calabasas and Pasadena. Data

extrapolated from the pilot study will serve as a guide for determining the sample size needed for

the program, one that will provide an effect that is both measurable and significant. Relevant

information will be extracted from past research of programs and interventions that have shown

rates of success. Some of the components from past research conducted will be manipulated to

cater to the programs target population and later applied to the program itself. Program staff

will be under the advisement and guidance of highly experienced and trained experts with at

least ten years of experience in working with college students in some form of substance abuse.

Instruments to measure change include pre and posttests at program recruitment and termination,
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 16

as well as the program materials, including PowerPoint presentations, brochures, and handouts,

as well as self-reported surveys distributed at every seminar and workshop.

Process Evaluation Monitoring of Program Implementation

Program monitoring will be conducted by the training of staff on how to effectively

handle and deal with college students prior to the implementation of the program. At program

implementation, program staff will join together in a series of meetings that occur before and

after the seminars and workshops. At this time, the staff will engage in a number of discussions

that include the agenda that takes place for the day, the goals and expectations from each session,

address concerns and/or problems that may have occurred and ways in which to troubleshoot

them, and suggestions for improving instruction in the future. One member will be designated as

the recorder, who will be in charge of documenting what occurred during the meeting in great

detail. Additionally, every student in attendance will be asked to sign in and out of each session.

At the end of each session, they will fill out a survey, based on a five-point Likert-scale, at the

end of every seminar and workshop that will assess the quality and validity of the information

presented, critique the program staffs delivery of information and instruction, highlight the good

and bad of each session, and include suggestions for the future.

Rationale for Choice of Statistical Techniques

Descriptive statistics univariate analysis. Knowledge questions will be reported as

nominal data in the form of a bar graph and the mode will be reported. The bar graph will show

the number and percentages of participants that answered questions 1 through 8 correctly and

incorrectly as these questions pertain to a college students level of knowledge in terms of


PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 17

prescription drugs and assessment of what is safe and unsafe. Univariate analysis will be

conducted to obtain these percentages using a chi-squared test.

Inferential statistics bivariate analysis. To determine whether program objectives

were met, data collected will be analyzed using inferential statistics to show a 0.05 level of

significance. To measure the 5% increase in positive behaviors from pretest to posttest, nominal

data taken from questions 9 through 15, which focuses on high-risk-taking behaviors of college

students and will be reported in the form of a pie chart and frequency table. The mode, mean,

and standard deviation will be reported as well. An independent sample t-test will be conducted

at a significance level of alpha=0.05 to allow program staff to make a meaningful evaluation

between the experimental and comparison group. A dependent sample t-test will compare the

pre and posttest results within each of the groups at a significance level of alpha=0.05.

Activity Month Month Month Month Month Month Month Month Month Month

1 2 3 4 5 6 7 8 8 9
Needs


Assessment
Program

development
Pilot testing

Sampling

Pretest

Program

Implementatio

n
Process

Evaluation
Posttest

Data Analysis

PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 18

Report Writing

Timeline

References

Boccanfuso, C. and Kuhfield, B. (2011). Multiple Responses, Promising Results: Evidence-

Based, Nonpunitive Alternatives to Zero Tolerance. Child Trends: Brief Research-to-

Results, 2011(09). Retrieved from http://www.nea.org/assets/docs/alternatives-to-zero-

tolerance.pdf

Bretch, M. L. (2013). Patterns and Trends in Drug Abuse in Los Angeles County, California:

2013. Retrieved from https://www.drugabuse.gov/sites/default/files/losangeles2014.pdf

California Department of Alcohol and Drug Programs (CDADP). (2009). Summary Report and

Recommendations on Prescription Drugs: Misuse, Abuse, and Dependency. Retrieved

from http://www.adp.ca.gov/Director/pdf/Prescription_Drug_Task_Force.pdf

California Department of Public Health. (2015). Prescription Opioid Misuse and Overdose

Prevention Workgroup. Retrieved from

http://www.cdph.ca.gov/Pages/OpioidMisuseWorkgroup.aspx

Cardinal Health. (2011). GenerationRx Outreach Program. Retrieved from

http://www.cardinal.com/us/en/generationrx

Cardinal Health. (2013). Cardinal Health Foundation, the Ohio State University Launch Fourth

Toolkit to Help Reduce Abuse of Prescription Drugs on College Campuses. Biotech

Business Week, 30. Retrieved from

http://search.proquest.com.mcc1.library.csulb.edu/docview/1328127835?

accountid=10351

CDC Grand Rounds: Prescription Drug OverdosesA U.S. Epidemic. (2012).


PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 19

Centers for Disease Control and Prevention. Retrieved from

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6101a3.htm

Centers for Disease Control and Prevention. (2016, June 21). Prescription Overdose Data | Drug

Overdose | CDC Injury Center. Retrieved from

https://www.cdc.gov/drugoverdose/data/overdose.html

Centers for Disease Control and Prevention. (2016, June 21). Understanding the Epidemic | Drug

Overdose | CDC Injury Center. Retrieved from

https://www.cdc.gov/drugoverdose/epidemic/index.html

Core Institute of Student Health Programs, Illinois. Core Alcohol and Drug Survey,

Long Form. Retrieved from http://core.siu.edu/_common/documents/longform.pdf

DrugFacts: Drug-Related Hospital Emergency Room Visits. (2011). National Institute on

Drug Abuse. Retrieved from http://www.drugabuse.gov/publications/drugfacts/drug-

related-hospital-emergency-room-visits

Executive Office of the President of the United States. (2015). California Drug Control Update.

Retrieved from https://www.whitehouse.gov/sites/default/files/docs/state_profile_-

_california.pdf

Johnson, E. , Porucznik, C. , Anderson, J. , & Rolfs, R. (2011). State-Level Strategies for

Reducing Prescription Drug Overdose Deaths: Utah's Prescription Safety Program. Pain

Medicine, 12, S66-S72. Retrieved from

http://onlinelibrary.wiley.com.mcc1.library.csulb.edu/doi/10.1111/j.1526-

4637.2011.01126.x/pdf

Jun, M.K. and King, R.A. (2013). Results of the Indiana College Substance Use Survey2013.
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 20

Bloomington, IN: Indiana Prevention Resource Center, Indiana University. Retrieved

from http://www.drugs.indiana.edu/publications/icsus/ICSUS_Survey_2013.pdf

Los Angeles Department of Public Health. (2013, January). Prescription Drug Abuse in Los

Angeles County. Retrieved from

http://publichealth.lacounty.gov/docs/HealthNews/PrescriptionDrug-12-13.pdf

National Association of School Nurses. (2013). Smart Moves, Smart ChoicesStudent Pretest:

Teen Prescription (Rx) Drug Abuse Awareness. Silver Spring, MD: National Association

of School Nurses. Retrieved from

http://www.smartmovessmartchoices.org/pdfs/SmartMoves_SchoolToolkit_Pre-

Test_Web.pdf

National Association of School Nurses. (2013). Smart Moves, Smart ChoicesGet Facts:

Take the Quiz. Silver Spring, MD: National Association of School Nurses. Retrieved

from http://www.smartmovessmartchoices.org/quiz

National Council on Alcoholism and Drug Dependence (NCADD). (n.d.). Learn About Drugs:

Prescription Drugs. Retrieved from http://www.ncadd.org/index.php/learn-about-

drugs/prescription-drugs

National Council on Patient Information and Education. (n.d.). Prescription Drug Abuse on

College Campuses. Retrieved from

http://www.talkaboutrx.org/documents/GetTheFacts.pdf

National Institute on Drug Abuse. (2015, August). Trends & Statistics | National Institute on

Drug Abuse (NIDA). Retrieved from https://www.drugabuse.gov/related-topics/trends-

statistics
PRESCRIPTION DRUG ABUSE AMONG COLLEGE STUDENTS 21

National Institute on Drug Abuse. (2016, February). Abuse of Prescription (Rx) Drugs Affects

Young Adults Most | National Institute on Drug Abuse (NIDA). Retrieved from

https://www.drugabuse.gov/related-topics/trends-statistics/infographics/abuse-

prescription-rx-drugs-affects-young-adults-most

National Institute on Drug Abuse (NIDA). (2012). Prescription Drugs. Retrieved from

http://www.drugabuse.gov/drugs-abuse/prescription-drugs

Office of National Drug Control Policy (ONDCP). (2011). A Response to the Epidemic of

Prescription Drug Abuse. Retrieved from

http://www.whitehouse.gov/sites/default/files/ondcp/Fact_Sheets/prescription_drug_abus

e_fact_sheet_4-25-11.pdf

Office of National Drug Control Policy (ONDCP). (n.d.) National Youth Anti-Drug

Media Campaign. Retrieved from http://www.whitehouse.gov/ondcp/anti-drug-media-

campaign

Policy Impact: Prescription Painkiller OverdosesWhat's the Issue?. (2013, July 2). Centers for

Disease Control and Prevention. Retrieved from

http://www.cdc.gov/homeandrecreationalsafety/rxbrief/

Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings.

(n.d.). Results from the 2012 NSDUH: Summary of National Findings, SAMHSA,

CBHSQ. Retrieved from

http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/N

SDUHresults2012.htm