Prescription-overdose prevention program focuses on children, medical community

By Ed Runyan


Thanks to an Ohio Department of Health grant of $220,000 over 38 months, public health nurse Kathy Parrilla is fighting opiate addiction in areas that could pay off for generations to come.

Parrilla, a registered nurse with the Trumbull County Combined Health District, formerly known as Trumbull County Board of Health, is focused on educating children and medical professionals such as doctors and dentists.

In the coming weeks, Parrilla will give presentations in three Trumbull County school districts to children in grades five to seven.

The children will receive a curriculum called Generation Rx that will teach them how to recognize the difference between prescription drugs and candy and make them understand the importance of taking prescription drugs only as prescribed.

“We feel that getting to the children at the younger age will prevent them from even starting on anything,” she said. “We want to give them the knowledge to be able to say no and why they want to say no.

“By getting to them at the younger age, what we’re hoping to do is prevent the vicious cycle we’re seeing now where they may start out on pills and then move to the heroin and fentanyl,” she said.

The health district was one of 14 Ohio agencies that received the funding, which runs through August 2019, in a program called the Prescription Drug Overdose Prevention Project.

Trumbull County qualified because of data showing it having among the state’s highest overdose death numbers and rate of opiates prescribed per person, Parrilla said.

Parrilla gave trainings last year to medical and dental students to ensure they understand their obligation to use the Ohio Board of Pharmacy’s online prescription reporting system to detect drug-seeking behavior in patients.

She also discussed with them new prescribing guidelines related to opiates for chronic pain the state instituted in recent years.

Through her interactions with dental students, 78 medical students and a few doctors, she’s seeing progress in their understanding of “weaning” techniques to use when bringing someone off of an opiate.

“We’re finding that they are starting to get more perspective, learning the weaning procedure rather than just saying, ‘You’re done now. I’m not going to write any more,’” Parrilla said.

The medical and dental students evaluated the training, saying they “strongly agreed” and “agreed” that the training was “very helpful and they would use it in their practice,” Parrilla said.

“That’s kind of our thought now: Let’s get to them before they start their [medical or dental] practice. Let’s make them responsible providers before they are faced with the decision on how to write that prescription,” Parrilla said.

She’s still working to schedule a session with more full physicians, known as attending physicians, perhaps at a medical meeting, she said.

Parrilla worked with the Mental Health and Recovery Board and others to create a six-minute video on YouTube featuring locally recognized drug-abuse professional Dr. Daniel Brown of Meridian Healthcare. In it, he talks about the difference between chronic and acute pain and ways to manage it without medication.

“There’s not a lot of evidence and support of using opiates long term for chronic treatment of pain unless that pain is a chronic, terminal pain,” Dr. Brown said in the video.

One notable feature of the grant is the thorough planning and documentation required to carry it out.

A lengthy work plan explains every facet of the program, identifies Parrilla as responsible for carrying it out, the populations to be addressed, the steps to be taken, and quantifiable accomplishments to be documented and evaluated.

The program, which began last July, already has achieved a number of training goals.

Parrilla, who is also the health district’s Project DAWN coordinator, trained five additional law enforcement agencies, the Warren Fire Department, the county drug court, Children Services, county jail officers and personnel with the Northeast Ohio Alternative Sentencing Program to recognize and respond to an overdose.

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