Substance Use Disorder/ Mental Health Committee July 16, 2015 Minutes

Transcription

1 Substance Use Disorder/ Mental Health Committee July 16, 2015 Minutes Facilitated by: Cindy Haynes & Irene Dwinnell Present: Debbie Royster, Paul Savery, Jessie McGinty, Nate Strizinger, Robert Thomas, Marissa Mortiboy, Cindy Haynes, Irene Dwinnell, Andrew Johnson, Yancee Perez, Kim Bailey, Ashley Barber, Karen Verhaeghe, Carey Unger, Kenisha Bethea, Jason Ferrell, Katherine Ruiz, Mel Downey-Piper Time Agenda Items Major Discussion Points Action steps and responsible persons 3-3:10 Introductions and review minutes Paul Savery s name will be added to the June minutes. 3:10-3:30 Durham County Dept. of Public Health Naloxone Outreach Program Mel-Downey-Piper Durham County Dept. of Public Health Distributing naloxone for opioid overdoses is something the health department has been working on for some time. The State has given the Durham County Department of Public Health (DCoDPH) $3200 for Project Lazarus. The health department pharmacy is distributing naloxone kits to the public which requires a five- minute training. Most of the funds received from the state were given to the NC Harm Reduction Coalition to purchase and build naloxone kits. They are giving the kits to methadone clinics or people who know heroin users. The NC Harm Reduction Coalition will train DCoDPH health educators who do HIV/STI testing in the community on how to use naloxone. If someone is identified as an IV drug user, the individual can receive a kit from a health educator. The health department is still in the process of making distribution possible for health educators. Durham County is one of the first counties in the state to do this. Other pieces of the grant include to forming a community coalition around this issue and review opioid overdose data from NC DETECT. NC DETECT tracks hospitalization data, deaths, etc. Only health departments and hospitals have access to this data which is updated constantly, almost in real time. The data should be shared with the community. Cindy will provide a list at the next meeting of agencies from North Carolina counties considering or already using naloxone. The committee will help collect data on naloxone use by police jurisdictions and impact on the community to help advocate for use in Durham city/county. Irene will take the lead with other committee members in finding out what other jurisdictions are doing. Cindy will contact Sherriff Laurus Paul from Cumberland County to share his experience with the committee.

2 Project Lazarus is a subcommittee of the Durham Crisis Collaborative. Members include first responders and physicians. Project Lazarus was originally developed as a community-based organization in response to the alarming of unintentional overdose deaths in Wilkes County. They formed a coalition of faith-based organizations, ER physicians, police, and more to reduce the incidence of overdoses and did so by more than 60% in its first year. The center of the model is coalition building and awareness. Data and evaluation are other pieces. Cindy serves Duke Health Systems and Northern Piedmont Community Care by educating on chronic pain and opioids. Safe medication disposals are done through safe boxes and Medicine Drop sites. There are five sites in Durham at the Justice Center, Sherriff s Office, Police Districts 2 and 3 and the police headquarters. Sites are under 24 hour surveillance. Pharmacies are being encouraged to participate in Operation Medicine Drop. Several pharmacies in Durham and two clinics at Duke Medicine participated in March. The drugs should not be flushed. Cindy will find out about the reasons for naloxone use resistance in the Durham police department. The committee will strategize on how to make another approach to the police department once they have data on barriers and reasons for resistance. Mel will send Cindy data on opioid overdoses. The health department will provide data on opioid overdoses each quarter. Mel shared data about overdose trends in Durham. In 2014, there were 30 cases of miscellaneous overdoes cases and 17 for heroin. At the midpoint of 2015, there have been 12 ER department visit for heroin and 33 from any type- heroin, methadone and unspecified. Overall opioid overdoses have decreased since There was discussion about heroin being laced with other substances in Durham, Orange and Wake Counties. Mel can bring quarterly data the committee to keep it updated. If a committee member is interested in doing further work on this issue, they should talk to Cindy about becoming involved with Project Lazarus. Durham County emergency responders have naloxone but aren t currently using it. Cindy plans to talk with firefighters to discuss the importance of using naloxone. Cumberland County has provided police with naloxone. Durham County police refused hearing from the Cumberland County s naloxone first responder program using an auto

3 ejector. Cindy will reach out to the Durham County Sherriff s Department again. It was suggested bringing Robert from the NC Harm Reduction Coalition to Durham County. City Councilman Steve Schewel may support this. The group needs to find out the barriers for Durham Police refusing to use naloxone. There was a comment from police that they felt EMS would be on scene first and they wouldn t be required to use it. Other barriers include encouraging overdoses by making naloxone available and using a syringe. Stigma needs to be addressed through putting a face to opioid overdoses. It s not just heroin but people misusing pain medicine. It could be a neighbor. Some stigma may be educating deputies from the chief down that they won t get stuck by a naloxone needle. Frame the injection as a medical procedure instead of a street procedure, similar to an Epi pen. Strategies for advocating to the Durham city and county police include getting data showing police first on scene and making a difference and a decrease in ER visits from surrounding police jurisdictions. Have smaller meetings with the police chief and show data. Find allies. Use a grassroots approach similar to Pitt County. The Pitt County Coordinator is willing to help and Karen has her contact information. The Sherriff s Department has allowed CJRC giving out kits to released inmates but it is not always practical due to the timing of release and sharing of that information. Resistance in the community is related to stigma having to do with addicts. Stigma must be reduced. Opioid users are often seen as not full citizens. The NC Harm Reduction advocates with police departments and will work with Cindy to get the naloxone kits out. An additional resource is Freedom House. Anyone actively using and needs detox can use Freedom House. Cindy wants to put a mobile crisis unit at Freedom House. Dr. Larry Greenblatt is willing to write standing orders for naloxone.

4 3:30-4:00 Review and Finalize Action Plan The action plan will guide the committee in its work over the next three year. Once the action plan is finalized, it needs to be approved by the Board of Health. The action plan should remain a living document and using the action plan to keep the committee accountable. Subcommittee work will be done between meetings and reported on at the monthly meetings. The four focus areas of the action plan are providing training and resources to faith-based organizations around mental health issues by reaching out to see what their needs are, providing information to providers, hospital and social workers on mental health resources and how and where to refer, getting providers on board in prescribing naloxone and educating the community and addressing suicide prevention in youth and doing activities in the community and partnering with Wanda Boone. Irene will bring the spreadsheet her intern compiled on contacting 109 private and public Durham County mental health providers to the next meeting. Find out if NCCU has a Recovery House from Wanda Boone. NC State, Duke and UNC Recovery House will be added to the action plan under strengths under naloxone. Some of the churches Debbie works with have asked for training because they are dealing with depression in their congregations. The NIH is researching ways to distribute information to the community. The process the committee is using for researching mental health providers matches what the researcher has seen so far. Irene had an intern over the summer pretend to be a consumer and a provider and call mental health providers to collect data about what she found. The original list of providers was from Alliance Behavioral Healthcare. Carlene and Bob are interested in working on the faith-based subcommittee. Carey is interested in the resources subcommittee and removed from suicide prevention. Remove Karen from the suicide prevention subcommittee. Carlene would like to be involved with the suicide prevention subcommittee but likely cannot attend meetings.

5 4:10-4:20 4:20-4:30 Next meeting Agenda Items for Future Meetings She will receive updates via . Jason would like to be part of the resources subcommittee. Cindy will contact the Cumberland County Police Chief on speaking at next month s meeting regarding naloxone use by first responders. A presentation on how substance use can mimic and exacerbate mental health issues and how the two intersect was suggested as a future topic. Send ideas on speakers and agenda items to Cindy and Irene. Announcements Carolina Outreach will work towards serving the Wilson area. They still have capacity for Spanish speaking clients for the ACT team. Friday, July 17, 3:30-5:00 pm, there will be a panel discussion at St. Thomas Moore in Chapel Hill about mental health in youth There will be a chronic pain presentation on July 28, Morehead Baptist Church starting at 6 pm. The Recovery Celebration will be on Saturday, September 19, 3-8 pm at the Criminal Justice Resource Center (CJRC), 326 E. Main St. The theme this year is visible, vocal and valuable and focuses on youth. There will be healthy eating demonstrations, line dancing, live music, food, children s activities. A Recovery Celebration planning meeting will be held July 30, 3pm at CJRC. Recovery speakers are needed. Speakers will focus on their lives in recovery. August 4 is National Night Out. Check the website to see what your community is doing. Thursday, August 20, 2015; 3-4:30 pm