Officer Al Fear Eastern Iowa Heroin Initiative Cedar Rapids Police Department U.S. Attorney s Office NDIA

Transcription

1 Officer Al Fear Eastern Iowa Heroin Initiative Cedar Rapids Police Department U.S. Attorney s Office NDIA Angie Asa-Lovstad, MS, CTF, CPS Co-Director, Alliance of Coalitions for Change (AC4C) Certified Facilitator, Facilitated.Direction

2 Faculty Disclosure All presenters and presentation planners report no actual or potential conflicts of interest associated with this presentation. All presenters and presentation planners have indicated that off-label use of medication will not be discussed during this presentation.

3 CPE Learning Objectives Upon successful completion of this activity, pharmacists and pharmacy technicians should be able to: Describe the opioid dependence epidemic being observed in Iowa and across the US. Describe current initiatives and programs available to combat the epidemic at the state level. Evaluate current programs available in regards to which would be best suited in your community. Describe the value that healthcare professionals bring to combating opioid abuse and misuse to other key civic leaders, and which programs would benefit the community. Formulate an opioid abuse strategy for your practice setting that aligns with the interests of your community.

4 A National Challenge with a Community Solution The Eastern Iowa Heroin Initiative Officer Al Fear Eastern Iowa Heroin Initiative Cedar Rapids Police Department U.S. Attorney s Office NDIA CRUSH of Iowa

5 The Crisis National Rise of Heroin Source: DEA 2016 National Heroin Threat Assessment

6 Source: DEA 2016 National Heroin Threat Assessment

7 Opioid Analgesics: Fentanyl Hydrocodone Morphine - Oxycodone

8 Locations of 2016 NDTS Respondents Reporting Heroin as Greatest Drug Threat

9 NATIONAL HEROIN DEATHS BY RACE & AGE

10 NATIONAL HEROIN DEATHS BY REGION

11 LINN COUNTY HEROIN STATISTICS 2015 Overdoses - Police Response 61 Overdose Calls involving Heroin 20 Opioid DEATHS 330..Heroin/Opioid Hospital Admissions 2016 Statistics 27.Opioids DEATHS 874..Heroin/Opioid Hospital Admissions

12 Opiates are drugs derived from opium. At one time "opioids" referred to synthetic opiates only. Now the term Opioid is used for the entire family of opiates including natural, synthetic and semi-synthetic.

13 Legitimate Injury Broken bone Sore back Work related Prescription of Opioid Painkillers Hydrocodone Oxycodone

14 Pills Injury occurs. Prescription of Opioids Transition Prescription Runs Out Addiction has set in withdrawal symptoms if you stop DOPE SICK HEROIN CHEAP Readily Available More Potent High

15 Once ADDICTION has set in. It is NO LONGER about getting HIGH It IS about NOT GETTING SICK.

16 Heroin/ Opioid Withdrawal Sweats Chills Diarrhea Vomiting Insomnia Restlessness Tremors Bone pain Seizures

17 The Heroin Cycle First use of opiate (typically prescription drug) Use becomes more and more regular Daily use/withdrawals Treatment RECOVERY Death

18 The Cost of Addiction Heroin typically costs about $20-$30 per 0.1 gram. A daily user will use at least 0.2 to 0.4 gram of heroin ($50 to $100) per day and sometimes up to $150 to $200 per day, This will depend on the purity of the heroin purchased (lower purity, may need to use/spend more for the same effect) Withdrawals may occur every 6-8 hours, which may necessitate multiple purchases in a day Dealer availability impacts ability to purchase SO $100 to $200 per day habit = $700 to $1400 spent per week just on heroin Over $36,000 (upwards of $70,000) spent per year to feed the addiction

19 Where Does the Money Come From? Oftentimes, the user will have a regular job with a paycheck (helps to hide addiction) Once the addiction progresses to daily use, maintaining a regular job becomes more difficult Heroin addiction does not care when bank accounts are depleted Beg, borrow money and items pawn shops Property crimes Theft Forgery Burglary Robbery Other crimes Financial fraud EBT/food stamps fraud Pseudoephedrine smurfing Drug crimes (middling deals for other users, recruiting other users, giving dealers rides) Sexual exploitation

20 LINN County/ASAC Pill Statistics Patient initial consultation: Rank the substance you are abusing 2007 Primary Secondary Third Total Primary Secondary Third Total Prescription Pills.115 people stated it was an issue for them 2014 Prescription Pills.423 people stated it was an issue for them In 7 Years A 300% Increase In Prescription Pill Abuse

21 What is Heroin? Heroin is 3 times more potent than morphine A Depressant Can be snorted, injected or smoked

22 The Effects of Heroin Use Once heroin enters the brain, it binds rapidly to the opioid receptors and releases dopamine warm flushing of the skin dry mouth heavy feeling in the extremities nausea, vomiting, and severe itching After the initial effects will be drowsy for several hours mental function is clouded heart function slows breathing is severely slowed, to be life-threatening. Slowed breathing can also lead to coma, permanent brain damage

23 Method of Delivery Snorting or smoking heroin 10 to 15 minutes for the drug s full effect Injecting heroin is a much faster Injection into muscle 5-8 Minutes Injection into vein takes 7 to 8 seconds

24 FENTANYL In early 2015, Agencies in Eastern Iowa first started seeing heroin laced with Fentanyl, followed by Fentanyl being sold as heroin, which is part of a national trend 100 times stronger than morphine, and 30 to 50 times stronger than heroin

25 On the left, a lethal dose of heroin On the right, a lethal dose of fentanyl

26

27

28 CARFENTANIL is an analogue of FENTANYL 10,000 times more potent than Morphine 100 times more potent than Fentanyl

29

30

31

32 Medical Staff Training Responsible Opioid prescribing Over prescribing? Alternatives to Opioids? Use of the State Prescription Monitoring Program (PMP) Doctor Shopping Currently 44% of Doctors are REGISTERED to use PMP

33 Accessibility Issue If someone came to your home, how easy would it be to grab one or a few out of the bottle? Would you notice that there is medication missing?

34 Pharm Parties Teenage parties involving prescription medications Pharm Party Pill Party Skittle Parties Everyone brings medications from home and place them into a bowl. The bowl gets passed around for everyone to use.

35

36

37

38 Text the word heroin to 51555

39 UNUSED, UNWANTED, or EXPIRED Medications Dispose of your opioid painkillers and help keep the pills off the street

40 We are here to help those who are abusing prescription medications and are suffering from substance abuse We are not here to arrest our way through the problem Please spread the word. FACEBOOK Eastern Iowa Heroin Initiative RECOVERY IS POSSIBLE

41 Questions & Discussion

42

43 Let s Have a Conversation Describe opioid dependence

44 What s working? What s NOT working?

45 What ideas are emerging?

46 What are you going to do differently? What are the collaborative ways we could work together to build a network to address emerging issues?

47 Table Sharing Report Out