Introduction Katie Westerman Oconomowoc Parent Education Network

Transcription

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2 Introduction Katie Westerman Oconomowoc Parent Education Network

3 Oconomowoc High School Principal Joseph Moylan

4 Current Drug Trends Brad Schimel Waukesha County District Attorney

5 Source: Wisconsin Dept of Health Services, Division of Public Health, Office of Health Informatics: Hospital Patient Data System

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7 Source: Wisconsin Department of Health Services, Hospital Patient Data System Note: Figure does not include three VA Hospitals. Emergency department visit counts exclude those admitted as inpatients.

8 800, , , , , , , , SE WI Needles "Exchanged" What are the numbers This chart reflects SE Wisconsin only The totals include needles distributed plus exchanged needles About 60 75% are distributed needles

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13 Source: AIDS Resource Center of Wisconsin Lifepoint Program Reported Deployments

14 Source: Wisconsin Ambulance Run Data System

15 '01 '05 '09 WI Opiate Deaths As Narcan deployments went up, so did deaths

16 Story of Love and Loss Jody Medinger Mother of ~ Samantha

17 Tim Westlake, M.D. Oconomowoc Memorial Hospital Emergency Physician October, 2014

18 What is an Narcotic/Opiate? Drug that affects the brain s own natural pain relieving receptors Used for thousands of years was opium, a residue of the poppy plant

19 Mechanism of Action:

20 Progression to Modern narcotics Codeine was formulated in the 1830 s, to be used mostly as a cough suppressant Opium addiction was major problem in 1850 s worldwide and in the US, so Morphine was developed as an alternative because it was thought to be less addicting.---it is Not So then in the 1890 s Bayer Pharmaceuticals chemically altered morphine trying to find a less addicting opiate.--- They created Heroin. --Also not less addicting In the late 1930 s a new narcotic formulation (Methadone) was touted as a safer alternate to heroin Also more addictive..

21 Got a Headache?

22 How About a Little Heroin for your cough?

23 We make fun of such crazy sounding ads, but. It is common for physicians to treat headaches with narcotic based medications. The most powerful cough medicines have narcotics in them.

24 What Came Next? Prescription Pain Pills were then developed Hydrocodone, Oxycodone among others Guess what just AS ADDICTIVE AS THEIR PREDECESSORS!!!!!!!

25 How Common is it? 1 in 5 teens has abused prescription drugs 1 in 3 teens say there is nothing wrong with abusing prescription drugs every once in a while More than 10% of high school students have admitted to using a Rx drug once or more times without a Doctors Rx in the last 30 days

26 Myth #1:Prescription drugs are safer than illicit drugs after all, it is just a doctors prescription NOT TRUE!!! Prescription Narcotics are broken down and used by the brain like any other narcotic Your body treats all narcotics the same

27 Josh s doctors were aware of his addiction problem and continued to prescribed him narcotic drugs. At the age of 22, Josh was prescribed OxyContin after a back injury. He got hooked and overdosed three times, before a he took a combination of three drugs prescribed for him that killed him -one day before his 25th birthday.

28 There is no chemical difference between prescription narcotics and Heroin. Period. The difference is the delivery mechanism.

29 Myth #2: If I take what s prescribed, I won t get hooked Also incorrect Our bodies are very efficient and over time stop making the natural pain relievers (Called endorphins) if we take extra opiate medications. It takes up to 2 weeks for the brain to become fully restocked on natural opiates after stopping the extra medication This is what the physical addiction comes from, and the withdrawl.

30 Stairway to Heroin. A little pill won t get me hooked More than 80% of heroin users first start with prescription narcotics, then progress to heroin mostly due to cost Most heroin users start snorting or smoking, almost all progress to mainlining or intravenous use also due to cost savings

31 Short Term Effects of Opiates

32 Effects: IMMEDIATE HARM: The initial effects of heroin include a surge of sensation a rush. This is often accompanied by a warm feeling of the skin and a dry mouth. Sometimes, the initial reaction can include vomiting or severe itching. After these initial effects fade, the user becomes drowsy for several hours. The basic body functions such as breathing and heartbeat slow down.

33 Within hours after the drug effects have decreased, the addict s body begins to crave more. If he does not get another fix, he will begin to experience withdrawal. Withdrawal includes the extreme physical and mental symptoms which are experienced if the body is not supplied again with the next dose of heroin. Withdrawal symptoms include restlessness, aches and pains in the bones, diarrhea, vomiting and severe discomfort. The intense high a user seeks lasts only a few minutes. With continued use, he needs increasing amounts of the drug just to feel normal.

34 Withdrawal syndrome With physical dependence body gets used to the presence of narcotics, and if the use of narcotics is reduced or stopped, an addict is experiencing withdrawal symptoms which are characterized by: restlessness nervousness, extreme irritability cravings for narcotics pain in bones and muscles nausea urge to vomit diarrhea insomnia hot & cold waves arms and legs twitching

35 Long Term Effects:

36 If You choose to take prescription drugs or use heroin, here s a glimpse into the future:

37 PHYSICAL CONSEQUENCES OF HEROIN External appearance The first time Vein has been arrested for possession of heroin at the age of 28, in Until he has been arrested 6 more times, again because of heroin.

38 External appearance During four and a half years that have passed since Meri s first arrest at the age of 18 in 2009, until February this year, this girl has been repeatedly caught for possession of heroin... During this time, she lost almost 45 lbs.

39 Teeth Complexion Weight loss Eye bags

40 Collapsed veins Abscesses and soft tissue infections, ulcers, possible sepsis complications. In particular, frequent infections at the injection site occur in form of subcutaneous abscess, striking traces of burning veins or swollen and blue hands due to circulation difficulties.

41 Infectious diseases HIV, Hepatitis In addition to bacterial infections, due to use of non-sterile needles, syringes, and risky behavior, transfer of infectious diseases is possible. Heroin addicts are at a higher risk for Hepatitis C and B which attacks the liver and the HIV virus which attacks the immune system.

42 Pulmonary diseases, liver, kidney and brain damage Pulmonary diseases include various types of pneumonia and tuberculosis which may occur due to addicts poor health condition and the depressive effects of heroin on respiratory system. Liver, kidney and brain damage, blood vessel occlusion that can lead to several complications and death. These problems occur because of toxic impurities mixed with narcotics in order to increase the weight.

43 Overdose and death High dose of narcotics reaches the brain and cannot be eliminated by existing physiological body capacities. Respiration is compromised as well as maintenance of blood pressure, heart rate and regulation of body temperature. In one word, all vital functions of the body are being endangered and can cause death.

44 How about just trying it once? From the day I started using, I never stopped. Within one week I had gone from snorting heroin to shooting it. Within one month I was addicted and going through all my money. I sold everything of value that I owned and eventually everything that my mother owned. Within one year, I had lost everything. I sold my car, lost my job, was kicked out of my mother s house, was $25,000 in credit card debt, and living on the streets of Camden, New Jersey. I lied, I stole, I cheated. I was raped, beaten, mugged, robbed, arrested, homeless, sick and desperate. I knew that nobody could have a lifestyle like that very long and I knew that death was imminent. If anything, death was better than a life as a junkie. alison

45 Emily, only eighteen years of age and three days from her first day in college, was killed accidentally when she consumed OxyContin that had been prescribed for a relative. Emily was not an experienced drug user, and all it took was one encounter with this drug. She had no chance to learn from this onetime experience. Had she any idea how deadly this drug was, she would still be alive.

46 Patrick Stewart died at 24 years of age after ingesting just one OxyContin. He had no other drugs in his system and only a small amount of alcohol. He made the tragic mistake of believing someone at a 4th of July celebration when he was told that OxyContin was "sort of like a muscle relaxant, that it was prescription and FDA approved, so therefore safe". Close friends say that Patrick had never before taken an OxyContin, did not know it was equivalent to "heroin in a pill".

47 No one plans on becoming a Heroin addict. AKA- You don t have to be a toothless, scab-covered, homeless dirtball to use heroin,--- but if you do choose to use it, there s a good chance you ll end up one.

48 My Experiences as an ER Doc Next Door at Oconomowoc Memorial over the past 14 years No Boundaries gender/age/race/socioeconomic class Once it gets started it, it often can t be stopped It is like a vampire, it can t come in unless you invite it.

49 In Waukesha County, you are statistically more likely to die of an opiate overdose than a car accident

50 Contributing factors to Opiate/Rx Drug Abuse Shift in past 10 yrs--a Perfect Storm---Govt. Regulation National shift for regulation encouraging better pain treatment Pain was thought to be under treated Medical reimbursement tied to pain scale and Pain as the 6 th vital sign Emphasis on patient satisfaction

51 Contributing factors to Opiate/Rx Drug Abuse Shift in past 10 yrs--a Perfect Storm---New Formulations New Formulations of Narcotic Medications Long acting, highly potent opiates that could be easily crushed and abused Advertising for these meds Used to use long acting opiates for end-stage cancer pain only, now used for chronic pain syndromes

52 Contributing factors to Opiate/Rx Drug Abuse Shift in past 10 yrs--a Perfect Storm--- Supply Huge increase in supply of high grade, highly potent at rock bottom prices Since war on terror, up to 90% of world s heroin comes from Afghanistan Used to see 20% purity, now seeing 80% and higher on streets dosing/overdosing is a huge problem with inconsistency

53 Contributing factors to Opiate/Rx Drug Abuse Shift in past 10 yrs--a Perfect Storm---Cultural Factors Little tolerance for discomfort by patients Physicians are compassionate, and want to alleviate suffering Lack of willingness to put the necessary hard work in to fully heal (I just want a pill to feel better) Human drive for intoxication goes back into antiquity

54 What is being done? Prescription Drug Monitoring Programs

55 What is being done? Regional and national awareness of what an epidemic problem prescription drug and heroin abuse has become Comprehensive State plans to battle the epidemic --National Governors Association Best Practice Policy Academy for Reducing Prescription Drug Abuse

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57 Sibling Speaks-Emma Pond---sister of Dan Pond

58 The Opiate Epidemic Chris Gleason, MA, CAADC, MAATP Director Rosecrance McHenry County

59 The current state In 2011, 4.2 million Americans aged 12 or older (or 1.6 percent) had used heroin at least once. An estimated 23 percent of individuals who use heroin will become dependent on it (NIDA). Illinois and Wisconsin are among the many states whose drug-related deaths outnumber motor vehicle related deaths.

60 The current state According to the University of Michigan, in 2010 the following percentage of students in our nation had abused prescription drugs for nonmedical purposes in the last year. Vicodin - 2.9% of 8th graders, 6.7% of 10th graders, and 10% of 12th graders Oxycontin - 2.1% of 8th graders, 3.6% of 10th graders, and 4.7% of 12th graders According to NIDA 2012, heroin use sky-rocketed in 2012:.1% of year olds,.8% of year olds and.2% of 26- older year olds used heroin.

61 Implications According to NSDUH Report According to the Substance Abuse and Mental Health Services Administration s (SAMHSA s) National Survey on Drug use and Health, 23.5 million people 12 years of age and older needed treatment for an illicit drug or alcohol abuse problem in 2009 An overwhelming 93 percent of young adults in NEED of treatment did not believe they actually needed it!

62 Effects Of Heroin Immediate a rush, accompanied by a warm flushing of the skin, dry mouth and heavy feeling in the extremities, slowed breathing, slowed cardiac function, suppression of pain, clouded mental functioning Long-term may transmit diseases such as HIV and hepatitis, collapsed veins, infection of heart lining and valves, tuberculosis

63 How Do I Know? Duration Euphoria sets in within seven seconds (intravenous injection), two to five minutes (intramuscular injection) or 10 to 15 minutes (sniffed or smoked). The high lasts from 10 to 30 minutes. Euphoria is followed by lethargy, sleepiness and apathy.

64 Questions and Myths Can I get addicted the first time I use heroin? Why do people get sober and then relapse? Are prescriptions as dangerous as heroin? Can you die from heroin withdrawal? Can you just quit heroin? Why here, why now? What can we do?

65 Barriers to engaging in treatment Presence of pain Suboxone works well with pain issues often not addressed in traditional opiate addiction treatment. As Suboxone accesses the same receptors of traditional narcotic medication (TIP 43) Addressing barriers do not need to solve barriers, simply addressing this is sufficient relates to empowerment and client responsibility

66 Treatment approaches Address barriers to treatment engagement Address possibility of prior negative treatment experiences Address issues related to pain Address stigma issues

67 Treatment considerations for counselors Client is the expert Encourage client ownership (empowerment) Skill development Focus on application of skills Education on medically assisted treatment options

68 Overdose Prevention Importance of education on: Change in tolerance Danger of heroin in area Discussion of Narcan Importance of ongoing recovery support Importance of continuing with doctors if medication has ben prescribed.

69 Key Points If in doubt, call. Rosecrance is here to help, if you are not sure if someone you love is abusing heroin or any other substance, call us, we can help. This epidemic is not going away This situation will not go away anytime soon and it will likely get worse before it gets better. We all will have to work together if we are to push this epidemic out of our community. There is Hope While the situation is not a happy one, success stories continue to occur. There is hope

70 Resources Heretohelp.com NIDA website SAMHSA TIP 43 and TIP 40, available through the Department of Health and Human Services SAMHSA website, including Diversion and Abuse of Buprenorphine: Final Report SAMHSA Overdose Prevention Tool Kit Suboxone.com

71 For information contact: Chris Gleason Director McHenry County 422 Tracy Court Crystal Lake, IL Phone:

72 AT LAST * Pictures of individuals in this presentation are for illustration purposes only. These pictures portray models and are not pictures of actual clients of Rosecrance. No inference should be made, or is implied, that the pictures used here are of individuals connected in any way to Rosecrance or to its affiliates or programs.

73 Ashley Herbst Road to Recovery

74 Metropolitan Drug Enforcement Unit Trends in Drug Abuse Captain Frank McElderry/ Detective Chris Kohl

75 Social Media Stress

76 Prescription Drugs Diverted Pharmaceuticals Oxycodone Oxycontin most prevalent Hydrocodone Hydromophine Methadone

77 Prescription Drugs Ranks as the second highest threat in our region. More Americans abuse prescription drugs than the number of Cocaine, hallucinogen, Heroin, and inhalant abusers combined. According to a DEA Milwaukee District Office, 2012

78 Prescription Drugs The increase in abuse of prescriptions has increased the most in the younger age groups. There are many reasons kids are abusing prescription drugs: Think the drugs are safe since the are medicine. Don t think the drugs are addictive.

79 Prescription Drugs More overdose related deaths from prescription drugs than any illegal street drug.

80 Opioid Painkiller Prescriptions Each day, 46 people die from an overdose of prescription painkillers* in the US. Health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills.

81 What might be causing this? Health care providers in different parts of the country don't agree on when to use prescription painkillers and how much to prescribe. Some of the increased demand for prescription painkillers is from people who use them nonmedically (using drugs without a prescription or just for the high they cause), sell them, or get them from multiple prescribers at the same time.

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83 Waukesha County Drug Related Deaths Waukesha County Medical Examiner s Office

84 Heroin Drug Threat Heroin Heroin deaths Record Number of Overdoses

85 The Addict Heroin is extremely addictive and deadly. Todays Heroin is much more pure than the dirty drug of the 60 s and 70 s. Heroin users are using a recreational mentality. Addicts will do almost anything to get their next high. Chasing the Dragon Burglaries, thefts, robberies, have all been linked to addicts looking for a way to get their next high.

86 What should you be looking for? Dirty and clean needles. BE CAREFUL!!!!! They don t care if you get poked! Tourniquets. Large rubber bands. Tin Foil/ Cotton balls / Baggies Missing or Dirty Spoons Alcohol wipes and sterile water Most of these items will be together in a Kit but not always.

87 The Heroin Kit

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89 Where does the paraphernalia come from? Pharmacies. Walgreens, etc. Convenient stores Anywhere a Diabetic can get supplies. ARCW (Aids Resource Center of Wisconsin) AKA Needle Exchange.

90 Needle Kit

91 ARCW (Aids Resource Center of Wisconsin) ARCW operates LifePoint in 11 cities throughout Wisconsin. LifePoint includes one-for-one exchange of used needles for new ones, as well as referrals for drug treatment, an overdose prevention program, and HIV and Hepatitis C testing, education, and risk reduction counseling. LifePoint is conducted through a fleet of vans that visit over 20 exchange sites at community locations convenient to participants. For more information about HIV, Hepatitis C, and STDs visit:

92 Used Paraphernalia

93 Continued. Wearing long sleeves when it s hot outside. Bruising on the arm at the elbow joint or forearm. Absence of bruising does not rule out use. Many addicts snort and /or smoke Heroin.

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95 Heroin Danger with Heroin use is lack of control. Heroin can range from 7% to 80% purity. This lack of control of purity can result in hot shots of Heroin. Overdose from the hot shot dose because the purity is too high.

96 Bought February, 2014

97 Corner cut packaging 2 GRAMS = $300.00

98 Dubs ($20 each), AKA bindles

99 Heroin kit from July, 2014

100 Looks are deceiving. $2,000 worth of Heroin. 100 Dubs

101 Heroin is not profitable?????

102 January 29 th, 2013

103 A Family s Journey to Recovery Your Choice

104 Don t be silent Take the next step Scott Bakkum OHS School Counselor AODA Program Coordinator