Powell Recovery Center

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1 Powell Recovery Center Presentation for The Female Clergy Support Group of MD Powell Recovery Center, Inc. 14 South Broadway Baltimore, MD

2 Community Support is Key to the Success of Community-Based Treatment Garnering community support for involvement in the treatment of opioid dependence is vital in preventing the cycles of drug use within vulnerable populations. (Ethical Use of Psychosocially Assisted Pharmacological Treatment for Opioid Dependence; World Health Organization Technical Development Group) Community-Based Treatment Model for Positive Community Engagement 2

3 Powell Recovery Center Mission Access to treatment - Treatment on Demand for public health clients Delivering high quality, innovative treatment typically for the first 6 months of care. Putting recovery within reach by creating solutions for recovery housing and access to services limited or not reimbursed under Medicaid, especially crisis management Returning value-add to our community

4 Powell Recovery Center Goals for Today Provide information on fentanyl Provide information on Overdose Prevention Provide an overview of community-based treatment and Powell s treatment services

5 Fentanyl A Killer

6 Fentanyl A Killer The man-made opioid is 50 times stronger than heroin and up to 100 times more powerful than morphine. Fentanyl is commonly laced in heroin, causing significant problems across the country, particularly as heroin abuse has increased. Drug cartels and dealers use fentanyl because it is cheaper and more accessible than heroin. Also, because of the potency, customers, when they live, are happy with the resulting product. Fentanyl is a killer -- even at very low levels. Ingestion of small doses can be fatal. Its euphoric effects are indistinguishable from morphine or heroin. The recent overdoses reported have been happening all over Baltimore, not just specific to one location.

7 Fentanyl vs. Carfentanil One million doses of fentanyl would fit in a shoebox. One million doses of carfentanil would fit in a golf ball.

8 Maryland Fentanyl Deaths Source: Jan 2017 WTOP Newscast

9 Changes in Fentanyl Deaths

10 Fentanyl Deaths in Nearly Every MD Jurisdiction, 2015

11 OVERDOSE PREVENTION

12 What does an overdose look like? There are different severities of opioid overdose Ranges from drowsiness/slurred speech to coma & possible death Early signs of an overdose include: Severe sleepiness can t stay awake Slow heartbeat Trouble breathing /Slow, shallow breathing (<12 breaths/minute) or snoring/gurgling Cold, clammy skin may look pale or blue Trouble walking (i.e., stumbling) Slurring words Pinpoint pupils Possible seizures If any of these signs are present, call 911 immediately. NARCAN may be administered while waiting for an ambulance

13 Signs of a severe opioid overdose Vomiting or gurgling noise

14 Do s of Responding to and Overdose Do stay with the person Do call 911 tell them someone is not breathing Do administer Narcan an opioid antagonist or blocker Do initiate CPR Unless instructed otherwise by 911 or person regains consciousness

15 Don t of Responding to and Overdose DON'T slap or try to forcefully stimulate the person it will only cause further injury. If you are unable to wake the person by shouting, rubbing your knuckles on the sternum (center of the chest or rib cage), or light pinching, he or she may be unconscious. DON'T put the person into a cold bath or shower. This increases the risk of falling, drowning or going into shock. DON'T inject the person with any substance (salt water, milk, speed, heroin, etc.). The only safe and appropriate treatment is NARCAN. DON'T try to make the person vomit drugs that he or she may have swallowed. Choking or inhaling vomit into the lungs can cause a fatal injury.

16 How to Get Narcan Baltimore City Residents Obtain your certificate Get your certificate on line at OR Attend face to face training (see schedule at Take your certificate to a pharmacy who stocks Narcan List of pharmacies stocking Narcan can be found at Most Walgreens, CVS, Safeway, and John Hopkins Pharmacies carry Narcan

17 How to Get Narcan Non City Residents Ask your doctor Maryland law allows any healthcare provider who can prescribe drugs in Maryland (including physicians, physician assistants, advance practice nurses, dentists and others) to prescribe naloxone to their patients. Your provider can prescribe you naloxone if: you are personally at risk for opioid overdose if you are likely to witness an overdose and be in a position to respond Maryland Overdose Response Program Visit the ORP website or contact the ORP for more information. NOTE: As of December 14, 2015 : A statewide standing order is now in effect allowing pharmacists to dispense naloxone to ORP certificate holders without a prescription.

18 Identify The Risks That Apply to the Individual I have recently not used in a while and my tolerance may be lowered, meaning I may be at risk of overdose I regularly mix drugs or drugs and alcohol I take prescription medication I don t eat or sleep regularly I use an unfamiliar supply regularly I regularly am along during drug use I am at increased risk due to IV drug use I don t know what to do in the event of an overdose

19 POWELL RECOVERY CENTER TREATMENT AND COMMUNITY ENGAGEMENT

20 Powell Recovery Center & Community Based Treatment Access to treatment - Treatment on Demand for public health clients Delivering high quality, innovative treatment typically for the first 6 months of care. Putting recovery within reach by creating solutions for recovery housing and access to services limited or not reimbursed under Medicaid, especially crisis management Supporting communities fighting the opioid epidemic

21 Powell Recovery Center Clients PRC s typical client presents with severe, chronic heroin dependence, no income, no employment and little history of employment; a high school drop-out, homeless or in a temporary dependence living situation; history of legal involvement due to illicit drug use; limited family resources and single parent family. The typical client is seeking treatment including buprenorphine maintenance for opioid dependence.

22 Abundant Communities to Support Client Recovery On the Block Village Client Services SUD Tx Client NA/AA Self Help Dual Recovery Tx Crisis Housing & Residential

23 Community-Based Services offered by Powell Recovery Center Powell has six buildings on the Broadway Campus providing behavioral healthcare treatment services. Powell receives referrals from hospitals/er, Baltimore Crisis Response, Behavioral Health Systems Baltimore for rapid screening and placement into treatment Churches Substance Abuse Ministries or clergy can also refer congregants for treatment Community-Based Treatment Model for Positive Community Engagement 23

24 Treatment on Demand Our Definition Eligible clients are scheduled for intake assessments for the date they request or within 1 business day of their requested appointment date. Our Goal Eligible clients will be scheduled for intake assessment for the date 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% Treatment on Demand Same Day Within 24 hours Not Met they request. 0% Jan-17 Feb-17

25 Community-Based Services offered by Powell Recovery Center Powell has a full continuum of care: Addiction medicine for alcohol, benzo and opioid withdrawal management/buprenorphine induction and maintenance with behavioral treatment. Crisis management to provide housing, food, personals at admission to stabilize clients. Intensive treatment and residential services that flow seamlessly to less intensive treatment and temporary housing as clients stabilizes in recovery

26 Dual Recovery Services for Rapid Engagement and Stabilization Approximately 50% of Powell s clients have a cooccurring mental health concern. Outpatient Mental Health Clinic for rapid psychiatric medication management and dual recovery behavioral health treatment. Psychosocial Rehab Program to support independent living for clients with additional needs.

27 Powell Recovery Center Treatment Services Gender specific treatment for addictions and dual recovery programs. Adult Sex Education by Planned Parenthood monthly Art and holistic interventions integrated into treatment, especially intensive treatment Phase-based treatment groups as client stabilizes and continues in recovery progress through the treatment phases supports progress Toxicology weekly for all clients onsite to provide structure and rapid response to relapse

28 Powell Recovery Center Crisis Housing PRC currently provides over 300 beds at no cost to clients to support recovery during treatment. PRC manages the housing with a value added ripple effect in the community. PRC hires those in recovery as House Monitors. PRC works with small landlord to support small business. PRC works in neighborhoods impacted by poverty and addiction.

29 Accessing Treatment Powell Appointment Line: Monday through Friday: 7 am to 6 pm Powell Treatment Admissions: Monday through Friday: 8:30 am to 5 pm

30 Kim, Please delete slides after 39 except "How to Access Treatment Services). The presentation is very long, and I want you to be able to cover the information. The group won't really have time to comprehend all the statistics since their knowledge of the subject matter is very limited. Vanessa - Deleted all you marked to delete no sweat will delete additional but slide numbers changed after deletions so not sure I cut everything after slide 39