Opioids and Heroin in Snohomish County Marijuana and Opioid Prevention Training May 2018
OPIOIDS 101 What are Opioids?
Opioids 101 Opium Poppy Plant Opiates: A type of pain medication that is naturally occurring. Morphine Codeine Semi-Synthenic Opioids: A type of pain medication that is derived from opium and codeine Hydrocodone Oxycodone Hydromorphone Oxymorphone Buprenorphine Heroin Synthetic opioids: Medication that are fully man made Tramadol Fentanyl Methadone
Opioids 101 Prescription Opioids are medication used to treat chronic or acute pain. Commerical Names Street Names Common Ways Taken Oxymorphone (Opana ) Ops, Oxycodone (OxyCon=n, Percodan, Percocet ) Fentanyl (Ac=q, Duragesic, Sublimaze ) Pandas, Stop Signs, Blues, Mrs. O, O Bomb O.C., Oxycet, Oxycotton, Oxy, Hillbilly Heroin, Percs Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, Tango and Cash, TNT Swallowed, snorted, injected Swallowed, snorted, injected Injected, smoked, snorted Hydrocodone (Vicodin, Lorcet ) Vike, Watson-387 Swallowed, snorted, injected Codeine (various brand names) Captain Cody, Cody, Lean, Schoolboy, Sizzurp, Purple Drank With gluteth- imide: Doors & Fours, Loads, Pancakes and Syrup Injected, swallowed (often mixed with soda and flavorings) SOURCES: NIDA hdp://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs
Opioids 101 How Do Opioids Work? Opioids work by binding to opioid receptors in the brain and nervous system. They slow down pain signals to the brain reducing feelings of pain. They release dopamine increasing the feeling of euphoria. pleasure physical & emotional pain https://www.youtube.com/watch?v=ndvv_m CSI
Opioids 101 Continued use Dependence Tolerance Signs of substance abuse: Not able to stop using the substance Drowsiness Shallow or slow breathing rate Nausea, vomiting Constipation Abandoning responsibilities Slurred speech Sleeping more or less than normal Euphoria (feeling high) Irritability Depression Lowered motivation Anxiety attacks.
Opioids 101 Dependence withdrawal if stopped (pain, vomiting, diarrhea, insomnia) Overdose = pinpoint pupils + consciousness & breathing death
THE EPIDEMIC What does the data tell us about opioids in Snohomish County?
Opioid Epidemic An epidemic is a widespread occurrence of an infectious disease in a community at a particular time. 174 people die daily in the US due to a drug overdose 63% of those deaths are due to prescription Opioids or Heroin Source: Center for Disease Control and Prevention, NCHS Data Brief 294, December 2017
Opioid-Related vs. All Drug Overdose Deaths 200 Opioid-Related Deaths Compared to All Drug Overdose Deaths Snohomish County, 2007-2017 180 160 140 120 100 80 60 40 20 0 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 All Drugs All Opioids Source: Washington State Department of Health
Opioid-Related Deaths by Type 160 Opioid-Related Deaths by Type Snohomish County, 2007-2017 140 120 100 80 60 40 20 0 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Heroin Rx Opioids Synthetic Opioids All Opioids Source: Washington State Department of Health
Going from Pain Pills to Heroin Oxycodone Heroin $80+ Courtesy of Dr. Caleb Banta-Green, UW s Alcohol & Drug Abuse Institute $10+
Opioid Overdoses Taken to ER Providence Regional Medical Center Everett, June-Dec 2017 (n=146) 48% Heroin Alone 20% Heroin + Methamphetamine 8% Heroin + Other 8% Own Rx 6% Own Rx + Other 5% Unknown/Other 5% Another s Rx Opioid + Benzodiazepine = 9% (not shown)
What our Youth are Telling Us 10 th graders who don t think drugs are wrong 77 percent of sophomores thought it was very wrong for someone their age to use illegal drugs 1in 4 12 th graders reporting any Heroin use in their lifetime 1 in 30 This is lower than the state average for other high school seniors 8 th graders who are abusing Rx meds 1 in 23 We had 4.4 percent of 13-14 yearolds reporting that they were currently using prescriptions not prescribed to them Source: Healthy Youth Survey, 2016
Risk Factors for Addiction Having depression, anxiety or other mental health issue A personal and/or family history of alcohol or substance abuse A history of physical, mental or sexual abuse Long-term use of opioid pain medication SAMHSA Center for the Application of Prevention Technologies, 2018
Need for Prevention Efforts Psychological and Social Problems Counseling & Social Supports Addiction Opiate Addiction Treatment Medicines Brain Changes and Dependence Courtesy of Dr. Caleb Banta-Green, UW s Alcohol & Drug Abuse Institute
What You Can Do Learn about the problem it s a community problem Overdose knowledge: recognition, call 911, rescue breathing/chest compressions, Narcan/naloxone Reducing stigma/increase awareness Being aware of your/your families medications Building community/sense of connectedness Support recovery
Naloxone/Narcan Training
THE MAC GROUP What is it, and why was it formed?
Timeline of MAC Group The Snohomish County Opioid Response MAC Group began meeting in late-summer 2017 Officially launched on November 20, 2017 Agency representatives meet bi-weekly (Mondays) Updates are shared every other Wednesday Will assess at end of first year (November 2018)
Goals of MAC Group Goal 1: Reduce opioid misuse and abuse. Goal 2: Lessen the availability of opioids. Goal 3: Reduce criminal activity associated with opioids. Goal 4: Use data to detect, monitor, evaluate, and act. Goal 5: Reduce collateral damage to the communities. Goal 6: Provide information about the response in a timely and coordinated manner. Goal 7: Ensure the availability of resources that efficiently and effectively support response efforts.
Snohomish Health District Public Health Efforts
Targeted Outreach and Training for Providers & Prescribers Snohomish Health District 23
Providing Options for Residents to Keep Prescriptions Safe Snohomish Health District 24
We ve Expanded our Needle Clean-Up Kit Pick-Up and Drop-Off Locations 25
What Public Health Is Doing Now Getting Age-Appropriate Opioid Curriculum in the Schools 26
What Public Health Is Doing Now Building Healthy, Resilient Families to Break the Cycle 27
A New One-Stop Resource Portal
Thank You! Pia Sampaga-Khim psampagakhim@snohd.org