Rx and Heroin Abuse :Taking Action

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1 Rx and Heroin Abuse :Taking Action Dan Hicks, Manager, Prevention Services November 21, 2014 Page 1

2 Rx Abuse & Heroin: Increasing Awareness Young people are abusing prescription drugs at alarming rates. These drugs act on the same brain systems as illegal drugs and pose similar risks for dangerous health consequences. After marijuana, prescription and over-thecounter medications account for most of the commonly abused drugs among high school seniors. Page 2

3 Rx Abuse & Heroin: Increasing Awareness Page 3

4 Rx Abuse & Heroin: Increasing Awareness Rx Magnets Page 4

5 Local Prevention Efforts Community Forums RX Multi-Agency Workgroup Media Campaigns Education Outreach RX Take Back Day Disposal Bins County-wide Recovery Month Conference Page 5

6 Prescription Drug Abuse: What You Can Do Parent Handouts Page 6

7 RX Billboard Campaign Prescription Drug Abuse Billboard Campaign June 2011 in Ojai on Hwy 33 Page 7

8 Rx & Heroin Abuse: Ventura County RESPONDS The Prescription Drug Abuse and Heroin Workgroup was launched in February 2012 in response to the growing problem of prescription pain medication and heroin Labeled a nationwide crisis and epidemic, reports from professionals and the community - far from immune. Confronting prescription drug and heroin abuse was essential to protecting the public health and safety of all citizens, including youth JOINT EFFORTS Page 8

9 Overview of Countywide Targets for Action

10

11 DATA SUPPORTING ACTION VENTURA COUNTY Selected Data Sources mobilizing LOCAL action State PDMP: C.U.R.E.S. data - ongoing State California Healthy Kids Survey bi-annual Local Medical Examiner/Coroner annual update Local Adolescent Treatment survey new/unique Local Jail Inmate survey new/unique

12 VENTURA S RX DRUG ABUSE WORKGROUP Convened in early 2012, including Alcohol and Drug Programs (ADP) Public Health Department Sheriff s Department County Office of Education County Health Care Agency /Ambulatory Care Subject Matter Experts by invitation Focused on nature and scope of the LOCAL problems KEY: Membership rank- can speak for their agencies

13 DATA-INFORMED STRATEGIES 1. LOCAL MATTERS! data speak to your needs, and community direction 2. USE MULTIPLE INDICATORS use PDMP and other sources; see our Ventura County Responds report 3. PARTNERSHIP MAKES THINGS POSSIBLE examples: custom survey administration in jails; data sharing agreements, mining existing data

14 Accidental Deaths From WITH BREAKOUT CATEGORIES

15 TARGETS FOR ACTION 1: Professional Development 2: Enforcement and Security 3: Education and Awareness 4: Safe Schools 5: Prevention Policy and Research

16 Rx & HEROIN ABUSE: Ventura County RESPONDS TARGET 1: PROFESSIONAL DEVELOPMENT GOAL: Expand professional training and development opportunities across all sectors. 16

17 Rx & HEROIN ABUSE: Ventura County RESPONDS ACTIONS 1.1 Prescriber Training Problem: Low utilization of PDMP among prescribers locally. Local Action: Training for Health Professionals (DDS, RN, MD) Case Example: Elinore McCance-Katz, MD, PhD, Chief Medical Officer, Substance Abuse and Mental Health Services Administration (SAMHSA), presented one of the first in a projected series of health care professional trainings, What Every Prescriber Should Know About Addiction to Pain Medicines.

18 Rx & HEROIN ABUSE: Ventura County RESPONDS ACTIONS 1.1 Prescriber Training (cont d) Problem: Limited opportunities for facilitated enrollment in CURES Local Action: C.M.E. events, Grand Rounds, physician registration Case Example: Medical Director for Behavioral Health hosting medical education with emphasis on importance of CURES, and value added opportunity for real-time registration by attendees

19 Rx & HEROIN ABUSE: Ventura County RESPONDS Health care professionals who prescribe...are in a key position to balance the benefits of prescribing opioid analgesics to treat pain against the risks of serious adverse outcomes including addiction, unintentional overdose, and death. Opioid misuse and abuse, resulting in injury and death, has emerged as a major public health problem. Appropriate prescribing practices and patient education are important steps to help address this public health problem. FDA Blueprint for Prescriber Education, 2013 In Ventura County, we believe LOCAL ACTION matters

20 Rx & HEROIN ABUSE: Ventura County RESPONDS TARGET 2: ENFORCEMENT & SECURITY GOAL: Support law enforcement, monitoring and security to enhance public safety by deterring drug misuse, abuse and diversion.

21 Rx & HEROIN ABUSE: Ventura County RESPONDS ACTIONS 2.1 Safe and Secure Rx Disposal Safe and confidential Rx disposal bins now actively used and supported by law enforcement in all 10 cities across the county. Board Supervisors raised local standard by unanimously declaring Every Day is Take Back Day in Ventura County.

22 Rx & HEROIN ABUSE: Ventura County RESPONDS Ventura County Board of Supervisors declaration: Every Day is Take Back Day

23 Rx & HEROIN ABUSE: Ventura County RESPONDS 2.3 Ventura County Interagency Pharmaceutical Crimes Unit Problem: Illegal prescribing of Rx opioids at the local level Local Action: Established Pharmaceutical Crimes Task Force, Ventura County Sheriff s Office (VCSO), the Ventura County Pharmaceutical Crimes Unit includes members of law enforcement from VCSO, Simi Valley PD, DA s Office, others. Case Example: The main mission of the task force is combating the transfer of legal medication to the illegal market. * Fifty-four arrests were made in the first six months * 120,000 pharmaceutical pills seized * CURES records important to several recent MD investigations * More than 60 search warrants, with $1.5 million+ in assets seized

24 TARGETS FOR ACTION PDMP value begins with prescriber policies, and grows local and even regional inter-agency cooperation. The Ventura County Interagency Pharmaceutical Crimes Unit, in conjunction with LA County Health Authority Law Enforcement Task Force (HALT) and the California Medical Board, concluded five month investigation into a pill mill. Detectives learned of this criminally operating medical clinic through a tip from a local Simi Valley pharmacist. The had previously contacted every pharmacy in Ventura County during the Summer of 2013 and made them aware of the task force. One Case: Doctor Shopping, MDs at clinic investigated, 3,000+ scripts written in name of 1 doc, 5 arrests

25 Rx & HEROIN ABUSE: Ventura County RESPONDS TARGET 3: EDUCATION & AWARENESS GOAL: Increase outreach and education for parents, patients and the public to raise awareness of prescription drug and heroin abuse problems and solutions.

26 Rx & HEROIN ABUSE: Ventura County RESPONDS 3.2 Drug Disposal Campaign A multimedia campaign on the importance of safe and secure drug disposal was directed to the public from a variety of angles, including a billboard on CA Highway 33, newspaper and radio ads, medicine chest reminder magnets, clinic posters and brochures. Concurrent outreach to real estate professionals warned of the risks of medicine chest thefts during open houses.

27 Rx & HEROIN ABUSE: Ventura County RESPONDS 3.4 Ventura County s Rx Drug Abuse Summit More that 240 local treatment and prevention professionals, healthcare experts, law enforcement, policymakers and other key stakeholders learned about CURES and local strategies.

28 Rx & HEROIN ABUSE: Ventura County RESPONDS TARGET 4: SAFE SCHOOLS GOAL: Collaborate with schools, PTAs and Ventura County Office of Education (VCOE) to increase communication channels and prevention opportunities for teachers, parents, students and school personnel.

29 Rx & HEROIN ABUSE: Ventura County RESPONDS 4.2 Teacher Education Teachers are vital for educating students about substance abuse. A Working Together insert was developed especially for teachers as a companion to the What You Need to Know About Rx Abuse and Heroin brochure. The materials help teachers deliver concise prevention messaging to students at the most teachable moments.

30 Rx & HEROIN ABUSE: Ventura County RESPONDS 4.4 Systematic School-based Data Collection The data collected from youth through surveys administered in schools provides invaluable information for effective collaborative prevention efforts. The Rx Workgroup will continue support of systematic school-based data collection and reporting, like the California Healthy Kids Survey, to gauge the prevalence of prescription drug misuse and heroin abuse among students in Ventura County. LIFETIME USE BY VENTURA COUNTY STUDENTS: 14% of 9th graders and 20% of 11th graders reported misusing Rx painkillers 4% of 9th graders and 5% of 11th graders reported using heroin California Healthy Kids Survey, Ventura County

31 Rx & HEROIN ABUSE: Ventura County RESPONDS TARGET 5: PREVENTION POLICY & RESEARCH GOAL: Expand Advance continued research and data analysis to develop key policy actions addressing Rx and heroin abuse.

32 Rx & HEROIN ABUSE: Ventura County RESPONDS 5.1 Tracking Local Data To better understand the prevalence and impacts of prescription drug and heroin abuse in Ventura County, relevant multiagency data from 2008 through 2012 were collected and analyzed. By developing an established baseline, the Rx Workgroup was able to create a tracking tool for ongoing monitoring, analysis and shared reporting of abuse trends over time. CURES data, in combination with local data, are now being used to: plan educational interventions, measure progress and plan new Targets for Action.

33 Rx & HEROIN ABUSE: Ventura County RESPONDS 5.2 Special Local Research HIGHLIGHTS 32% of respondents reported heroin use in their lifetime. Of those who reported lifetime heroin use, 45% indicated beginning with Rx opioids, then moving to heroin. Transition from prescription-type opioids to heroin was highest among the respondents in younger age groups. Of respondents who ever misused Rx opioids, 61% bought or received them from a friend or family member.

34 Rx & HEROIN ABUSE: Ventura County RESPONDS 5.4 Legislative Analysis Active legislative analysis and reporting help inform and shape some Target Actions. EXAMPLE: Rx Workgroup carefully followed the recent introduction, amendments and approval of CA Senate Bill 809 establishing CURES database funding and expansion. Improvement of CURES will, in turn, advance Workgroup s goal to improve data links between physicians, pharmacists and law enforcement, ultimately benefitting public safety.

35 Rx & HEROIN ABUSE: Ventura County RESPONDS 5.5 Future Policy Actions New policies and projects being studied and considered by the Rx Workgroup include: - Enhanced E.R. and ambulatory care opioid prescription policies to patients and the public; - Pharmaceutical product stewardship; - Overdose education and prevention programs; and - Drug-impaired driving;.

36 Rx RISK: Prescribers Portal In our Rx RISK: Prescribers Portal we provide links to our resources and materials that may be used to inform patients and staff about the problems and prevention of Rx misuse. Page 36

37 Working together to Prevent Opioid Abuse For Health Care Providers: Screen for addiction risk factors See Opioid Risk Tool, etc. Note symptoms of abuse Whenever possible, report to CURES Use tamper-resistant Rx pads, support anti-diversion w LE Report lost or missing Rx pads Consider smaller quantities of drugs with abuse potential Rx abuse prevention signage in exam rooms (we have it!) If you suspect abuse, say no to addictive drugs Promote safe Rx use and secure disposal Advocate for increasing CEU credit for prescribing training Page 37

38 VCkidsFYI: Text News for Parents Page 38

39 VCkidsFYI: Text News for Parents Free text message updates about: TEENS DRUGS ALCOHOL Get the facts. Keep kids safe. Page 39

40 Overdose Prevention and Rescue Project Overdose Prevention Programs Make drug user health, safety & survival a priority Educate family, friends and loved ones about overdose prevention Have saved lives Nationally From , more than 53,000 individuals trained to respond 10,171 overdose reversals reported during this time Majority of individuals trained are drug users, esp those leaving jail 60 programs distributing naloxone (at 200 sites) in 18 US states In 2012, 55% of naloxone distributed was injectable; 45% intranasal Locally Launched pilot program in October 2014 Focus only on groups at elevated risk, small scale, required training Local data will inform pilot, and be used for outcome evaluation

41 Overdose Rescue Project & Naloxone Distribution You Can Save a Life. Some signs of an overdose: Breathing slowly or not at all Unconscious Lips are blue Call 911 Immediately Overdose is most common when: Tolerance is low after not using opioids (after jail or detox) Drugs are mixed especially with alcohol or benzos Resistance is down due to sickness or other health issues Using alone.

42 Rx Abuse & Heroin: ADP Treatment Services Range of outpatient treatment services designed to help individuals coping with a substance use disorder Our services include screening, crisis intervention, individual, group and family counseling, HIV education, assessment and evaluation, referrals to communitybased services, and outreach to the community We serve the entire County. Clinics located in Oxnard, Ventura, Fillmore and Simi Valley. Specialized programs for pregnant and parenting women, adolescents, and cooccurring disorders Page 42

43 ADP Youth Services Programs Evidence-Based Curriculum Multi-lingual staff & programming Evidence-based treatment model State certified Alcohol & Drug Counselors Licensed staff Therapist referrals Licensed Drug Medi-Cal provider Page 43

44 ADP Youth Services Programs What We Offer Prevention, education & intervention Screening, assessment & referral Drug testing Access to detoxification referrals Joint agency collaboration with mental health services Crisis mental health emergency services Collaborative inter-agency team approach On-site HIV testing and counseling Residential treatment referrals Page 44

45 3 steps to get help Page 45

46 Adult, Youth & Women s Services Page 46

47 Contact Us ADP Outpatient Locations A New Start for Moms, 1911 Williams Drive, Suite 140, Oxnard Fillmore Center, 828 Ventura Street, Suite 250, Fillmore Oxnard Center, 1911 Williams Drive, Oxnard Simi Valley Center, 3150 E. Los Angeles Avenue, Simi Valley Ventura Center, 24 East Main Street, Ventura Page 47

48 Contact Us Our ADP Programs & Services Adult Services Youth Services Women s Services - A New Start For Moms Driving Under the Influence (DUI) Program Prevention Services Website: VenturaCountyLimits.org venturacountylimits.org/ Page 48

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