THE PRESCRIPTION DRUG AND OPIATE ADDICTION EPIDEMIC IN SOUTHERN ILLINOIS

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1 Community Behavioral Healthcare Association of Illinois Frank Anselmo, MPA Chief Executive Officer 3085 Stevenson Drive, Suite 203 Springfield, Illinois Phone: 217/ Fax: 217/ THE PRESCRIPTION DRUG AND OPIATE ADDICTION EPIDEMIC IN SOUTHERN ILLINOIS A Call for Community Health Solutions OCTOBER 2014 A report by The Community Behavioral Healthcare Association of Illinois

2 Executive Summary Introduction I came home one day in 2006 to find my two sons, ages 21 and 23, dead from an overdose of prescription drugs and heroin. One of my sons was a Valedictorian of his high school and the other was a 3 year air force veteran, stated Chris Marler, a parent advocate and a resident of Centralia, Illinois. Ms. Marler made this statement as the opening speaker of a forum held in Mt. Vernon, Illinois on August 8, titled THE PRESCRPITION DRUG/OPIATE ADDICTION EPIDEMIC IN SOUTHERN ILLINOIS: A Call for Community Health Solutions. The forum was organized in response to the prescription drug abuse and opiate addiction crisis in communities throughout Southern Illinois. The main focus of the forum was to begin a dialogue for a regional action plan to address the problem. This report provides an overview of the issues and recommendations that were presented and agreed upon at the forum. The increasing abuse of prescription drugs and opiate addiction, which includes heroin, across the United States, has caused the U.S. Department of Justice to declare it an urgent and growing public health crisis. Prescription drugs are the second most illicit drug among persons 12 and older after marijuana. The Southern Illinois region or the lower 33 counties have not been spared from this crisis and is most like other communities in the United States that have seen an significant increase in drug related deaths, arrests and other and familial problems as a result of increase use of prescription drugs and opiate addiction. Addiction to prescription medications, heroin and other opiates including certain prescription pain killers is impacting the lives individuals from every background and walk of life. Purpose of the Report During the March 2014 monthly meeting of the Southern district members of the Community Behavioral Healthcare Association of Illinois (CBHA), members discussed holding a legislative forum on an issue that was affecting the southern district. After a brief discussion, there was totally agreement as each member talked about how their behavioral healthcare agency was experiencing a significant increase in the number of individuals seeking treatment for prescription drug abuse and heroin addiction. The discussion also included a need to have a coordinated regional response to the problem similar to the response the rallied around when experiencing the methamphetamine crisis over 10 years ago. The CBHA members decided to hold a forum that would include all sectors of the, including a representative of the Illinois Heroin Crisis Legislative Taskforce. On Friday, August 8, 2014, CBHA and co sponsor SIU s Center for Rural Health and Social Service Development held the forum at Crossroads Hospital in Mt. Vernon, Illinois. The event was attended by 75 individuals, representing the state police, the courts, behavioral health providers, state probation, schools, teachers, parents, state mental health and substance use divisions, physicians, consumers and local media outlets. The forum was the first step towards developing a regional action plan focused on understanding the depth of the prescription drug abuse and heroin addiction problem in Southern Illinois and developing a strategy to address the problems. The information included in this report was derived from the forum attendees who included: a panel of experts, stakeholders and a survey that was completed by the attendees at the end of the event. This report will seeks to reveal the extent of the prescription drug abuse 2

3 and heroin addiction problem in the lower 33 counties of southern Illinois and offer recommendations. This report will be available to the public and offered to the Illinois Heroin Crisis Legislative Taskforce as they develop statewide solutions o address the epidemic. Key Findings From the August 2014 Community Forum 1. Mr. Tom McNamara, a forum panelist and retired Illinois State Policeman is nationally recognized for his work on narcotic enforcement. He discussed the increase amount of heroin entering southern Illinois over the last several years. State police are seeing an increase in purity of heroin at 30% compare to 5 7% in the 70s and an increase number of heroin related arrests. 2. All of the substance use treatment providers in attendance have seen a significant increase in individuals seeking treatment for opioid prescription drug abuse and heroin addiction. One provider reported a 300% increase over the last 2 years 3. According to Wendell Arms, a panelist and Director of Substance Use treatment at Comprehensive Connections, Heroin is the #1 drug of choice for people y/o. 4. Dr. Micahel Blain, another panelist and Board Certified physician in Family Medicine who specializes in Addiction Medicine, informed the forum attendees that his 5 year addiction medicine practice in Eldorado, Illinois has also seen a significant increase in patients seeking treatment for opioid addiction. 5. According to Mr. McNamara, individuals are switching to heroin because of the high cost of some prescription drugs. For example 1 80 mg oxycontin pill cost $60 dollars compared to $7 $10 dollars for a bag of highly potent heroin. 6. According to Sgt. Jonathan Edwards of the state police, southern Illinois is a targeted distribution area for heroin and prescription drug trafficking. Sgt. Edwards also stated that the region would be well served to track doctors RX practices to flag those dispensing significant amounts of prescription pain killers. 7. According to Randy Malan, administrator in state s Prescription Drug Monitoring Program (PDMP), the state of Illinois has a very effective PDMP, however the program is voluntary and does not require physicians to query their current or prospective patients. 8. Mr. Malan stated that opioid use in Illinois increased 43% from 1999 to Dr. Balin reported that during the weekend of August. 1 3, 2014, the hospital emergency room where he was the attending physician saw 4 overdoses on opiates. 10. Ms. Chris Marler, a parent advocate and one of the forum panelists, believes that most parents were like her, uneducated about the signs and symptoms of drug use, abuse and dependency. 3

4 Key Recommendations Effective solutions will require acting on advice from public health, clinical and legal experts, and forging partnerships across federal, state and local governments, healthcare providers, the healthcare and benefits industries, pharmacies, schools and universities, and employers. a) Expand Public Education/Awareness & Build Community Partnerships i) Increase Public Education Efforts ii) Build Community Partnerships, including faith based organizations, courts, providers, police, schools, etc. to develop a Regional Action Plan iii) Expand Programs to Enable Proper Disposal of Prescription Drugs iv) Promote efforts to increase the availability of naloxone in the as a safe antidote for opioid overdose v) Support Good Samtarian Laws b) Increase Access to Substance Abuse Treatment i) Support measures to increase funding and capacity for addiction treatment, especially increasing the number of detox, residential beds and the number of Medication Assisted Treatment programs ii) Leverage HIT to improve clinical care and reduce abuse iii) Expand the Screening, Brief Intervention and Referral to Treatment (SBIRT) iv) Expand Insurance Coverage of Substance Abuse Services v) Fund and expand Drug Courts vi) Continue efforts to integrate drug abuse treatment and primary care c) Ensure Responsible Prescribing Practices i) Provide Education for Healthcare Providers ii) Increase Regulation of Pill Mills aimed at Interventions iii) Track Prescriber Patterns iv) Make Rescue Medicines More Widely Available (such as naloxone) v) Train 911 operators to help callers use naloxone on overdose patients to help their odds of surviving. vi) Ensure Patients Receive the Pain Medications They Need; Do not Over Prescribe d) Improve Prescription Drug Monitoring Programs i) Encourage the state to Utilize PDMP to Improve Access to Substance Abuse Services ii) Ensure PDMP Operate Efficiently and Effectively iii) Link PDMP to Electronic Health Information Exchanges and EHRs iv) Provide Needed Resources for improving PDMP e) Support Law Enforcement efforts i) Support police, probation officers and others in the criminal justice system efforts to address the supply side of the prescription drug and heroin problem ii) Educate police, probation officers and others in the criminal justice system about the nature of addiction so that it becomes a treatment issue instead of merely a law enforcement issues iii) Support law enforcement role in their efforts to reduce overdose deaths 4

5 Appendix 1 Post Forum Questionnaire What Can We Do about Prescription Drug Abuse and Opioid Addiction in Southern Illinois? N=50 Do you agree or disagree with the statements below? o Tougher punishment will discourage people from using and selling drugs. 62% Disagree o Drug abuse is an illness to be treated, rather than a crime to be punished. 96% Agree o The public is generally unaware of the dangers of nonmedical prescription drug use. 88% Agree o We should focus on reducing the demand for drugs rather than trying to stop the supply. 82% Agree Do you favor or oppose the following actions? o Register all prescriptions through drug database 84% Agree o Require drug screening tests in workplaces 78% Agree o Raise funds for more treatment options in the county 98% Agree o Increase law enforcement efforts. 88% Agree o Increase drug awareness messages in communities. 100% Agree o Increase drug education in schools 98% Agree o Create group homes for recovering drug abusers 96% Agree Are you concerned about the following? o There are too few drug abuse prevention programs 92% Agree o Some people think prescription drugs are relatively safe. 98% Agree o Laws for punishing drug dealers are not tough enough 88% Agree o Laws for punishing drug users are not tough enough 58% Agree 32% Disagree o Costs to the taxpayers for fighting drug use are too high 74% Agree o It's too easy for drugs to come into our county. 100% Agree o There is too much sharing of prescription drugs 100% Agree 5

6 What is the best idea, program or practice you heard in the forum today? Overdose Prevention Program Physician s Suboxone Program and Medication Assisted Treatment Get Naloxone into the Educate families and the Narcon Availability All stakeholders need to work together Educate the clergy All parties need to work together to address the problem human service providers, police, schools, hospitals, businesses, legislators, probation, courts, churches, etc Prescription Drug Monitoring Program Personal Testimony by the parent and persons in recovery Training for first responders Addiction is a chronic treatable illness. Understanding the medical and psychological aspects of addiction. Harm Reduction Methods Seek out the largest voice to lead the effort to educate the public What can you do personally to discourage prescription drug abuse in the? Educate the about substance use and to reduce stigma Advocate for Change and resources Encourage alternate ways to manage pain Encourage lock boxes for prescription drugs Reach out to the local faith based Identify patients and connect them to care What should your do about this issue? Develop ways to educate people Work together to find solution to in the about the problem prescription drug and opioid addiction Develop more positive programs and drug education programs for youths Organize more local town hall meetings to get the all stakeholders involved Develop more drug prevention program, especially to youths Establish drug prevention/education curriculum for schools Enforcement of proper drug disposal Monitor drug use in your Create a hotline Local governmental agencies should Develop coalitions and action plans to address the problem Utilize volunteers to educate the 6

7 What policies local, state or national should be changed or implemented to prevent or treat prescription drug abuse? Develop more Diversion Programs Establish new rules policies to make it easier to access drug treatment Mandate more education for medical professionals, ie, doctors and hospitals More oversight on doctors who over prescribe opioid prescriptions Increase state and local funding for drug treatment, in particular detox and residential programs Monitor physicians dispensing habits Require laws for pharmacies to check IDs for over the counter and prescribed drugs Tougher penalties for drug trafficking Involuntary treatment for substance abusers More resources the Prescription Drug Monitoring Program Change old and outdated drug treatment policies. ie 28 days of residential treatment, need for more recovery services Establish policies that would force doctors and probation to work together Establish more Drug Courts Reduction in manufacturing of some drugs with no efficacy More resources the Prescription Drug Monitoring Program Make drug treatment mandatory for persons arrested with drug problems Establish time limits for certain prescriptions More state funding to educate, doctors, police, courts and schools Develop uniform prescribing procedures for doctors Counties Represented: Williamson, Union, Hamilton. Saline, Jefferson, Jackson, Wayne, Marion, White, Gallain, Hardin, Franklin, Clinton, Washington, Bond, Pulaski, Alexander, Johnson and Massac Resources: National Institute on Drug Abuse Research Report Series on HEROIN 14.pdf U.S. Department of Health and Human Services Addressing Prescription Drug Abuse in the United States: Current Activities and Future Opportunities Centers for Disease Control and Prevention Policy Impact: Prescription Painkiller Overdoses 7

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