Patterns of Heroin and Other Substance Use in Youth and Young Adults in Suburban Cook County

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1 Patterns of Heroin and Other Substance Use in Youth and Young Adults in Suburban Cook County 2014 School Nurse Conference Steven M. Seweryn, EdD, MPH April 24, 2014

2 Learning Objectives To become familiar with patterns and trends in heroin and other substance use nationally and locally Identify populations at increased risk for heroin and opiate use

3 NATIONAL CONTEXT: HEROIN AND OPIOID USE

4 US: Trends in Mortality: Drug Overdose vs Motor Vehicle Death Rates Motor Vehicle Traffic Drug Poisoning (Overdose) Deaths per 100,000 population Year NCHS Data Brief, December, 2011, Updated with 2009 and 2010 mortality data 4

5 18,000 16,000 US Overdose Deaths, 2010 Opioid analgesics #1 Heroin #5 14,000 12,000 Deaths 10,000 8,000 6,000 4,000 2,000 0 Drug Class Jones CM et al Pharmaceutical overdose deaths, United States, JAMA 2013 and CDC/NCHS NVSS MCOD

6 OVERDOSE DEATHS: Opioid Analgesic Deaths: 11 years of increases Heroin: Deaths increasing in recent years 18,000 16,000 14,000 Number of deaths 12,000 10,000 8,000 6,000 Opioid analgesics Heroin 4,000 2, Year CDC NCHS/NVSS Mutliple Cause of Death File

7 US: Nonmedical use of opioid analgesics and heroin have increased. SAMHSA NSDUH 2012

8 US: Chronic nonmedical use of opioid analgesics has increased 35 Rate per 1,000 population 12 years old % Increase Days Past Year Nonmedical Use Days Past Year Nonmedical Use Days Past Year Nonmedical Use Frequency of Past Year Nonmedical Use Days Past Year Nonmedical Use Jones, C.M., Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers United States, 2002 Jones 2004 CM. and Frequency of Drug prescription Alcohol pain Depend. releiver (2013), nonmedical use, and Arch Intern Med Sep 10;172(16):1265-7; 8

9 US: Increase in heroin use has occurred among people who were past year nonmedical users of opioid analgesics 700 Number of past year users among persons 12 years old (numbers in thousands) Overall Past Year Heroin Use No Past Year NMU Opioids 1 29 Days Past Days Past Days Past Year NMU Opioids Year NMU Opioids Year NMU Opioids Jones, C.M., Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers United States, and Drug Alcohol Depend. (2013), 9

10 US:18-25 year olds have highest rates of chronic nonmedical use of opioid analgesics and heroin use Past year chronic nonmedical use Past year heroin use Rate per 1,000 population Age Group Jones CM. Frequency of prescription pain releiver nonmedical use, and Arch Intern Med Sep 10;172(16):1265-7; SAMHSA NSDUH Public Use File

11 Increasing number of Emergency Department (ED) visits due to nonmedical use of opioid analgesics and use of heroin 400, , ,000 Number of ED visits 250, , , ,000 Opioid analgesics Heroin 50, Year SAMHSA DAWN ED Public Use Files

12 SUBURBAN COOK COUNTY HEROIN AND SUBSTANCE USE PATTERNS AND TRENDS 12

13 Recent Pattern: Increase in Heroin Deaths among Collar Counties Heroin Overdose Deaths: Collar Counties Will DuPage Kane

14 Suburban Cook County CCDPH: Regional Districts Other: North West Southwest South Skokie HD Evanston HD Oak Park HD Stickney Twnshp HD

15 Suburban Cook County Opiate and Heroin Mortality Cause of Death Drug Poisoning/Overdose Opiate Related Heroin Related * Preliminary Count 2 : 41 Heroin Deaths District North 22 South 6 Southwest 9 West 4 Gender Male 34 Female 7 Age Group Source: 1 - IDPH Death Master Pullfile IDPH Illinois Vital Records System, 2013

16 Emergency Room Chief Complaint Number of Visits by Year Heroin Use Heroin Overdose Source: CCDPH Syndromic Surveillance System (ESSENCE)

17 Emergency Room Chief Complaint Visits by Age Group and Year Heroin Use Heroin Overdose

18 Suburban Cook County Youth Risk Behavior Survey 2010: Proportion of 12 th Graders Ever Tried by Type of Drug Heroin Rx w/out Dr. Orders Marijuana SCC US Cigarettes Alcohol 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Source: Youth Risk Behavior Survey, SCC 2010, US, 2011

19 Illinois Youth Survey 2012 Suburban Cook County Schools* Use in Past Year Substance Used 8th Grade 10th Grade 12th Grade Alcohol 36% 54% 69% Cigarettes 8% 12% 21% Marijuana 12% 28% 41% Any Illicit Drugs (excluding marijuana) 2% 4% 9% Heroin 1% 1% 1% Any Prescription Drugs 3% 5% 9% Prescription Painkillers 1% 3% 5% Over-the-Counter Drugs 3% 3% 4% Source: Illinois Youth Survey, 2012 *School participating: N=110

20 Suburban Cook County Youth Risk Behavior Survey 2010: Proportion of 12 th Graders Used in Past 30 Days by Type of Drug Cocaine 3.8% 3.0% SCC Cigarettes 16.5% 25.1% US Marijuana 26.1% 28.0% Alcohol 49.0% 48.4% 0% 20% 40% 60% 80% 100% Youth Risk Behavior Survey, SCC-2010, US--2011

21 Illinois Youth Survey 2012 Suburban Cook County Schools* Use Past 30 Days Substance Used 8th Grade 10th Grade 12th Grade Alcohol 20% 34% 51% Cigarettes 4% 7% 14% Marijuana 8% 19% 29% Any Prescription Drugs 1% 3% 5% Prescription Painkillers 1% 2% 4% Over-the-Counter Drugs 1% 2% 2% Source: Illinois Youth Survey, 2012 *School participating: N=110

22 Summary Drug overdose deaths are a leading cause of injury deaths Majority of overdose deaths are opioid related in including heroin Since 2008 increased number of heroin related ED visit and overdose deaths Youth age years, males at highest risk Associated risk of heroin use among non-medical users of opioid prescription drugs High prevalence of alcohol use in school aged youth may impact later patterns of illicit drug use including heroin Small but consistent pattern of illicit and prescription drugs use reported among school aged youth

23 References Jones CM. Frequency of prescription pain releiver nonmedical use, and Arch Intern Med Sep 10;172(16):1265-7; SAMHSA NSDUH Public Use File 2011 CCDPH. (2011). Suburban Cook County Youth Risk Behavior Survey, Retrieve from CCDPH, Epidemiology Program. (2013). Mortality data (unpublished). CCDPH, Communicable Disease Control Unit, Enhanced Surveillance Program. (2013). ESSENCE syndromic surveillance system data (unpublished). CDC. (2011). Youth Risk Behavior Surveillance System, Retrieved from Kirby T, Barry AE. Alcohol as a gateway drug: a study of US 12th graders. J Sch Health Aug;82(8): doi: /j x. University of Illinois, Center for Prevention Research and Development Illinois Youth Survey, Retrieved from

24 Contact Information Steven M. Seweryn, EdD, MPH Director, Community Epidemiology and Health Planning Unit Interim Director, Prevention Services Unit (office)

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