Methamphetamine Problem and Solution Using the Strategic Prevention Framework Logic Model

Transcription

1 Methamphetamine Problem and Solution Using the Strategic Prevention Framework Logic Model Many Voices One Vision Indianapolis, Indiana Barbara Seitz de Martinez, PhD, MLS, CPP Indiana Prevention Resource Center August 2, 2007 The Indiana Prevention Resource Center is funded, in part, by a contract with the Indiana Family and Social Services Administration, Division of Mental Health and Addiction, financially supported through HHS/Substance Abuse Mental Health Services Administration, Center for Substance Abuse Prevention, Substance Abuse Prevention and Treatment Block Grant. The IPRC is operated by the Indiana University Department of Applied Health Science and School of Health, Physical Education and Recreation. It is affiliated with the Department s Institute of Drug Abuse Prevention.

2 Outcomes-Based Prevention Assessment Evaluate Sustainability & Cultural Competence Capacity Building Implement evidence- Based PPP Strategic Plan Source: U.S. Department of Health and Human Services, SAMHSA, CSAP

3 Meth Strategies Substance-Related Consequences and Use Community Crime Family services School Healthcare Intervening Factors Strategies Individual Physical damage Psychological damage Harm loved ones Family disintegration Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

4 Methamphetamine Source:

5 Methamphetamine Powder Crystal Source: DEA, Photo Library, Ice / Crystal / Pipe

6 Methamphetamine Powder Source: DEA, Photo Library, Bag of Ice / Crystal

7 Methamphetamine Powder Source: DEA, Photo Library, Powder

8 Methamphetamine Source: How It Is Stored

9 Administration Smoking** immediate, intense rush, lasting a few minutes Injecting immediate, intense rush, lasting a few minutes Snorting In 3-5 min., euphoria, long-lasting high up to 12 hrs. Oral ingestion In min., euphoria, long-lasting high up to 12 hrs. Source: NIDA, Research Report Series: Methamphetamine Abuse Addiction, 1998:3-4

10 Prevalence World Wide Use Methamphetamine Cocaine: 10 million regular users Heroin: 15 million regular users Meth: 42 million regular users Source: World Health Organization, Cited by Richard Rawson (UCLA Integrated Substance Abuse Programs, and Pacific South West Addiction Technology Transfer Center), Meth: A Focus on Women and Children, Women and Children in Recovery Conference of the Indiana Family and Social Services Administration, Division of Mental Health and Addiction, IN Government Building, April 7, 2005

11 Half-Life The half-life of cocaine is.5 to 1.5 hours The half life of meth is 9 to 24 hours The half-life of smoked cocaine is 1 to 1.5 hours The half life of smoked meth is 11 to 12 hours Source: Minnesota Department of Health. Implications of Route of Administration for Cocaine and Methamphetamine for Drug Abuse and Neurobehavioral Sequellae

12 Consequences of Use Substance-Related Consequences and Use Ill effects to addict: addiction burns brain damage loss of children HIV/STDs loss of job weight loss loss of marriage paranoia imprisonment hallucination dental damage, fetal effects Other effects to community: violent crime child abuse child neglect strain on child services school personnel strained healthcare services strained law enforcement judicial system family disintegration

13 Consequences of Use: Short-term Short-term Effects: Rush Wakefulness Physical activity Loss of appetite Increased respiration Dopamine plays an important role in the regulation of pleasure. In addition to other regions, dopamine is manufactured in nerve cells within the ventral segmental area and is released in the nucleus accumbens and the frontal cortex. Increased blood pressure Tremors/convulsions Hyperthermia Source: NIDA Research Report Series: Methamphetamine & Stop_Drugs.org,

14 Consequences of Use: Long-term Effects Dependence and addiction psychosis Paranoia Hallucinogens Mood disturbance Repetitive motor activity Stroke Weight Loss Tooth damage Extent of brain damage (up to 50% of dopamineproducing cells in the brain) Source: NIDA, Research Report Series: Methamphetamine Abuse Addiction, 1998:4

15 Source: Bill O Dell, Community Prevention Specialist, West Virginia Prevention Resource Center, What s Up with Meth PowerPoint, 2004 Burns and Scratching

16 Same Woman Source: DOJ, DEA, Pseudoephedrine Brochure, Aug. 2003

17 Damage over time Source: DOJ, DEA, Pseudoephedrine Brochure, Aug. 2003

18 Repetitive Action Source: Michael G. Heavican, U.S. Attorney for District of Nebraska, Photos taken by Lincoln police of persons arrested for meth possession

19 Use: Consumption Patterns Substance-Related Consequences and Use Overall consumption data Info about drug being consumed Homemade for self-use Street drug (imported vs. local manufacture) Form of the drug (powder? Ice? ) Manner of consumption (needle? smoked?) Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

20 Use: Consumption Patterns Substance-Related Consequences and Use Overall consumption data Location/context of use: Consumption in risky situations Parties (in homes, private or public) In school In homes with children At work Association with unsafe sex (STDs, HIV) Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

21 Use: Consumption Patterns Substance-Related Consequences and Use There s no such thing as a typical meth user. -- recovering meth addict Who is using? Groups to target. Rural / urban / suburban White / Hispanic / African-Americans Heterosexual / homosexual Young adult / older adult / youth Men / women Substance users / polydrug users Who is using? High-Risk Groups? Pregnant women Youth, college students Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006 Q: Is meth used in combination with other drugs? A: Methamphetamine users are likely also to be users of alcohol, marijuana and cocaine rather than users of drugs like heroin. Source: Website page of meth/faq.html accessed 1/20/07.

22 Consumption Patterns: Impact on Children Substance-Related Consequences and Use Overall consumption data Info about impact upon children Dangers in lab setting Role modeling Risk of physical/emotional neglect/abuse by parent Risk of abuse by other adults Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

23 Consequences: Drug Endangered Children Patterns of Use: Source: Bill O Dell, Community Prevention Specialist, West Virginia Prevention Resource Center, What s Up with Meth PowerPoint, 2004

24 Consequences: Drug Endangered Children Substance-Related Consequences and Use Effects upon Parenting: 1. Insomnia 2. Intense sleep 3. Intense hunger 4. Depression Binge Phase: Physical Abuse agitated, violent behavior Sexual Abuse libido increased Neglect intensely self-centered Crash Phase: Physical Abuse violent, easily agitated Sexual Abuse children unprotected from others Neglect no supervision, neglect of child s needs

25 Why Children Are More Vulnerable Shorter, closer to the ground (chemical vapors) Growing and developing rapidly Higher metabolic and respiration rates Developing nervous system (more vulnerable) Different habits, e.g., hand-to-mouth (higher risk) Source: Richard Rawson (UCLA Integrated Substance Abuse Programs, and Pacific South West Addiction Technology Transfer Center), Meth: A Focus on Women and Children, Women and Children in Recovery Conference, IN Government Building, April 7, 2005

26 Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006 Consequences for Children

27 Prevalence Indiana 6 th -12 th Graders, 2006 Meth Use by IN Children, 2006 (IPRC) Grade Lifetime Annual Current 6 th 0.5% 0.3% 0.2% 8 th 2% 1.4% 0.9% 10 th 3.5% 2.4% 1.2% 12th 5% 3.1% 1.5% Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey. Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents 2006 Survey. Indiana Prevention Resource Center, Accessed 1/20/07. Monitoring the Future, 2006 survey, (University of Michigan, 2006) Accessed 1/21/07.

28 Prevalence Indiana 6 th -12 th Graders, 2006 Meth Use by IN Children (%), 2006 Lifetime Annual Current Gr IN U.S. IN U.S. IN U.S NA 0.3 NA 0.2 NA Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey. Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents 2006 Survey. Indiana Prevention Resource Center, Accessed 1/20/07. Monitoring the Future, 2006 survey, (University of Michigan, 2006) Accessed 1/21/07.

29 Prevalence Indiana 6 th -12 th Graders, 2006 Gr Tranquilizer Use by IN Children (%), 2006 Lifetime Annual Current IN U.S. IN U.S. IN U.S NA 0.3 NA 0.2 NA Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey. Italics indicates a statistically significant drop from 2005 to 2006 in Indiana. Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents 2006 Survey. Indiana Prevention Resource Center, Accessed 1/20/07. Monitoring the Future, 2006 survey, (University of Michigan, 2006) Accessed 1/21/07.

30 Prevalence Indiana 6 th -12 th Graders, 2006 Gr Alcohol and Smoking Behaviors (%) Binge Drinking Daily Smoking IN U.S. IN U.S. 6 7 NA 3 NA Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey. Italics indicates a statistically significant drop from 2005 to 2006 in Indiana. Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents 2006 Survey. Indiana Prevention Resource Center, Accessed 1/20/07. Monitoring the Future, 2006 survey, (University of Michigan, 2006) Accessed 1/21/07.

31 Prevalence Indiana 6 th -12 th Graders, 2006 Current Drug Use by IN Children (%), 2006 Gr Meth Alcohol Binge Cigarettes Marij Tranq Cocaine Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey. Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents 2006 Survey. Indiana Prevention Resource Center, Accessed 1/20/07.

32 Intervening/Causal Factors Substance-Related Consequences and Use Community Crime Family services School Healthcare Individual Physical damage Psychological damage Harm loved ones Family disintegration Intervening Factors Community Availability Price Local labs, street, retail Social Social Norms Enforcement Individual Perceptions of risk Perceptions of harm Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

33 Availability of Chemicals: Precursor Source: Ephedrine / Pseudoephedrine

34 Availability of Chemicals: Precursor Precursor (pseudoephedrine) Reagent: e.g., water reactive metal (lithium, sodium, red phosphorous, iodine, sodium hydroxide) Source: DEA Solvent (acetone, alcohol, benzene, camp fuel, chloroform, ethanol, ether, methanol, mineral spirits, paint/lacquer thinner, toulene, xylene) Glassware and hardware Source: IN State Police, Clandestine Laboratory Team, 2005

35 Keeping Ahead of the Criminals

36 Keeping Ahead of the Criminals From Phenylalanine From: (Speed Raver) A surprisingly simple synthesis is possible from the amino acid phenylalanine, which is available at health food stores for about $14 for 100 tablets. Phenylalanine is 2-amino-3-phenylpropanoic acid, which is more or less amphetamine with a COOH where the Ch4 should be at the end of the chain. Thionyl chloride will replace the OH with a Cl, which falls off and is replaced by H when you give it lithium aluminum hydride, sodium borohydride, or hydrogen gas and nickel/platinum. If you use hydrogen and metal for that step, you'll ha v e to reduce the carbonyl group with one of the hydrides, so best save time + effort and use them and do both reductions at once. When that carbonyl is reduced, you now have amphetamine. Go back up to that first one I mentioned for upgrading amphetamine into methamphetamine. Don t know if this is true. Need to keep ahead of the criminals.

37 Chemicals: Reagant Source: Red Phospherous

38 Map: Meth Lab Busts, 2006 Total lab busts: 6,435 Indiana Prevention Resource Center

39 Map: Meth Lab Busts, 2006 Indiana Prevention Resource Center Source: IN State Police, 2007 Total lab busts, 993

40 Map: Meth Lab Busts, 2006 Total lab busts, 993 Indiana Prevention Resource Center Source: IN State Police, 2007

41 Incomplete Data Not all labs are found Not all agencies report all seizures Not all agencies that report to the Indiana State Police also report to the DEA We have no way to know for other states what percent of lab seizures are being reported to the DEA

42 Intervening/Causal Factors Substance-Related Consequences and Use Community Crime Family services School Healthcare Individual Physical damage Psychological damage Harm loved ones Family disintegration Intervening Factors Social Values Overachievement Thinness ideal Economic success Letting others set your goals Seeking the high Thrill of risk taking Individual Coping mechanism Peer pressure Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

43 Intervening/Causal Factors Substance-Related Consequences and Use Intervening Factors Strategies Community Crime Family services School Healthcare Individual Physical damage Psychological damage Harm loved ones Family disintegration Community Availability Price Retail Social Social Norms Enforcement Individual Perceptions of risk Perceptions of harm Address problems identified and causal factors Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

44 Strategies Substance-Related Consequences and Use Community Crime Family services School Healthcare Individual Physical damage Psychological damage Harm loved ones Family disintegration Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006 Community Availability Price Retail Social Social Norms Enforcement Intervening Factors Individual Perceptions of risk Perceptions of harm Coping Mechanism Peer Pressure Strategies Reduce availability Legislation/Policy Dye in anhydrous Awareness campaigns Community action Curricula / programs Trainings CPS, School Provisions for DEC Healthcare workers Law enforcement Support Networks

45 Strategies Substance-Related Consequences and Use Intervening Factors Strategies Legislation controlling the sale of ephedrine by retailers (7/05) Meth Law Senate Enrolled Act 444 Limits amount of purchase Records names of purchasers Database to track purchases Tracking log books Source: Accessed 1/20/07 Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

46 Strategies Substance-Related Consequences and Use Intervening Factors Strategies IN Drug Endangered Children Response Protocol IN Drug Endangered Children Comprehensive Care Protocol Policy and Planning Strategies lab clean-ups Enforcement Strategies highway patrols, campaigns Precursor Chemical Control Strategies tags on ammonia tanks Prevention/Drug Demand Reduction Strategies education Property Remediation/Meth Lab Clean-up Strategies loans Treatment Strategies Transition help for reentry from prison

47 Strategies Substance-Related Consequences and Use Intervening Factors Strategies Meth Tip Hotline: IN Criminal Justice Institute Meth Data Repository Indiana Meth Watch Program (CJI) Meth Free Indiana Coalition Midwest Governors Association Regional Meth Summit Governor s Commission for a Drug-Free Indiana Strategic Prevention Framework State Incentive Grant Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

48 Prevention Is Prevention Goal: To delay/reduce/eliminate initiation Goal: To promote parenting & life skills Goal: To promote a drug-free lifestyle Goal: To promote positive values Goal: To promote healthy communities Multiple strategies across multiple domains

49 Thank you so much! Contact: Indiana Prevention Resource Center 800 / / seitzb@indiana.edu