prescription drug and heroin abuse in fairfax county
DESCRIPTION
Prescription Drug and Heroin Abuse in Fairfax County Recent Trends and Strategies for PreventionTRANSCRIPT
Prescription Drug and Heroin Abuse
in Fairfax County: Recent Trends and
Strategies for Prevention
Presentation to the Board of Supervisors Human Services Committee
December 9, 2014
Background
• The national death rate from heroin overdoses has doubled in the past two years, to 2.1 deaths per 100,000 persons annually.
• Local stories have been chronicled in the media.
• In September, the Board directed staff to review the issue.
• In October, Police convened a stakeholder meeting, kicking off the process of developing a comprehensive strategy.
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Stakeholder Involvement to Date
• Police
• Sheriff
• Fire and Rescue
• Commonwealth’s Attorney
• Parents/Community
• Fairfax County Public Schools
• Community Services Board
• Health
• Neighborhood and Community Services
• Unified Prevention Coalition
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Prescription Drug and Heroin Use
• Prescriptions of opioids for use as painkillers have grown dramatically over the past two decades
• Opioid use can create dependency, resulting in addiction and heroin use
• Heroin user demographics have changed, trending younger
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Data Issues
• There is no single measure, or small number of measures, that can adequately provide a clear and comprehensive overview of the prevalence and impact of opioid abuse.
• Complications include:– medical coding,
– self-reporting,
– relatively small raw numbers at the local level, and
– the variety of types and names of opioid drugs.
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Opioid Overdose Deaths, Sales, & Treatment Admissions, United States, 1999–2010
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0
1
2
3
4
5
6
7
8
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Rate
Year
Opioid Sales KG/10,000
Opioid Deaths/100,000
Opioid Treatment Admissions/10,000
Sources of Pain Relievers for Nonmedical Use Among Past Year Users 12+ Years Old, United
States, 2012.
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Number of Heroin Overdoses and Fatalities, Fairfax County
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0
10
20
30
40
50
60
70
2012 2013 2014*
Overdoses
Fatalities
*2014 is through November
100 89107
48
100135
213 210
389422
398 415
487
414
468508
0
100
200
300
400
500
600
2007 2008 2009 2010 2011 2012 2013 2014
Nu
mb
er
of
De
ath
s
2014 is estimated based on data through June 30, 2014
Heroin Prescription Opiods
Number of Fatal Heroin & Prescription Opiate Overdoses, Virginia, 2007-2014
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EMS Patient Contacts,Fairfax County
Demographics
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2%
10%
35%
27%
17%
7%
2%
15-19
20-24
25-34
35-44
45-54
55-64
65+
Fairfax County EMS Contacts, Suspected Heroin Overdose,
2011-2014
Fatal Heroin Overdoses by Age, Virginia,
2013 - July 11, 2014
30-Day Use of Select Substances, FCPS 8th, 10th, 12th graders, 2010-2013
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0
5
10
15
20
25
2010 2011 2012 2013
Pe
rce
nt
Re
po
rtin
g
Alcohol
Binge Drinking
Cigarettes
Marijuana
Painkillers
Other Rx
Heroin
Similar and Related Efforts
• Combat Heroin and Prescription Drug Abuse, New York State
– http://combatheroin.ny.gov/
• Winchester/Valley Addiction Action Committee
• Prince William County
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Governor’s Task Force on Prescription Drug and Heroin Abuse
• Included in the A Healthy Virginia action plan
• Five issue areas:
– Education and awareness
– Treatment
– Storage and disposal
– Enforcement
– Data and monitoring
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New Resources
• CSB Heroin/Opiates Web Page
http://www.fairfaxcounty.gov/csb/heroin-opiates/
• Police Heroin Tip Line
1-844-373-3634
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Fairfax Framework for Prevention
• Five strategic areas:– Education and awareness– Treatment– Prescription drug storage, disposal, and monitoring– Enforcement– Data and monitoring
• Objective(s) for each area• Potential strategies• Existing efforts• Opportunities for partnership, collaboration and
adaptation
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Education and Awareness
• Objective: Increase public awareness of the dangers of misuse and abuse of prescription drugs and heroin and their connection to each other.
• Potential Strategies: – Website: information, referral, resources
– Seminars and other public events; speakers bureau
– Messaging: print, web, social media, and other media
– School curriculum
– Messaging tools for elected officials
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Prescription Drug Storage, Disposal, and Monitoring
• Objective: Increase safe disposal of unused prescription drugs.
• Potential Strategies:
– Expanded drug take-back
– Public education on safe disposal
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Prescription Drug Storage, Disposal, and Monitoring
• Objective: Promote best practices in prescribing opioids.
• Potential Strategies:
– Painkiller prescribing guidelines
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Prescription Drug Storage, Disposal, and Monitoring
• Objective: Monitor the prescription use of opioids.
• Potential Strategies:
– Parent education on monitoring medication
– Public education on safe storage
– Education for coaches, physical therapists, and athletic trainers to monitor athletes who have been prescribed painkillers
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Treatment
• Objective: Facilitate access to opioid addiction treatment.
• Potential Strategies:
– Recommended treatment services, counseling, and information on adherence to standards of treatment for addiction
– First responders referrals to treatment
– Service directories and navigation supports
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Treatment
• Objective: Incorporate training on the County’s availability and use of Naloxone by first responders to treat individuals who have overdosed on opioids.
• Potential Strategies:
– Training for first responders, health care providers, and others on the use of Naloxone by Fairfax County FRD
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Treatment
• Objective: Expand opportunities for peer support components in treatment and recovery programs.
• Potential Strategies:
– Incentives for incorporation of peer support into recovery and treatment
– Recruitment and training of participants
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Enforcement
• Objective: Prioritize access to treatment over prosecution in law enforcement of opioid use and overdose.
• Potential Strategies:– Review options for drug courts, diversion, and
referrals
– Good Samaritan law
– Accessible means of referrals for first responders
– Review of Police Department guidelines and/or policy for how to handle opioid use and overdose
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Enforcement
• Objective: Increase prosecution of illegal heroin and opioid distributors/dealers.
• Potential Strategies:
– Expanded use of a regional grand jury process to expedite indictments of suspected dealers
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Data and Monitoring
• Objective: Monitor local trends in prescription drug and heroin use to identify needs and monitor progress.
• Potential Strategy:– Identify key indicators and align data sets and measures
where possible
– “Prescription Drug and Heroin Abuse Report Card”
• Objective: Evaluate the strategies included in the final strategic plan.
• Potential Strategy:– Evaluation plans for identified strategies
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Next Steps
• Identify and engage stakeholders.
• Develop action plans, including leads and coordination strategies.
• Coordinate with Governor’s Task Force.
• Explore alternative funding strategies.
• When feasible, begin implementation.
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Recommendations
• Direct staff to present the plan, with funding and policy requirements, to the Board at an upcoming Human Services Committee meeting.
• Ensure opportunities exist to include strategies in the next year’s legislative program.
• Direct staff to develop strategies for an expanded drug take-back program, to include funding and resource requirements.
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Questions?
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Contacts
Capt. Paul Cleveland, Police
703-802-2711
Jesse Ellis, Neighborhood & Community Services
703-324-5626
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