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
Jul 08, 2015
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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