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Ohio Opiate Epidemic Aaron adams D.O ., F.A.A.F.P .

Ohio Opiate Epidemic Aaron adams D.O ., F.A.A.F.P. Scioto County Heath Commissioner Ohio Drug Task Force. SEOW. SEOW. SEOW. SEOW. For Every 1 Overdose Death From Prescription Painkillers There Are……. 10 treatment admissions for abuse 32 emergency department visits for misuse or abuse

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Ohio Opiate Epidemic Aaron adams D.O ., F.A.A.F.P .

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  1. Ohio Opiate EpidemicAaron adams D.O., F.A.A.F.P. Scioto County Heath Commissioner Ohio Drug Task Force

  2. SEOW

  3. SEOW

  4. SEOW

  5. SEOW

  6. For Every 1 Overdose Death From Prescription Painkillers There Are…… • 10 treatment admissions for abuse • 32 emergency department visits for misuse or abuse • 130 people who abuse or are dependent • 825 people who take prescription painkillers for non medical use CDC

  7. In the United States…. • Enough prescription painkillers were prescribed in 2010 to medicate every American Adult around-the-clock for one month. • 2 million people reported using prescription painkillers nonmedically for the first time in 2010- nearly 5,500 people a day CDC

  8. In Scioto County… • 9.7 million doses of prescription painkillers were dispensed in Scioto County last year • 123 doses for each of the 79,000 men, women and children in the county • Between 1999 and 2008, there was a 360% increase in accidental over-dose deaths in Scioto County; 92% of these deaths are due to prescription medication • Oxycodone toxicity deaths in Scioto County have quadrupled in the past 3 years. • 85% of substance abuse treatment requests at the Scioto County Counseling Center are now for opiate addiction, marking a 300% increase in just the past 3 years. State Medical Board of Ohio

  9. Time Period 10/1/2008 through 3/31/2009 Oxycodone dispensers(In Grams)

  10. CDC

  11. CDC

  12. Other Source 7.1% Got from drug dealer or stranger 4.4% Took from friend or relative without asking 4.8% Bought from friend or relative 11.4% Prescribed by one doctor 17.3% Obtained free from friend or relative 55% CDC

  13. Scioto County Crime TrackerBy township Bloom 3 Theft 1 Defrauding creditors 1 Identity theft Brush Creek 1 Identity theft Clay 1 Burglary 1 Theft Green 1 Theft Harrison 1 Criminal damaging 1 Burglary 1 Breaking and entering 1 Criminal simulation 1Disorderly conduct 1 Domestic Violence

  14. Scioto County Crime TrackerBy township Jefferson 1 Breaking and entering 1 Theft 1 Cruelty to animals Morgan 1 Telecommunications Harassment 1 Domestic violence Porter 1 Criminal Trespass 1 Theft 1 Telecommunications fraud 1 Forgery 2 Domestic violence 1 Violate protection order Rarden 1 Theft Rush 1 Breaking and entering

  15. Operating a vehicle impaired (OVI) • 466 OVI arrested in Scioto County alone in 2011 • Compared to 325 in Lawrence County • 220 in Jackson County • 118 in Pike County • 64 in Adams County. • “Part way through the year, at one point, we [Scioto County] were in the top 5 counties in the state for OVI arrests,” – Lt Karla Taulbee OSHP • Drugs are also included in these OVI arrest statistics • There were 13,799 OVI-related crashes on Ohio roadways, killing 401 and injuring 8,517 Portsmouth Daily Times March 9, 2012

  16. Paul H volkman • Chicago doctor who operated pill mills in Portsmouth and Chillicothe Ohio • Sentenced for illegally prescribing and dispensing pain pills outside the scope of a legitimate medical practice that resulted in deaths of 4 people from 2003-2005 • Convicted May 10, 2011 on 4 counts of illegal drug distribution that resulted in death • Life sentence for each count • Also sentenced on 13 other counts that resulted in prison sentences from 10-20 years

  17. Paul Volkman trial • UPDATE: Many Speak Out as Pill Mill Doctor Sentenced to Four Life Terms

  18. Pike County Ohio Pill mill

  19. NPR Men’s Health The New York Times … . . . John Terrett is a Washington DC based correspondent for al Jazeera English.

  20. Prevention • 36 states have operational Prescription Drug Monitoring Programs. • House Bill 93 • Scioto County • Shut down 12 “pill mills” • Prevention not Permission Syringe Exchange • SOLACE • High Intensity Drug Trafficking Area (HIDTA)

  21. Community Anti-Drug coalitions of America (Cadca) • Goal of safer, healthier and drug-free communities • More than 5,000 community anti-drug coalitions in the US and abroad • Nonprofit status in the US • Collaboration among groups or sectors of a community with common goals • All Scioto County schools signed MOU with health department to participate in drug free community alliance grant application

  22. Opiate numbers drop dramatically • Preliminary projections from Ohio Department of Alcohol and Drug Addiction Services (ODADAS) nearly 1.5 million fewer opiates were dispensed in Scioto County in 2011 • In 2010 there were 9,713,494 opiates dispensed in Scioto County • In 2011 a 20% decrease- 8,234,516 the biggest change in the state

  23. Jan-June 2011 SEOW

  24. Drug related deaths • According to Scioto County Coroner, Dr. Darren Adams • In 2010 there were 24 deaths directly related to drugs and 19 deaths that were drug-related • In 2011 there were 20 deaths directly related to drugs and 11 deaths that were drug-related

  25. Scioto county2nd chance • In operation since July 13,2011 • Serving clients who have relationships with • Scioto County Court of Common Pleas • Portsmouth Municipal Court • Scioto County Jail • Clients must have no less than 15 separate legal charges prior to admission • Mean potential jail or prison day total for each client is 250

  26. Scioto County 2nd Chance • 25 out of 28 clients completed the program thus far • 70% of clients who complete residential alcohol and drug treatment do not re-enter the court systems • Some main recipients of community service • Salvation Army • American Red Cross • Main Street Portsmouth • God’s Pantry (Church food pantry)

  27. Scioto County2nd chance • Experience work-like activities in preparation for actual employment • Individualized vocational services are provided after brief stabilization period • Clients are educated and assisted in job readiness • Interviewing • Resume building • Cold calling • Professionalism • Jobs that are “black money” or “under the table” are not permitted

  28. 2nd chance- county and statepotential savings • Based on 70% of not re-offending in the future • 6 month estimate savings $401,625-$580,125 • 12 month estimate savings $803,250-$1,160,250 • 18 month estimate savings $1,204,875- $1,740,375 • Depending on jail per diem being $45-$65/day

  29. ODH activities • Conducting prescription drug abuse education and awareness pilot projects in high-risk areas • Two projects funded: Montgomery and Scioto Counties • Funding period: 2010-2013 (4 years) • Coalition building • Media campaign • Results seen already • 1.5 million fewer pills prescribed in Scioto County in 2011, as compared to 2010 Webpage: http://www.healthyohioprogram.org/poison

  30. Odh activities • Ohio’s first Naloxone Distribution Program • Naloxone distribution programs (NDPs) provide overdose training and take-home doses of Naloxone, to be administered nasally or by muscular injection, to those who are deemed high-risk for an overdose • Since 1996, more than 53,000 individuals have been trained by NDPs resulting in more than 10,000 overdose reversals using Naloxone

  31. Ohio opiate drug task force 2012 • Developing a white paper for best practices • Opioid prescribing in the Emergency Departments

  32. Opioid prescribing policies by e.d.s Why Emergency Departments? • The ED is the largest ambulatory source for opioid analgesics with 39% of all opioids prescribed, administered, or continued in the U.S. coming from EDs. This may be an even higher percentage in Ohio • Nationally, opioid prescribing for pain-related ED visits increased from 23% in 1993 to 37% in 2005 • ED treatment of pain is frequently indicated without the benefit of an established doctor-patient relationship and often in an environment of limited resources • Closure of “pill mills” may result in increased drug seeking behavior (e.g. doctor shopping) at ED • In Ohio, 16% of 2008 fatal overdose victims had a history of doctor shopping

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