Heroin - Choices

Report
PRESCRIPTION DRUGS AND
HEROIN
JENNIFER TACKITT
KRISTI DUNIGAN
JAZZMIN BROWN
OUR STORY WITH HEROIN
JESSE
NIKKI AND JESSE
NIKKI TODAY
HISTORY AND FACTS
• HEROIN IS PROCESSED FROM MORPHINE, A NATURALLY OCCURRING OPIATE EXTRACTED FROM THE
SEEDPOD OF CERTAIN VARIETIES OF POPPY PLANTS. THE OPIUM POPPY HAS BEEN CULTIVATED FOR
MORE THAN FIVE THOUSAND YEARS FOR A VARIETY OF MEDICINAL USES.
• HEROIN WAS FIRST SYNTHESIZED FROM MORPHINE IN 1874. FROM 1898 THROUGH TO 1910,
BAYER, THE GERMAN PHARMACEUTICAL COMPANY, MARKETED IT UNDER THE TRADEMARK NAME
HEROIN AS A COUGH SUPPRESSANT AND AS A NON-ADDICTIVE MORPHINE SUBSTITUTE (UNTIL IT
WAS DISCOVERED THAT IT RAPIDLY METABOLIZES INTO MORPHINE). ONE YEAR AFTER BEGINNING
SALES, BAYER EXPORTED HEROIN TO 23 COUNTRIES.
HISTORY AND FACTS
• HEROIN IS MANUFACTURED FROM OPIUM POPPIES CULTIVATED IN FOUR PRIMARY SOURCE
AREAS: SOUTH AMERICA, SOUTHEAST AND SOUTHWEST ASIA, AND MEXICO. ALTHOUGH
AFGHANISTAN PRODUCES THE MAJORITY OF THE WORLD'S HEROIN, SOUTH AMERICAN HEROIN
HAS BECOME THE MOST PREVALENT TYPE AVAILABLE IN THE U.S., PARTICULARLY IN THE NORTHEAST,
SOUTH AND MIDWEST. THE PARTICULAR FORM KNOWN AS "BLACK TAR" FROM MEXICO, A LESS
PURE FORM OF HEROIN, IS MORE COMMONLY FOUND IN THE WESTERN AND SOUTHWESTERN
UNITED STATES. THIS HEROIN MAY BE STICKY LIKE ROOFING TAR OR HARD LIKE COAL, WITH ITS
COLOR VARYING FROM DARK BROWN TO BLACK.
FACTS
• STREET HEROIN IS RARELY PURE AND MAY RANGE FROM A WHITE TO DARK BROWN POWDER OF VARYING
CONSISTENCY. SUCH DIFFERENCES TYPICALLY REFLECT THE IMPURITIES REMAINING FROM THE MANUFACTURING
PROCESS AND/OR THE PRESENCE OF ADDITIONAL SUBSTANCES. THESE "CUTS" ARE OFTEN SUGAR, STARCH,
POWDERED MILK AND OCCASIONALLY OTHER DRUGS, WHICH ARE ADDED TO PROVIDE FILLER.
• HEROIN CAN BE SNIFFED, SMOKED OR INJECTED. MEXICAN BLACK TAR HEROIN, HOWEVER, IS USUALLY INJECTED
(ONCE DISSOLVED) OR SMOKED BECAUSE OF ITS CONSISTENCY. LIKE OTHER OPIATES, HEROIN IS A SEDATIVE DRUG
THAT SLOWS BODY FUNCTIONING. PEOPLE WHO USE IT DESCRIBE A FEELING OF WARMTH, RELAXATION AND
DETACHMENT, WITH A LESSENING SENSE OF ANXIETY. DUE TO ITS ANALGESIC QUALITIES, PHYSICAL AND EMOTIONAL
ACHES AND PAINS ARE DIMINISHED. THESE EFFECTS APPEAR QUICKLY AND CAN LAST FOR SEVERAL HOURS,
DEPENDING ON THE AMOUNT OF HEROIN TAKEN AND THE ROUTE OF ADMINISTRATION. INITIAL USE CAN RESULT IN
NAUSEA AND VOMITING, BUT THESE REACTIONS FADE WITH REGULAR USE.
WHY DO THEY CONTINUE USE?
• WITHDRAW BEGINS WITHIN 6-12 HOURS
• SYMPTOMS MAY INCLUDE SWEATING, ANXIETY, DEPRESSION, CHILLS, SEVERE MUSCLE ACHES,
NAUSEA, DIARRHEA, CRAMPS AND FEVER.
• MAJOR WITHDRAWAL SYMPTOMS PEAK BETWEEN 48 AND 72 HOURS AFTER THE LAST DOSE
AND CAN LAST UP TO A WEEK. FOR SOME WITHDRAWAL CAN BE AS LONG AS A FEW
MONTHS AFTER STOPPING THE DRUG. SUDDEN WITHDRAWAL BY HEAVILY DEPENDENT USERS
CAN BE FATAL.
CONNECTION TO PRESCRIPTION DRUGS
• IN THE U.S., 50.4 MILLION AMERICANS (20.3%) AGES 12+ HAVE USED RX DRUGS
NONMEDICALLY AT LEAST ONCE IN THEIR LIFE; THIS INCLUDES PAIN RELIEVERS, SEDATIVES,
TRANQUILIZERS, AND STIMULANTS (2007).
• IN INDIANA, OVER A MILLION HOOSIERS (20.7%) REPORTED THAT THEY MISUSED RX DRUGS
AT LEAST ONCE IN THEIR LIFE (2002-2004)
MORGAN COUNTY WORK
• GRASS ROOT PRESENTATIONS
• COMMERCIALS, TV INTERVIEWS, NEWSPAPER ARTICLES.
• GRANT AWARDED THROUGH DMHA.
• COMMUNITY ASSESSMENT
• WHAT ARE THE PROBLEMS IN THIS COUNTY?
• PRESCRIPTION DRUG ABUSE AGES 12-25
• 14 OVERDOSE DEATHS LAST YEAR.
• RESOURCE ASSESSMENT
• COMMUNITY ACTION PLAN
INDIANA RX DRUG ABUSE TASK FORCE
• ESTABLISHED BY INDIANA ATTORNEY GENERAL GREG ZOELLER, SEPTEMBER 2012
• PURPOSE TO SIGNIFICANTLY REDUCE THE MISUSE & ABUSE OF CONTROLLED
PRESCRIPTION DRUGS,
• THEREBY DECREASING THE NUMBER OF ADDICTIONS & DEATHS
ASSOCIATED WITH THESE DRUGS IN THE STATE OF INDIANA.
• MADE UP OF MORE THAN 80 PEOPLE, INCLUDING LEGISLATORS, LAW
ENFORCEMENT OFFICIALS, HEALTHCARE PROVIDERS, EDUCATORS &
REPRESENTATIVES FROM STATE & LOCAL AGENCIES.
WHAT DOES THE TASK FORCE DO?
COMMITTEES
• EDUCATION
• ENFORCEMENT
• INSPECT (INDIANA SCHEDULED PRESCRIPTION
ELECTRONIC COLLECTION & TRACKING PROGRAM)
• TAKE-BACK
• TREATMENT & RECOVERY
HOW DOES THE TASK FORCE HELP?
• EDUCATION COMMITTEE HAS BEEN
TASKED WITH PROVIDER & PUBLIC
EDUCATION & AWARENESS AROUND THE
ISSUES OF CONTROLLED SUBSTANCE
PRESCRIBING, APPROPRIATE USE, ABUSE,
DIVERSION & OVERDOSE.
•
Enforcement committee is responsible for expanding the
working knowledge of law enforcement & working with the
Office of the Attorney General to develop effective
legislation to prevent the establishment of “pill mills” in
Indiana.
HOW DOES THE TASK FORCE HELP?
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INSPECT (INDIANA SCHEDULED PRESCRIPTION ELECTRONIC COLLECTION &
TRACKING PROGRAM) COMMITTEE WAS CHALLENGED WITH ENSURING
SUSTAINABILITY OF INSPECT & IMPROVING PROVIDER ACCESS TO INDIANA’S
PRESCRIPTION DRUG MONITORING PROGRAM.
TAKE-BACK COMMITTEE WAS RESPONSIBLE FOR EXPLORING OPPORTUNITIES
FOR PATIENTS TO DISPOSE OF UNUSED CONTROLLED SUBSTANCES IN A
CONVENIENT, SAFE & ENVIRONMENTALLY-FRIENDLY WAY.
TREATMENT & RECOVERY COMMITTEE IS RESPONSIBLE FOR EXPLORING ISSUES
AROUND ACCESS TO TREATMENT, INCLUDING IDENTIFYING AREAS WITH A
SHORTAGE OF MENTAL HEALTH & ADDICTION SERVICE PROVIDERS, &
DEVELOPING TOOLS TO BETTER UNDERSTAND THE IMPACT OF PRESCRIPTION
DRUG ABUSE ON NEWBORN INFANTS & FAMILIES IN INDIANA.
PRESCRIPTIONS ARE NOT THE PROBLEM
• LACK OF :
• EDUCATION & UNDERSTANDING ARE
• PROPER USE
• ADDICTION KNOWLEDGE
• TRUE NEED
• SAFE DISPOSAL
• EVERYONE NEEDS TO REACH THE NEXT LEVEL OF AWARENESS OF
IMPACT MISUSE & ABUSE OUTCOMES
DOES “X” COUNTY HAVE AN ISSUE?
• SADLY, “YES”
• ALL COMMUNITIES DO
• & IT WILL AFFECT YOU.
• HOW?
 PUBLIC SAFETY
 CRIMES
 STOLEN MEDICATION
 INCREASES IN DEALING
 $ TO SUPPORT HABIT
 FRAUD
 HEROIN INCREASE
 ECONOMIC DECLINE
IT’S A PROBLEM FOR TEENS
• NOT LIMITED TO
PAINKILLERS
• MORE ADD/MOOD
ALTERING PILLS
• “PHARM PARTIES”
• “MY FRIEND ADDY”
1 in 5 Indiana Teens Have Admitted to
Abusing Prescription Drugs
HOW IS THIS HAPPENING
“UNDER A DOCTORS CARE”?
• “FIRST DO NO HARM”
• DISCONNECTS IN THE SYSTEM EXIST
• ADDICTION RISK VARIES
• TOLERANCE CAN BUILD
• SYMPTOMS OR PAIN TREATMENT EXPECTATION
• EVOLUTION OF THE PROBLEM
• PAIN IS SUBJECTIVE
Learn to save yourself or others from:
1.
STARTING TO TAKE RISKS
2.
CONTINUING TO TAKE RISKS
3.
AND MAYBE EVEN CROSSING A
FINE LINE
INTO A LIFE OF ADDICTION
Over the counter
may be where
the behavior
starts.
Prescription Drugs
can be misused
with consequences.
Heroin can be
where some of
it leads.
Diversion (Dealing) is Not the Only Way People Get Pills
http://www.cdc.gov/homeandrecreationalsafety/rxbrief/
Highlights of Youth Education Program
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UNDERSTANDING ADDICTION
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NO ONE CHOOSES TO BE AN ADDICT
THERE IS NO CLIQUE/DEMOGRAPHIC THAT MATCHES
UNDERSTANDING BASIC LEGAL RISKS
RECOGNIZING THE SIGNS
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SIGNS OF DENIAL
CONNECTION AND PROGRESSION OF DRUG ABUSE
SIDE EFFECTS
STREET NAMES
LIFELINE LAW
RX AND ENVIRONMENTAL SUSTAINABILITY
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DISPOSAL
WATER SUPPLY RISK
SAFETY
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MEDICATION ACCESS TO YOUTH, ELDERLY AND PETS
SOCIAL MEDIA CONVERSATIONS AND THE RX RISK
HOW CAN YOUR GENERATION HELP?
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BITTERPILL.IN.GOV RESOURCES
TASK FORCE MILESTONE ACCOMPLISHMENTS
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HELPED PASS KEY LEGISLATION THAT HELPS IN THE FIGHT AGAINST PRESCRIPTION
DRUG ABUSE
SECURED FUNDING FOR THE STATE PRESCRIPTION DRUG MONITORING
PROGRAM, INSPECT
BEST PRESCRIBING PRACTICES TOOLKIT FOR PHYSICIANS (DEVELOPED IN LARGE
PART BY PHYSICIANS)
RESEARCHED APPROPRIATE PRESCRIPTION DRUG DISPOSAL OPTIONS
EDUCATED HEALTH CARE & LAW ENFORCEMENT PROVIDERS AT THE 4TH ANNUAL
PRESCRIPTION DRUG ABUSE SYMPOSIUM
RESEARCHED ADDICTION TREATMENT OPTIONS
NEONATAL ABSTINENCE SYNDROME RESEARCH
NATIONALLY, INDIANA IS TAKING AN ACTIVE ROLE IN COMBATING PRESCRIPTION
DRUG ABUSE.
PARTNERSHIPS ARE CRITICAL
SO PLEASE, BE OUR PARTNER!
• SPREAD THE WORD (PUBLIC & PHYSICIANS)
• REMOVE SHAME AND STIGMA FOR YOUNG PEOPLE AND FAMILIES, BE AN
OBJECTIVE PARTNER.
• STAY INFORMED BITTERPILL.IN.GOV
• WHAT ARE THE LATEST MEDICAL TREATMENTS?
• PROPER DISPOSAL OF UNUSED MEDICATIONS
• POLICE/SHERIFF DEPARTMENT CAN HELP!
• SHOW UP! COME TO COMMUNITY EVENTS, TAKE A SEAT AT THE PLANNING TABLE.
JAZZMIN’S JOURNEY

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