The Challenge of Opioid Addiction Valerie Valcour RN, Health District Director Carol Plante, Healthy...

The Challenge of Opioid Addiction

Valerie Valcour RN, Health District Director Carol Plante, Healthy Lamoille Valley * September 3, 2014

http://www.bing.com/images/search?q=vermont+photos&qpvt=Vermont+photos&FORM=IGRE#view=detail&id=6DA5F4803EE0D1A4C934403BC415D363E3901C16&selectedIndex=46

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Lamoille Valley Opiate Summit - 2014

Purpose: Build a web between local efforts

and the greater community Spark innovative strategies

Vermont Department of Health

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AGENDA State of the State Gallery Walk Recap of June Governor's Opiate Summit Break Sharing Groups – “What struck you?” Wrap Up – Next Steps


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PREVENTION

Effective prevention addresses various risk and protective factors that can either increase or decrease substance use/abuse.


Risk & Protective FactorsThe Root Causes +/-

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PREVENTION

Place Matters Health is where we live, work, learn, play

& pray.


Opioids – including prescription painkillersand heroin – are powerful drugsthat can be powerfully addictive.

Facts About the Problem


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The numbers are going in the right direction.


2002/3 2003/4 2004/5 2005/6 2006/7 2007/8 2008/9 2009/10 2010/11 2011/120

5

10

15

20

25

9%8%

7% 7% 7% 6% 6% 6% 7%6%

15%13% 13%

15%14% 13% 14% 13% 13%

12%

3% 3% 3% 3% 3% 3% 3% 3% 4% 3%

Non-medical use of prescription pain relievers% Vermonters reporting non-medical use in the past

year, by age group12-17 18-25 26+

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Heroin use among Vermonters is low and stable.

2% of high school students reported ever using heroin in 2013 (Youth Risk Behavior Survey)

This is down, although not significantly, from 3% in 2011

Fewer than 1% of Vermonters ages 12+ reported using heroin in the past year in 2011/12 (NSDUH)

This is unchanged from 2010/11

In 2011/12 Vermont had a significantly lower prevalence of heroin use compared to the United States


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Non-medical pain reliever use is related to heroin use.

NSDUH found that recent (12 months preceding interview) heroin incidence rate was 19 times higher among those who reported prior non-medical pain reliever use than those who did not

NIDA reports that nearly half of young people who inject heroin, surveyed in three recent studies, reported abusing prescription opioids before starting to use heroin.

Vermont Department of Health Source: National Survey on Drug Use and Health, 2003-2012

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Heroin deaths are on the rise in Vermont.

Vermont Department of Health Source: Office of the Chief Medical Examiner

Note: Total opioid includes un-identified opioids. Heroin and prescription opioids are not mutually exclusive.

2004 2005 2006 2007 2008 2009 2010 2011 2012 20130

10

20

30

40

50

60

70

31

44

5552

47 47

39

52

4650

61 2 4 2

51

9 9

20

36

46

56 55

4952

39

61

54

68

Drug-related deaths involving an opioidTotal # by drug type, January 1, 2004 - December

31, 2013Rx Opioid Heroin Total Opioid

• These are big numbers for our small state

• 50+ die from opioid poisoning every year

• Young people are most at risk• Addiction is a lifelong chronic disease• Costs are high – families and

communities torn apart • young lives shattered • treatment, health care, law enforcement, corrections, human services $$$

Why do we call this a crisis?

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The number of people treated is up since 2004.


Source: Alcohol and Drug Abuse Treatment Programs

2004 2005 2006 2007 2008 2009 2010 2011 2012 20130

1,000

2,000

3,000

4,000

5,000

6,000

1,1991,455

1,8972,113

2,2722,630 2,622

2,944 3,478

4,043

State-funded substance abuse treatment system# admissions by primary substance of abuse, Vermont

Alcohol Marijuana/Hashish Heroin/Other Opioids All Others

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The number of people treated for heroin is up.


2004 2005 2006 2007 2008 2009 2010 2011 2012 20130

500

1000

1500

2000

2500

3000

671

710

722631 617 694 623 654

913

1,375

513

719

1,139

1,4251,602

1,867 1,946

2,210

2,4772,596

15 26 36 57 53 69 53 80 89 72

State-funded substance abuse treatment system# admissions for opioid abuse/dependence, by type of opioid,

VermontHeroin Other Opioids/ Synthetics Non-prescription Methadone

Source: Alcohol and Drug Abuse Treatment Programs

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Age at first use for opioids is older than for alcohol.


0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60 63 660

100200300400500600700800900

1,000

Average age of first use of opiates and alcohol in the Vermont state-funded substance abuse

treatment system

Opiates Alcohol

Age of First Use

Source: Alcohol and Drug Abuse Treatment Programs, admissions 2005-2011

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People seek treatment for opioid addiction sooner.


0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 640

100

200

300

400

500

600

700

Elapsed time (years) between age of first use and age at treatment admission for daily users

of opiates and alcohol

Alcohol Opiates

Elapsed Time (Years)

Source: Alcohol and Drug Abuse Treatment Programs, admissions 2005-2011

Research shows that a comprehensive approach, using principles of effective prevention, intervention, treatment, recovery and enforcement, is most effective.

Making a difference


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Substance Abuse Continuum of Care

Recovery Services

Vermont Agency of Human Services

Intensive Outpatient Treatment

Outpatient Treatment

Screening, Brief Intervention, Referral for

Treatment

Prevention Services

Highest Level of Care

Lowest Level

of Care

Fewest Numbe

r of People

Largest Numbe

r of People

Specialty Treatment Residential Opioid Hub

Opioid abuse and addiction is a complex problem with far-reaching consequences.

The good news is Vermonters excel at community action. With everyone working together, we can make progress.

Good News: We can do this!


2009 – 2013 Youth Risk Behavior Survey

Local Data


Current Rx Drug Use


2009 2011 20130

102030405060708090

100

Percent of students who ever misused a stimulant or pain reliever

LNSU LSSU OSSU VT

Source: Youth Risk Behavior Survey

Perception of risk of harm


2009 2011 20130

20

40

60

80

100

Percent of students who think people their age

risk harming themselves if they binge drink on weekends

LNSU LSSU OSSU VT




2009 2011 20130

10

20

30

40

50

60

70

80

90

100

Percent of students who think people their age risk harming themselves if they

smoke marijuana regularly

LNSU LSSU OSSU VT




2009 2011 20130

20

40

60

80

100

Percent of students who think people their age risk harming themselves if they smoke

a pack of cigarettes a day

LNSU LSSU OSSU VT


Parental disapproval


2009 2011 20130

102030405060708090

100

Percent of students who think their parents think it is wrong or very wrong for them to

drink alcohol

LNSU LSSU OSSU VT




2009 2011 20130

102030405060708090

100


smoke marijuana

LNSU LSSU OSSU VT




2009 2011 20130

102030405060708090

100


smoke cigarettes

LNSU LSSU OSSU VT


Effective Prevention


Evidence-based strategies

Population level

Multi-sector

Vermont Prevention Model

Partnership for Success


• Prescription Drug initiatives

• Community-wide education

• eCheckUp To Go

• State of Our Youth Campaign

• Youth Engagement

• Town Ordinances & Town Wellness Plans

• Saturation & Party Patrols

Healthy Community Design


• Addresses health issues and trends

• Built environment influences eating and activity patterns

• Increases access to walking, biking, outdoor recreation, local farms and food and community

gardens

* Creates opportunities that make it easier to eat healthy and be physically active

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Gallery Walk Hub & Spoke Rapid Intervention Community Court Healthy Lamoille Valley – Partnership for

Success Healthy Lamoille Valley – Healthy

Community Design North Central Vermont Recovery Center


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Governor’s Forum on Opiate June 16, 2014 Recap


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Governor’s Forum

LV Charge to the Community – Address: Stigma

Host a viewing of Anonymous People http://manyfaces1voice.org/

Housing & Transportation Screening Workplace & School Environment Issues Family Support Women & Children It takes a Community


http://manyfaces1voice.org/




Refreshments

Networking

10 MINUTE BREAK


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1. What did you learn from the gallery walk?

1. What intrigued you?2. What questions do you have about

prescription drug abuse and opioid use in Lamoille Valley?

3. What connection can you take or make?

1. How will you apply this info?

4. If you had a no cost or low cost strategy to combat the problem of opioid and prescription drug abuse, what would it be?


The Challenge of Opioid Addiction Valerie Valcour RN, Health District Director Carol Plante, Healthy...

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