Prescription Drugs and Heroin

1. Prescription Drugs and Heroin Jennifer Tackitt Kristi Dunigan Jazzmin Brown

2. Our Story with Heroin

3. Jesse

4. Nikki and jesse

5. Nikki today

6. 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.

7. 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.

8. 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.

9. 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.

10. 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)

11. 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

12. 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. Indiana Rx Drug Abuse Task Force

13. Committees Education Enforcement INSPECT (Indiana Scheduled Prescription Electronic Collection & Tracking Program) Take-Back Treatment & Recovery What Does the Task Force Do?

14. Education committee has been tasked with provider & public education & awareness around the issues of controlled substance prescribing, appropriate use, abuse, diversion & overdose. How Does the Task Force Help? • Enforcementcommittee 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.

15. 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. How Does the Task Force Help?

16. 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 Prescriptions are NOT the Problem

17. 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 Does “X” County Have an Issue?

18. Not limited to Painkillers More ADD/Mood altering pills “Pharm Parties” “My Friend Addy” It’s a Problem for Teens • 1 in 5 Indiana Teens Have Admitted to Abusing Prescription Drugs

19. “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 How is this Happening “Under a Doctors Care”?

20. Starting to take risks Continuing to take risks And maybe even crossing a fine line into a life of addiction • Heroin can be where some of it leads. • Learn to save yourself or others from: • Over the counter may be where the behavior starts. • Prescription Drugs can be misused with consequences.

21. Diversion (Dealing) is Not the Only Way People Get Pills • http://www.cdc.gov/homeandrecreationalsafety/rxbrief/

22. Understanding addiction No one chooses to be an addict There is no clique/demographic that matches Understanding basic legal risks Recognizing the signs Signs of denial Connection and progression of drug abuse Side effects Street names Lifeline Law Rx and environmental sustainability Disposal Water Supply Risk Safety Medication access to youth, elderly and pets Social media conversations and the Rx risk How can your generation help? BitterPill.in.gov Resources • Highlights of Youth Education Program

23. 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. Task Force Milestone Accomplishments

24. Partnerships Are Critical

25. 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. So PLEASE, Be Our Partner!

26. Jazzmin’s Journey