Drug Overdose PreventionKennebec County

Jayne HarperOverdose Prevention Health EducatorPrevention CenterData provided by Maine Health Information Center

Outline

Drug Overdose Prevention Project Myths Defining Addiction Drug Overdose Statistics Drug Overdose Prevention Resources

Myth Buster #1

Addiction Treatment is NOT effective.

TRUE OR FALSE

FALSE:Research tell us: Nearly seventy percent (69%) of patients with

addictions-related medical conditions who received health care as part of the addictions treatment program were abstinent 6 months after leaving treatment.[1]

Recent studies show that after six months, treatment for alcoholism is successful for 40 to 70 percent of patient/clients; [2]

Cocaine treatment is successful for 50-60 percent [2] Opiate treatment for 50-80 percent[2]

[1] Weisner, C., Mertens, J., Parthasarathy, S., Moore, C., & Lu, Y. (2001). Integrating Primary Medical Care with Addiction Treatment, A Randomized Controlled Trial. Journal of the American Medical Association, 286(14), 1715-1723.

[2] The Robert Wood Johnson Foundation. (February 2001). Key Indicators for Policy Update, Substance Abuse, The Nation’s Number One Health Problem. Princeton New Jersey.

Did you know? Relapse rates for treatment of alcohol,

opioids and cocaine are less than those for hypertension and asthma, and equivalent to those of diabetes.

Compliance rates for treatment of alcohol, opioids and cocaine are greater than compliance rates for hypertension and asthma!

Source: O’Brien, C.P., & McLellan, A.T. (1996). Myths about the Treatment of Addiction. The Lancet, 347, 237-240.

Myth Buster #2

Treating addiction is a waste of money. TRUE

OR FALSE

FALSE:

Research tells us:

Every dollar spent on drug treatment in the community is estimated to return $18.52 in benefits to society in terms of reduced incarceration rates and associated crime costs to taxpayers.

Source: “Substance Abuse Treatment and Public Safety.” Justice Policy institute (2008)

Continued

A substance-abuse treatment prenatal program for pregnant drug abusers returns the initial expenditures more than twice over in what is not spent on the costs of increased crime and psychosocial functioning and reduced emergency room visits.

Source: Substance Abuse Funding News. Prenatal Substance-Abuse Services Return Treatment Cost Twofold. Retrieved March 12, 2003 from http://cdpublications.com/.

Myth Buster # 3

Medicated Assisted Treatment (methadone and suboxone) is trading one addiction for another

True  OR   False

FALSE Medication-free therapies, such as AA, NA, etc, alone cannot

stabilize the chemical upsets of opioid addiction.

Methadone is prescribed as in maintenance therapy, acts as a normalizer rather than a narcotic. The patient is able to function in every physical, emotional, and intellectual capacity without impairment.  It is orally effective and does not produce mood swings, tranquilization or narcotic effects.

Methadone patients can obtain college educations, perform all types of intellectual  and physical skills, marry and raise families.  Methadone does not produce dependency like many other medications prescribed.  For many addicts the alternative to methadone maintenance is:  continued illicit use of heroin, criminal behavior, jail and premature deaths.*

* Source: J. Woods, M. Beresky NAMA. http://www.medicalassistedtreatment.org/57642/index.html

Defining Substance Use Disorder

A Disease of the Brain“…in the vulnerable brain, if you use drugs at a high enough dose, frequently enough and for

long enough, you literally change the way nerve cells communicate in such a way that you develop this compulsive, out of control use

despite knowing that all kinds of terrible things can happen to you, and despite even experiencing many of those things.”

-Hyman

Substance Use Disorder - Addiction

…..is a chronic, progressive, primary disease of the brain that stems from an altered brain chemistry

A person takes a drug of abuse activating the same brain circuits as do behaviors linked to survival, such as eating, bonding and sex. The drug causes a surge in levels of dopamine, which results in feelings of pleasure. The brain remembers this pleasure and wants it repeated.

The addictive process moves in, undoes or weakens what the brain knew before, and then teaches it something else entirely.Source – Why Can’t They Just Stop – HBO Series

It’s not a lack of will power…it’s not a lack of

moral courage…it’s neurochemistry

Science tells us…SUBSTANCE USE DISORDER/ADDICTION IS A BRAIN DISEASE.

It was like a hard hitting reality – “I am an alcoholic.” I am one of those people I see on TV. I am one of those people I used to criticize, thinking, How can they be so weak? Julie, Recovering Alcoholic, source, “Why can’t they just stop” HBO Series Book

Like other chronic illnesses, addiction – with the proper treatment – can be managed, so that an addict can live a life without drugs.

Source – Why can’t They Just Stop, HBO Series

Drug Overdose Data

Almost two-thirds of Americans have friends or family members who have struggled with addiction.Source: “What Does America Think About Addiction Prevention and Treatment?” Harvard School of Public Health/Robert Wood Johnson Foundation/ICR (2006)

If left untreated or mistreated, this disease can and will result in death

It is a disease characterized by denial and relapse

It is manifested by repetitive, compulsive use of substances (drugs, alcohol, food) or activities (sex, gambling) despite adverse consequences

It has strong genetic components It cannot be cured and requires lifelong

treatment

How Common is Drug and Alcohol Addiction?

Approximately 10% of any population is addicted to drugs or alcohol

Over 22 million people experience addiction to alcohol or drugs

Addiction is more common than diabetes, which occurs in approximately 7% of the population

US Substance Abuse Statistics

Addiction crosses all socio-economic boundaries. 10% of teachers, 10% of plumbers, and 10% of CEOs have an addiction

1 in 4 deaths are due to the effects of alcohol, tobacco and drugs

What are the top ways people get Prescription drugs (18-25 yr olds)

Family or Friend From one doctor Buying them from a friend or

relative

Local Maine Data

Drug Overdose Problem on the rise

Number of Maine Deaths due to drugs 1997 – 34 drug related deaths

19 were accidental 2006 - 167 drug related deaths

135 accidental

Toxicology findings:Prescription drugs were found in most of

the deceased’s toxicology report

Unintentional Drug Overdose 911 CallsKennebec County

0

100

200

300

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500

# of

cal

ls

Unintentional DrugOverdose

314 382 361 324 367

2002 2003 2004 2005 2006

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140

Unintentional Drug Overdoses Kennebec County, Top 5 Towns

Waterville Augusta Winslow Oakland Winthrop

Available Prevention Resources

Save-A-Life DVDTake as Directed (Rx Safety) DVDOverdose Posters and Wallet CardsSubstance Use Services Book/Pamphlets

Drug Overdose Prevention DVD

Drug Overdose DVD – Created by the members of the overdose task force (Delta Ambulance, Discovery House, MaineGeneral and Kennebec Medical Associates).

This DVD was create to help inform people who use drugs, friends and families about how to prevent overdose deaths.

Goals of the Save-A-Life DVD 1. Identify high risk times of overdose

Resuming drugs after abstinence Using in new setting-unfamiliar of drug source Mixing Using alone When an overdose does occur, recognizing signs

& symptoms and knowing what to do 2. Inform adults of supports and services

available in the community if they want treatment

Cont

Educate users and family members about the signs and symptoms of overdose and the importance of calling 911 when these symptoms are observed

What is Overdose?

An amount of drug that is more than what should be taken at one time.

Causes Of Overdose Deaths Mixing of Substances – opiates in

combination with other CNS depressants (alcohol, benzodiazepines)

Family, friends and other users failure to recognize overdose, or having seen non fatal overdose in the past, and failing to act

Failure to call 911 due to fear of arrest Delay in calling 911 (delaying it for hours

even with symptoms of deep sleep, snoring and respiratory difficultly

Causes of OD Continued Failure of treatment staff to recognize risk

factors for overdose Lack of access to treatment. Heroin injectors

not in methadone treatment are 4 times more likely to die than those in treatment.

Observers not knowing emergency response “recovery position & CPR”

Naloxone (not available or used by injectors, family members).

Lack of interagency collaboration to address overdose problem (Public Health Treatment, EMS, and Police)

Signs and Symptoms of Overdose

Some signs are: Not Breathing Turning Blue Not responding Snoring Deeply Central Nervous Irritation such as

confusion, vertigo, nausea, vomiting, seizures, etc.

What do you do if someone is Overdosing CALL 911! Place person in the rescue position

The 2 major risk factors for people lying on their back: 1: Tongue can fall back onto throat, block

airway 2: Fluids (i.e. vomit) can collect in the back of

the throat and cause drowning

Thank you!

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