Substance Use by liuqingyan


									Drug Overdose Prevention
Kennebec County

  Jayne Harper
  Overdose Prevention Health Educator
  Prevention Center
  Data provided by Maine Health Information Center
   Drug Overdose Prevention Project
   Myths
   Defining Addiction
   Drug Overdose Statistics
   Drug Overdose Prevention Resources
Myth Buster #1

Addiction Treatment is
     NOT effective.
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
 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,
Myth Buster #2

 Treating addiction is a
    waste of money.
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
Source: “Substance Abuse Treatment and Public Safety.” Justice Policy institute (2008)

 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
Myth Buster # 3

    Medicated Assisted
   Treatment (methadone
  and suboxone) is trading
  one addiction for another
      True OR 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.
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.”
Substance Use Disorder - Addiction

…..isa 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
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
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
 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
How Common is Drug and Alcohol

 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
 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
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 Calls
                                  Kennebec County


       # of calls




                           2002       2003          2004     2005   2006
Unintentional Drug         314         382          361      324    367
Unintentional Drug Overdoses Kennebec County,
                 Top 5 Towns









              Waterville   Augusta   Winslow      Oakland     Winthrop
Available Prevention

  Save-A-Life DVD
  Take as Directed (Rx Safety) DVD
  Overdose Posters and Wallet Cards
  Substance 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
 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
 Educate users and family members
  about the signs and symptoms of
  overdose and the importance of
  calling 911 when these symptoms are
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
 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
 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
   2: Fluids (i.e. vomit) can collect in the back
    of the throat and cause drowning
Thank you!
 Comments
 Questions
 Request for resources

To top