Prescription Drug and Heroin Abuse in Fairfax County Recent Trends and Strategies for Prevention

1. Prescription Drug and
Heroin Abuse
in Fairfax County:
Recent Trends and
Strategies for Prevention
Presentation to the Board of Supervisors
Human Services Committee
December 9, 2014

2. Background
• The national death rate from heroin overdoses
has doubled in the past two years, to 2.1 deaths
per 100,000 persons annually.
• Local stories have been chronicled in the media.
• In September, the Board directed staff to review
the issue.
• In October, Police convened a stakeholder
meeting, kicking off the process of developing a
comprehensive strategy.
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3. Stakeholder Involvement to Date
• Police
• Sheriff
• Fire and Rescue
• Commonwealth’s
Attorney
• Parents/Community
• Fairfax County Public
Schools
• Community Services
Board
• Health
• Neighborhood and
Community Services
• Unified Prevention
Coalition
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4. Prescription Drug and Heroin Use
• Prescriptions of opioids for use as painkillers
have grown dramatically over the past two
decades
• Opioid use can create dependency, resulting in
addiction and heroin use
• Heroin user demographics have changed,
trending younger
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5. Data Issues
• There is no single measure, or small number
of measures, that can adequately provide a
clear and comprehensive overview of the
prevalence and impact of opioid abuse.
• Complications include:
– medical coding,
– self-reporting,
– relatively small raw numbers at the local level, and
– the variety of types and names of opioid drugs.
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6. Opioid Overdose Deaths, Sales, & Treatment
Admissions, United States, 1999–2010
8
7
6
5
4
3
2
1
0
Opioid Sales KG/10,000
Opioid Deaths/100,000
Opioid Treatment Admissions/10,000
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Rate
Year
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7. Sources of Pain Relievers for Nonmedical Use
Among Past Year Users 12+ Years Old, United
States, 2012.
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8. Number of Heroin Overdoses and
Fatalities, Fairfax County
70
60
50
40
30
20
10
0
2012 2013 2014*
Overdoses
Fatalities
*2014 is through November
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9. Number of Fatal Heroin & Prescription
Opiate Overdoses, Virginia, 2007-2014
Heroin Prescription Opiods
100 89
107
48
100
135
213 210
389
422
398 415
487
414
468
508
600
500
400
300
200
100
0
2007 2008 2009 2010 2011 2012 2013 2014
Number of Deaths
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2014 is estimated based on data through June 30, 2014

10. EMS Patient Contacts,
Fairfax County
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11. Demographics
Fatal Heroin Overdoses by Age,
Virginia,
2013 - July 11, 2014
2%
10%
35%
27%
17%
7%
2%
15-19
20-24
25-34
35-44
45-54
55-64
65+
Fairfax County EMS Contacts,
Suspected Heroin Overdose,
2011-2014
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12. 30-Day Use of Select Substances,
FCPS 8th, 10th, 12th graders, 2010-2013
25
20
15
10
5
0
2010 2011 2012 2013
Percent Reporting
Alcohol
Binge Drinking
Cigarettes
Marijuana
Painkillers
Other Rx
Heroin
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13. Similar and Related Efforts
• Combat Heroin and Prescription Drug Abuse,
New York State
– http://combatheroin.ny.gov/
• Winchester/Valley Addiction Action
Committee
• Prince William County
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14. Governor’s Task Force on Prescription
Drug and Heroin Abuse
• Included in the A Healthy Virginia action plan
• Five issue areas:
– Education and awareness
– Treatment
– Storage and disposal
– Enforcement
– Data and monitoring
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15. New Resources
• CSB Heroin/Opiates Web Page
http://www.fairfaxcounty.gov/csb/heroin-opiates/
• Police Heroin Tip Line
1-844-373-3634
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16. Fairfax Framework for Prevention
• Five strategic areas:
– Education and awareness
– Treatment
– Prescription drug storage, disposal, and monitoring
– Enforcement
– Data and monitoring
• Objective(s) for each area
• Potential strategies
• Existing efforts
• Opportunities for partnership, collaboration and
adaptation
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17. Education and Awareness
• Objective: Increase public awareness of the
dangers of misuse and abuse of prescription
drugs and heroin and their connection to each
other.
• Potential Strategies:
– Website: information, referral, resources
– Seminars and other public events; speakers bureau
– Messaging: print, web, social media, and other media
– School curriculum
– Messaging tools for elected officials
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18. Prescription Drug Storage,
Disposal, and Monitoring
• Objective: Increase safe disposal of unused
prescription drugs.
• Potential Strategies:
– Expanded drug take-back
– Public education on safe disposal
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19. Prescription Drug Storage,
Disposal, and Monitoring
• Objective: Promote best practices in
prescribing opioids.
• Potential Strategies:
– Painkiller prescribing guidelines
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20. Prescription Drug Storage,
Disposal, and Monitoring
• Objective: Monitor the prescription use of
opioids.
• Potential Strategies:
– Parent education on monitoring medication
– Public education on safe storage
– Education for coaches, physical therapists, and
athletic trainers to monitor athletes who have
been prescribed painkillers
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21. Treatment
• Objective: Facilitate access to opioid addiction
treatment.
• Potential Strategies:
– Recommended treatment services, counseling,
and information on adherence to standards of
treatment for addiction
– First responders referrals to treatment
– Service directories and navigation supports
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22. Treatment
• Objective: Incorporate training on the
County’s availability and use of Naloxone by
first responders to treat individuals who have
overdosed on opioids.
• Potential Strategies:
– Training for first responders, health care providers,
and others on the use of Naloxone by Fairfax
County FRD
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23. Treatment
• Objective: Expand opportunities for peer
support components in treatment and
recovery programs.
• Potential Strategies:
– Incentives for incorporation of peer support into
recovery and treatment
– Recruitment and training of participants
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24. Enforcement
• Objective: Prioritize access to treatment over
prosecution in law enforcement of opioid use and
overdose.
• Potential Strategies:
– Review options for drug courts, diversion, and
referrals
– Good Samaritan law
– Accessible means of referrals for first responders
– Review of Police Department guidelines and/or policy
for how to handle opioid use and overdose
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25. Enforcement
• Objective: Increase prosecution of illegal
heroin and opioid distributors/dealers.
• Potential Strategies:
– Expanded use of a regional grand jury process to
expedite indictments of suspected dealers
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26. Data and Monitoring
• Objective: Monitor local trends in prescription drug
and heroin use to identify needs and monitor progress.
• Potential Strategy:
– Identify key indicators and align data sets and measures
where possible
– “Prescription Drug and Heroin Abuse Report Card”
• Objective: Evaluate the strategies included in the final
strategic plan.
• Potential Strategy:
– Evaluation plans for identified strategies
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27. Next Steps
• Identify and engage stakeholders.
• Develop action plans, including leads and
coordination strategies.
• Coordinate with Governor’s Task Force.
• Explore alternative funding strategies.
• When feasible, begin implementation.
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28. Recommendations
• Direct staff to present the plan, with funding and
policy requirements, to the Board at an upcoming
Human Services Committee meeting.
• Ensure opportunities exist to include strategies in
the next year’s legislative program.
• Direct staff to develop strategies for an expanded
drug take-back program, to include funding and
resource requirements.
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29. Questions?
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30. Contacts
Capt. Paul Cleveland, Police
paul.cleveland@fairfaxcounty.gov
703-802-2711
Jesse Ellis, Neighborhood & Community Services
jesse.ellis@fairfaxcounty.gov
703-324-5626
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