Addressing the Opioid Epidemic Orientation for Volunteers Presented by: [Name of organization] January 2017

Objectives Discuss the current opioid epidemic Provide overview of the organization and its goals Describe the general role and responsibilities of a volunteer

What is An Opioid Class of drug including both prescription pain medications and illicit drugs Can cause both physical and psychological dependence Examples: Prescription pain medications Natural opioids: Morphine, codeine Semi-synthetic opioids: Oxycodone, oxymorphone, hydrocodone, hydromorphone Synthetic opioids: methadone, fentanyl, tramadol Illicit drugs Heroin Reference https://www.cdc.gov/drugoverdose/data/analysis.html "Opiate Abuse." DrugAbuse.com. N.p., 13 Aug. 2016. Web. 26 Jan. 2017. Available at: http://drugabuse.com/library/opiate-abuse/#signs-and-symptoms

The Facts Drug overdose death has become the leading cause of injury death in the US (incidence higher than deaths caused by motor vehicle accidents) 55,403 lethal drug overdoses reported in 2015, of which 20,101 were related to overdose due to prescription pain medications, and 12,990 were related to heroin overdose In 2015, 3.8 million (1.4%) people 12 years or older were misusing pain medications 4 in 5 new heroin users started by abusing prescription pain medications 1. Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Available at: http://wonder.cdc.gov/ucdicd10.html 2. Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. Online Database, released September, 2016. Available at: https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.htm 3. Jones CM. Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers - United States, 2002-2004 and 2008-2010. Drug Alcohol Depend. 2013 Sep 1;132(1-2):95-100. doi: 10.1016/j.drugalcdep.2013.01.007. Epub 2013 Feb 12.

New Jersey State Specific Statistics 128,000 people addicted to opioids or heroin in 2015 32,529 substance abuse treatment admissions related to opioids in 2015 27,621 cases related to heroin abuse 4,908 cases related to abuse of other opioids Ocean, Essex, and Monmouth are the three counties with the highest number of reported cases Department of Human Services. New Jersey Drug and Alcohol Abuse Treatment Substance Abuse Overview 2015. Trenton, New Jersey. June 2016.

Drugs of abuse Marijuana Alcohol Opioids Methamphetamine MDMA (Ecstasy/Molly) Cocaine Inhalants Steroids Tobacco/Nicotine Commonly Abused Drugs Charts." National Institute on Drug Abuse (NIDA). N.p., 01 Jan. 2016. Web. 26 Jan. 2017. Available at: https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts

NIDA (2015). Nationwide Trends NIDA (2015). Nationwide Trends. Retrieved January 26, 2017, from https://www.drugabuse.gov/publications/drugfacts/nationwide-trends

NIDA (2015). Nationwide Trends NIDA (2015). Nationwide Trends. Retrieved January 26, 2017, from https://www.drugabuse.gov/publications/drugfacts/nationwide-trends

Prescription drug abuse Current trend Increased number of pain medications being prescribed Greater social acceptance of using medications for different purposes Risks include misuse, abuse, addiction, and overdose One in every four chronic users of prescription opioids for non- cancer pain in primary care settings are affected by addiction Over 1,000 people are treated in the emergency department everyday for misusing prescription opioids "Prescription Opioid Overdose Data." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 16 Dec. 2016. Web. 26 Jan. 2017.

Heroin abuse Heroin is a semi-synthetic opioid with no accepted medical use in the US Heroin is injected or snorted, which enters the body and brain very quickly to produce an extreme high that is highly addictive and dangerous In 2015, approximately 0.3 million (0.1%) people 12 years or older were currently using heroin "Heroin Overdose Data." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 16 Dec. 2016. Web. 26 Jan. 2017.

"Today’s Heroin Epidemic Infographics "Today’s Heroin Epidemic Infographics." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 07 July 2015. Web. 26 Jan. 2017.

From prescription opioids to heroin Approximately 3 out of 4 new heroin users report having abused prescription opioids in the past Easier access to heroin than prescription opioids Heroin does not require a prescription Street price for heroin may be more affordable than prescription opioids The concern with heroin Higher risk of overdosing Variable concentration with harmful impurities Transmission of diseases through injection & needle sharing "Heroin Overdose Data." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 16 Dec. 2016. Web. 26 Jan. 2017. NIDA (2014). Heroin. Retrieved January 26, 2017, from https://www.drugabuse.gov/publications/research-reports/heroin

Acute vs. Chronic consequences of opioid use Drowsiness & sedation Decreased breathing Withdrawal Blood borne diseases through needle use Overdose Chronic Tolerance Physical and psychological dependence Inability to maintain interpersonal relationship Inability to maintain normal performance at work Kosten, T. R., & George, T. P. (2002). The Neurobiology of Opioid Dependence: Implications for Treatment. Science & Practice Perspectives, 1(1), 13–20.

Recognize opioid dependence Declined performance at work, home, or school Loss of interest in favorite activities Changes in eating or sleeping habits Increased aggression or irritability Sudden change in social network Constantly feeling tired and sleepy Deteriorating relationships with family members and friends "Opiate Abuse." DrugAbuse.com. N.p., 13 Aug. 2016. Web. 26 Jan. 2017. Available at: http://drugabuse.com/library/opiate-abuse/#signs-and-symptoms NIDA. "What to Do If Your Adult Friend or Loved One Has a Problem with Drugs." National Institute on Drug Abuse (NIDA). N.p., 19 Jan. 2016. Web. 26 Jan. 2017.Available at: https://www.drugabuse.gov/related-topics/treatment/what-to-do-if-your-adult-friend-or-loved-one-has-problem-drugs

Opioid overdose deaths have quadrupled since 1999, and continues to increase in the US "Data Overview." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 16 Dec. 2016. Web. 26 Jan. 2017.

Economic burden of opioid abuse Nonmedical use of opioid pain relievers cost insurance companies up to $72.5 billion annually in health-care cost Social & economical consequences Cost of prevention and treatment Increased incidences of opioid overdose deaths Safety risk to the public due to drug affected driving Environmental contamination due to inappropriate disposal and illicit cultivation Loss of productivity at work Neonatal abstinence syndrome Volkow, Nora. "Prescription Opioid and Heroin Abuse." National Institute on Drug Abuse (NIDA). N.p., 29 Apr. 2014. Web. 26 Jan. 2017. Available at: https://www.drugabuse.gov/about-nida/legislative- activities/testimony-to-congress/2016/prescription-opioid-heroin-abuse

Physical dependence vs. addiction Body is used to having a high level of opioid Abrupt discontinuation will result in withdrawal symptoms (nausea & vomiting, anxiety, etc.) Physical Dependence Uncontrollable craving and compulsive use, inability to control drug use There is no addiction without craving Addiction Addiction is a chronic, progressive brain disease due to altered brain structure and function Kosten, T. R., & George, T. P. (2002). The Neurobiology of Opioid Dependence: Implications for Treatment. Science & Practice Perspectives, 1(1), 13–20.

Treatment options Best treatment option is PREVENTION! Counseling & Behavioral Therapies Individual and group counseling Inpatient and residential treatment Intensive outpatient treatment Case or care management Recovery support services 12-step fellowship Peer supports Medication Assisted Treatment Buprenorphine Methadone Naltrexone "Treatment for Substance Abuse Disorders." SAMHSA. N.p., 8 Sept. 2016. Web. 26 Jan. 2017. Available at: https://www.samhsa.gov/treatment/substance-use-disorders

Take Home Points Prescription opioids is just as dangerous as illicit drugs when not taken as directed Prescription opioid abuse is strongly linked to heroin abuse Opioid addiction is a disease which requires treatment The best treatment for opioid addiction is prevention

Available resources National 24/7 Helpline: 1-800-662-HELP (4357) New Jersey Addiction Services 24/7 Hotline: 1-844-276- 2777 Substance Abuse and Mental Health Services Administration: https://www.samhsa.gov

[INSERT YOUR ORGANIZATION NAME HERE] Use this section to briefly introduce your organization, your goals/mission statements, and upcoming events

Volunteers Use this section to introduce your expectations of your volunteers, and describe their roles & responsibilities