The Challenge of Opioid Addiction Valerie Valcour RN, Health District Director Carol Plante, Healthy Lamoille Valley * September 3, 2014

2 Lamoille Valley Opiate Summit  Purpose:  Build a web between local efforts and the greater community  Spark innovative strategies Vermont Department of Health

3 Lamoille Valley Opiate Summit AGENDA  State of the State  Gallery Walk  Recap of June Governor's Opiate Summit  Break  Sharing Groups – “What struck you?”  Wrap Up – Next Steps Vermont Department of Health

4 PREVENTION Effective prevention addresses various risk and protective factors that can either increase or decrease substance use/abuse. Vermont Department of Health Risk & Protective Factors The Root Causes +/- Risk & Protective Factors The Root Causes +/-

5 PREVENTION  Place Matters  Health is where we live, work, learn, play & pray. Vermont Department of Health

Opioids – including prescription painkillers and heroin – are powerful drugs that can be powerfully addictive. Facts About the Problem Vermont Department of Health

7 The numbers are going in the right direction. Vermont Department of Health

8 Heroin use among Vermonters is low and stable.  2% of high school students reported ever using heroin in 2013 (Youth Risk Behavior Survey) This is down, although not significantly, from 3% in 2011  Fewer than 1% of Vermonters ages 12+ reported using heroin in the past year in 2011/12 (NSDUH) This is unchanged from 2010/11 In 2011/12 Vermont had a significantly lower prevalence of heroin use compared to the United States Vermont Department of Health

9 Non-medical pain reliever use is related to heroin use.  NSDUH found that recent (12 months preceding interview) heroin incidence rate was 19 times higher among those who reported prior non-medical pain reliever use than those who did not  NIDA reports that nearly half of young people who inject heroin, surveyed in three recent studies, reported abusing prescription opioids before starting to use heroin. Vermont Department of Health Source: National Survey on Drug Use and Health,

10 Heroin deaths are on the rise in Vermont. Vermont Department of Health Source: Office of the Chief Medical Examiner Note: Total opioid includes un-identified opioids. Heroin and prescription opioids are not mutually exclusive.

These are big numbers for our small state 50+ die from opioid poisoning every year Young people are most at risk Addiction is a lifelong chronic disease Costs are high – families and communities torn apart young lives shattered treatment, health care, law enforcement, corrections, human services $$$ Why do we call this a crisis?

12 The number of people treated is up since Vermont Department of Health Source: Alcohol and Drug Abuse Treatment Programs

13 The number of people treated for heroin is up. Vermont Department of Health Source: Alcohol and Drug Abuse Treatment Programs

14 Age at first use for opioids is older than for alcohol. Vermont Department of Health Source: Alcohol and Drug Abuse Treatment Programs, admissions

15 People seek treatment for opioid addiction sooner. Vermont Department of Health Source: Alcohol and Drug Abuse Treatment Programs, admissions

Research shows that a comprehensive approach, using principles of effective prevention, intervention, treatment, recovery and enforcement, is most effective. Making a difference Vermont Department of Health

17 Substance Abuse Continuum of Care Recovery Services Vermont Agency of Human Services Intensive Outpatient Treatment Outpatient Treatment Screening, Brief Intervention, Referral for Treatment Prevention Services Highest Level of Care Lowest Level of Care Fewest Number of People Largest Number of People Specialty Treatment Residential Opioid Hub

Opioid abuse and addiction is a complex problem with far-reaching consequences. The good news is Vermonters excel at community action. With everyone working together, we can make progress. Good News: We can do this! Vermont Department of Health

2009 – 2013 Youth Risk Behavior Survey Local Data Vermont Department of Health

Current Rx Drug Use Vermont Department of Health Source: Youth Risk Behavior Survey

Perception of risk of harm Vermont Department of Health Source: Youth Risk Behavior Survey

Perception of risk of harm Vermont Department of Health Source: Youth Risk Behavior Survey

Perception of risk of harm Vermont Department of Health Source: Youth Risk Behavior Survey

Parental disapproval Vermont Department of Health Source: Youth Risk Behavior Survey

Parental disapproval Vermont Department of Health Source: Youth Risk Behavior Survey

Parental disapproval Vermont Department of Health Source: Youth Risk Behavior Survey

Effective Prevention Vermont Department of Health Evidence-based strategies Population level Multi-sector Vermont Prevention Model

Partnership for Success Vermont Department of Health Prescription Drug initiatives Community-wide education eCheckUp To Go State of Our Youth Campaign Youth Engagement Town Ordinances & Town Wellness Plans Saturation & Party Patrols

Healthy Community Design Vermont Department of Health Addresses health issues and trends Built environment influences eating and activity patterns Increases access to walking, biking, outdoor recreation, local farms and food and community gardens * Creates opportunities that make it easier to eat healthy and be physically active

30 Lamoille Valley Opiate Summit  Gallery Walk  Hub & Spoke  Rapid Intervention Community Court  Healthy Lamoille Valley – Partnership for Success  Healthy Lamoille Valley – Healthy Community Design  North Central Vermont Recovery Center Vermont Department of Health

31 Lamoille Valley Opiate Summit  Governor’s Forum on Opiate  June 16, 2014  Recap Vermont Department of Health

32 Governor’s Forum  LV Charge to the Community – Address:  Stigma Host a viewing of Anonymous People  Housing & Transportation  Screening  Workplace & School Environment Issues  Family Support  Women & Children  It takes a Community Vermont Department of Health

Lamoille Valley Opiate Summit Refreshments Networking  10 MINUTE BREAK Vermont Department of Health

34 Lamoille Valley Opiate Summit What did you learn from the gallery walk? 1. What intrigued you? 2. What questions do you have about prescription drug abuse and opioid use in Lamoille Valley? 3. What connection can you take or make? 1. How will you apply this info? 4. If you had a no cost or low cost strategy to combat the problem of opioid and prescription drug abuse, what would it be? Vermont Department of Health