1. Ohio’s Opioid Epidemic
Veronica Scherbauer, Criminal Justice Initiatives Coordinator

2. HOLD FOR VIDEO LET’S FACE HEROIN

3. National Epidemic
Centers for Disease Control and Prevention (2015). Leading causes of death report, national and regional, , United States, Unintentional injuries, all ages, all races, both sexes total deaths,

4. Ohio’s Opioid Epidemic
Ohio Department of Health, Healthy Ohio (N.D.) Burden of injury in Ohio, ,
Ohio Department of Health Bureau of Vital Statistics

6. Ohio’s Opioid Epidemic
A lot has contributed to this dramatic increase. To fully understand we must go back.
1996: Purdue Pharma releases OxyContin AND American Pain Society identifies pain as the 5th vital sign.
1998: Black tar heroin arrives in Columbus and spreads to major cities AND Pain clinics open around the country.

7. Ohio’s Opioid Epidemic
1998
Dr. Procter opens what is thought to be the US’s first pain clinic. He prescribes oxycontin to people for around $250 cash per prescription. Proctor was making $1 million a year and seeing as many as 80 patients a day.
Talk about Portsmouth.

8. Drug Cartels Target Ohio Neighborhoods
Targeted because:
Safe Neighborhoods
Access to vehicles
Money
Cell Phone

9. Ohio’s Opiate Epidemic
The US is about 4% of world population and will use about 80% of the world’s hydrocodone in 2014.
The US consumes nearly 50x’s more Hydrocodone than the 2nd highest prescribing country, Palau. Hydrocodone is also the most prescribed pill in the US. About 17 times more prescriptions for hydrocodone were written than the next three most common prescriptions combined.
1. Hydrocodone/acetaminophen (pain)
2. Synthroid (thyroid)
3. Lisinopril (blood pressure)
4. Simvastatin (cholesterol)

10. 500% increase since 2000

11. 3,050 Ohio Residents died from unintentional overdose in 2015
*Ohio Department of Health

12. Fentanyl – Related Cases
Much of this increase is attributable to fentanyl laced heroin, which began to appear in 2014.
Heroin-related deaths accounted for 1,177 (47.4%) percent of unintentional drug overdose deaths in 2014, compared to 983 (46.6%) in 2013.
Prescription Opioid-related deaths accounted for 1,155 (46.5 %) of unintentional Drug Overdose deaths in 2014 compared to 726 (34.4%) in Fentanyl-related drug overdose deaths are categorized as prescription opiate deaths, a contributing factor to the increase.

13. BCI Labs Statewide Cases
2010
2011
2012
2013
2014
2015
Fentanyl Cases 34 31 27 39
387
1,110
Heroin Cases
2,378
2,791
3,951
4,971
6,471
6,832
*Ohio Bureau of Criminal Investigation

14. Carfentanil is used as a tranquilizing agent for elephants and other large mammals. Carfentanil is approximately 100 times more potent than fentanyl, which can be lethal at the 2-milligram range (photograph), depending on route of administration and other factors.

16. Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry
Opioids directly affect the brain by altering it physically. The pathways that send messages to the brain and body are rerouted, damaged or destroyed. This becomes important in understanding the reason behind behaviors of those addicted to opioids.

17. Overall brain damage
Obvious signs of damage is evident in brain scans of opioid addicted persons in a Spect scan, a nuclear image with 3D pictures.

18. Long-Term Effects of Opiates
Results of IV drug use include heart valve infection, vein collapse and infection, MRSA, Pneumonia, liver function decrease, blood clots due to undissolved solids.

19. Breaking the Cycle of Addiction

20. OVERDOSE: Know the signs!
If you observe:
Little or no respirations, noisy or raspy breathing.
Cardiac arrest, little or no pulse.
Foaming from the mouth.
Pinpoint pupils.
Little or no response to stimulation.
Bluish or gray lips, skin, nail beds.
Call EMS immediately!
Use Narcan/Naloxone
Know what an overdose looks and sounds like. If someone you know has an opioid problem, have Naloxone readily available.

21. Naloxone (NARCAN) 4.6 minutes to arrive at scene
18 minutes spent at scene
12.2 minutes for transport to hospital
Average EMS response time in Ohio is minutes
NEED SOURCE

23. To achieve recovery and put addiction and it’s consequences behind you…you have to take a different road.

24. Heroin Unit
Attorney General DeWine’s Heroin Unit was formed in 2013 (here is a picture of the press conference when the unit was announced). Our Heroin Unit provides: (1) investigative and (2) community outreach assistance. When asked, we help local law enforcement with technical assistance needs, as well as providing assistance with criminal case investigations or prosecution.

25. The Community Outreach Team
The Community Outreach Team for Mike DeWine assists communities throughout Ohio confronting the opioid and heroin epidemic. Awareness of issues from the opiate and heroin problem are a top concern in every community. We help facilitate ideas to address immediate concerns and longer term initiatives. We meet regularly with coalitions, task forces, grassroots efforts, church leaders, medical and treatment providers. We regularly assist with connecting persons with needed resources. In raising awareness, sharing ideas and reaching nearly every community in Ohio, the formation of robust coalitions, initiatives such as Naloxone accessibility and reentry programs take root.

26. Ohio Joint Study Committee on Drug Use Prevention and Education

27. Ohio’s Opiate Epidemic
Trends - Positive
Increased use of MAT/Medicaid
Increased use of Naloxone - rebate
Greater Awareness
Drug Courts
Community Engagement
Recovery Housing
Law Enforcement’s Response
Legislation

28. You Can Help!

29. What We Have Learned Must Engage All 12 Sectors of the Community
Government
Victims/Survivors
Justice
Volunteers
Treatment
Youth & Youth Serving Org.
Law Enforcement
Faith-Based
Medical
Media
Education
Business
In order to mobilize the community we have found that you have to include all sectors.
Coming from the Board setting, I know that it is sometimes hard to worry about awareness.

30. OD parents, 4 year old, walking down sullivant ave. stuffed animals.

31. Ohio Attorney General’s Heroin Unit
Amy C. O’Grady, Director of Criminal Justice Initiatives
(614)