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

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

3. 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
"Opiate Abuse." DrugAbuse.com. N.p., 13 Aug Web. 26 Jan Available at:

4. 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 on CDC WONDER Online Database, released December, Available at:
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, Available at:
3. Jones CM. Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers - United States, and Drug Alcohol Depend Sep 1;132(1-2): doi: /j.drugalcdep Epub 2013 Feb 12.

5. 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 Trenton, New Jersey. June 2016.

6. 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 Web. 26 Jan Available at:

7. NIDA (2015). Nationwide Trends
NIDA (2015). Nationwide Trends. Retrieved January 26, 2017, from

8. NIDA (2015). Nationwide Trends
NIDA (2015). Nationwide Trends. Retrieved January 26, 2017, from

9. 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 Web. 26 Jan

10. 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 Web. 26 Jan

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

12. 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 Web. 26 Jan
NIDA (2014). Heroin. Retrieved January 26, 2017, from

13. 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.

14. 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 Web. 26 Jan Available at:
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 Web. 26 Jan Available at:

15. 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 Web. 26 Jan

16. 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 Web. 26 Jan Available at: activities/testimony-to-congress/2016/prescription-opioid-heroin-abuse

17. 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.

18. 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 Web. 26 Jan Available at:

19. 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

20. Available resources National 24/7 Helpline: 1-800-662-HELP (4357)
New Jersey Addiction Services 24/7 Hotline:
Substance Abuse and Mental Health Services Administration:

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

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