Managing Opioid Medications – written by Dennis Dyer

Managing Opioid Medications-written by Dennis Dyer – A.C.C.A.D.A. Director

Since we are in an opioid epidemic most people know that there are risks associated with opiate-based painkillers.  We know that in the early 2000s the medical system began to increase the use of opioid painkillers. This was due to a movement in the medical system to better address pain in those suffering from various medical problems. Drug companies use aggressive marketing to increase profits. Unfortunately that exposed large numbers of patients to opioid painkillers and fueled the epidemic. These drugs provided those already using drugs and alcohol a new high.  Many of those who became addicted to the pills eventually moved on to heroin use. A few years ago 2,400,000 doses of these painkillers were dispensed by pharmacies in Ashland County alone.  Due to lower prescribing by doctors in 2017 the number of doses of opioid painkillers went down by 650 thousand doses to 1.75 million doses last year.  That is a reduction of 650,000 doses from the high of 2.4 million. That is a down 27%. The medication average strength has also being reduced. – Source: OAARS Website.

Many of those filling prescriptions for painkillers only take what they believe they need. In many cases when the pain is manageable they stop taking the pills. The remaining pills are typically stored in the medicine cabinet or a dresser drawer. Some may even be left in a basket on the countertop. My guess is that a third or more are not used for the pain and are then present in the home of the patient.  A lot of us will save the medication thinking the pain will return and we will be needing it later.  Others just don’t want to waste the medication. Many have also heard that they should not flush the medication and that there are environmental issues related to disposal.

This means that there are likely hundreds of thousands of doses of opioid painkillers in the homes of area residents. A considerable number of these medications are diverted for misuse. While the number of prescribed painkillers has gone down, we still have to be concerned about the large amount of unused opioid painkillers in our homes! When you have the medications at home, keep in a safe place where the drugs cannot be stolen.

We can all contribute to reducing the misuse of these drugs by proper disposal.

Here is how medication can be disposed of properly:

1) DISPOSE OF IN A DROP BOX: Take the medication to the drop boxes at the Ashland County Sherriff’s office. There is a drop box in the lobby of the County Jail.  There is another box at the Loudonville Police station.

2) DISPOSE OF IN THE TRASH: Use an in-home neutralization kit and dispose of in the trash. If you don’t have a kit put the medication in as sealable plastic bag. Add something that will make the medication unusable like cat litter or coffee grounds and then put in the trash.

Please encourage your friends and family to dispose of unused medications. One should avoid flushing medication down the toilet.

Alcohol and Drug Prevention at A.C.C.A.D.A.

Guest Column:  A.C.C.A.D.A. Alcohol/Drug Prevention    Kris Hickey has worked as a prevention educator in Ashland County for 27 years. She is employed at A.C.C.A.D.A. and is a State Certified Prevention Consultant.

Almost everyone today knows someone directly or indirectly that has been affected by the opiate crisis in our country.  Families, communities, schools religious organizations and the government are all scrambling to try and find a solution to this ever growing issue. The Ashland County Council on Alcoholism and Drug Abuse, Inc. (A.C.C.A.D.A.) believes that prevention works.  A.C.C.A.D.A. has been providing various prevention programs to area schools and organizations for over 30 years.

Currently, A.C.C.A.D.A.’s main prevention program targets kindergarten through high school students. The program is called Too Good For Drugs! (TGFD) The program is a 10 week, comprehensive, evidence based program provided by the Mendez Foundation. TGFD is designed to build skills such as decision making, coping skills and assertive communication styles along with understanding peer pressure and practicing refusal strategies.   It reinforces resiliency and emphasizes positive attitudes and healthy choices as the norm.  Students are taught how to determine if a friend is a going to be a positive or negative influence on their lives and how to deal with that issue.  The program, depending on the age of the participant, also addresses social, emotional and physical effects of tobacco, alcohol, marijuana, street drugs, over the counter and prescription medications. By the time a student reaches 8th grade, they will have a basic working knowledge of the harmful effects of all of these drugs.  The program emphasizes avoiding drug use and other risky behaviors.

Many people believe that showing disturbing pictures of the effects of drug use is an effective prevention program.  However, it has been proven repeatedly that scare tactics do not prevent adolescents from engaging in risky behaviors.  Adolescents believe they are invincible and nothing bad will happen to them. They are also quick to recognize scare tactics and discount them.  The TGFD program impresses upon students that most people do not use drugs and looks at the social consequences of deciding to use drugs. Having students consider that their actions will affect their siblings, parents, classmates, community and friends has more of an impact on decision making than scare tactics. Too Good For Drugs does a good job at examining those social consequences.

TGFD believes strongly that having positive role models in children’s lives is a major component to combating the drug problem. When kids can recognize and value how they are connected to adults in their communities and families, they are healthier in general.  Children need to feel like they are a part of something. This could be involvement in families, 4H, sports, band, church, civic organizations etc. Being made to feel important and worthwhile strengthens protective factors that help guard against poor choices leading to drug use. When kids go through the Too Good For Drugs program, they learn about the importance of being connected to others.

You may be wondering how you begin drug prevention in kindergarten? Certainly, you wouldn’t want to discuss the effects of heroin on a developing brain with 5 year olds. Rather, discussing staying healthy, exercising, eating healthy, getting enough rest, dealing with feelings and friendship skills are the main focus of the program at this age. In 3rd grade we begin to discuss Tobacco, Alcohol and Marijuana. By 5th grade the program is discussing different categories of drugs like depressants, stimulants, hallucinogens and Prescription Drug use, misuse and addiction..  At the middle school level the program gets more into social consequences and physical consequences of drug use.  Peer pressure refusal strategies are incorporated at all levels.

Ideally, the TGFD program is designed to grow with a student as they move through school. Several districts do this quite well. Crestview and Hillsdale have almost every grade level K-8 receiving the TGFD program.  That means that all the students in those districts are receiving 10 weeks every year of drug prevention education. Comprehensive repeated exposure to evidence based knowledge about alcohol and drugs is a great start to combating the opiate problem that we are experiencing.

Other Districts in our area are following suit. Reagan Elementary has implemented the program in all of their classes this year as did Taft Intermediate. We hope to expand the program and fill gaps in other schools. Ashland Middle School also has had classes of TGFD running this school year.  Mapleton is doing the program in kindergarten, 7th and 8th grades. Loudonville schools have implemented the program in kindergarten, 2nd and 4th grades.  We would like to see the TGFDs program in every classroom K-8 in Ashland County.

Classroom time is precious. State mandates and standardized testing has made it so that prevention programming has to compete against other required educational activities. However, in light of the enormity of this issue, we have to make time.  We need, as a community, to realize that prevention works and it is a good starting point to combat this problem. Involving families, schools and churches will only make the message stronger. Together, with A.C.C.A.D.A., the schools, the community and families we can make a difference by giving kids the skills that they need to be successful, drug free, productive and healthy human beings. Please continue to support prevention efforts in your local schools. We also thank all the principals and teachers who have recognized the need for this kind of programming and welcomed us into their classrooms.

The Mental Health and Recovery Board of Ashland County has supported and funded the A.C.C.A.D.A. prevention effort for the last 28 years and continues to encourage further development of alcohol/drug prevention in Ashland County. 

 

 

 

 

 

School Prevention Programs Key To Fighting Opiate Crisis

Guest Column: A.C.C.A.D.A. Alcohol/Drug Prevention Kris Hickey has worked as a prevention educator in Ashland County for 27 years. She is employed at A.C.C.A.D.A. and is a State Certified Prevention Consultant.

Almost everyone today knows someone directly or indirectly that has been affected by the opiate crisis in our country. Families, communities, schools religious organizations and the government are all scrambling to try and find a solution to this ever growing issue. The Ashland County Council on Alcoholism and Drug Abuse, Inc. (A.C.C.A.D.A.) believes that prevention works. A.C.C.A.D.A. has been providing various prevention programs to area schools and organizations for over 30 years.

Currently, A.C.C.A.D.A.’s main prevention program targets kindergarten through high school students. The program is called Too Good For Drugs! (TGFD) The program is a 10 week, comprehensive, evidence based program provided by the Mendez Foundation. TGFD is designed to build skills such as decision making, coping skills and assertive communication styles along with understanding peer pressure and practicing refusal strategies. It reinforces resiliency and emphasizes positive attitudes and healthy choices as the norm. Students are taught how to determine if a friend is a going to be a positive or negative influence on their lives and how to deal with that issue. The program, depending on the age of the participant, also addresses social, emotional and physical effects of tobacco, alcohol, marijuana, street drugs, over the counter and prescription medications. By the time a student reaches 8th grade, they will have a basic working knowledge of the harmful effects of all of these drugs. The program emphasizes avoiding drug use and other risky behaviors.

Many people believe that showing disturbing pictures of the effects of drug use is an effective prevention program. However, it has been proven repeatedly that scare tactics do not prevent adolescents from engaging in risky behaviors. Adolescents believe they are invincible and nothing bad will happen to them. They are also quick to recognize scare tactics and discount them. The TGFD program impresses upon students that most people do not use drugs and looks at the social consequences of deciding to use drugs. Having students consider that their actions will affect their siblings, parents,classmates, community and friends has more of an impact on decision making than scare tactics. Too Good For Drugs does a good job at examining those social consequences.

TGFD believes strongly that having positive role models in children’s lives is a major component to combating the drug problem. When kids can recognize and value how they are connected to adults in their communities and families, they are healthier in general. Children need to feel like they are a part of something. This could be involvement in families, 4H, sports, band, church, civic organizations etc. Being made to feel important and worthwhile strengthens protective factors that help guard against poor choices leading to drug use. When kids go through the Too Good For Drugs program, they learn about the importance of being connected to others.

You may be wondering how you begin drug prevention in kindergarten? Certainly, you wouldn’t want to discuss the effects of heroin on a developing brain with 5 year olds. Rather, discussing staying healthy, exercising, eating healthy, getting enough rest, dealing with feelings and friendship skills are the main focus of the program at this age.

In 3rd grade we begin to discuss Tobacco, Alcohol and Marijuana. By 5th grade the program is discussing different categories of drugs like depressants, stimulants, hallucinogens and Prescription Drug use, misuse and addiction.. At the middle school level the program gets more into social consequences and physical consequences of drug use. Peer pressure refusal strategies are incorporated at all levels.

Ideally, the TGFD program is designed to grow with a student as they move through school. Several districts do this quite well. Crestview and Hillsdale have almost every grade level K-8 receiving the TGFD program. That means that all the students in those districts are receiving 10 weeks every year of drug prevention education.

Comprehensive repeated exposure to evidence based knowledge about alcohol and drugs is a great start to combating the opiate problem that we are experiencing.

Other Districts in our area are following suit. Reagan Elementary has implemented the program in all of their classes this year as did Taft Intermediate. We hope to expand the program and fill gaps in other schools. Ashland Middle School also has had classes of TGFD running this school year. Mapleton is doing the program in kindergarten, 7th and 8th grades. Loudonville schools have implemented the program in kindergarten, 2nd and 4th grades. We would like to see the TGFDs program in every classroom K-8 in Ashland County.

Classroom time is precious. State mandates and standardized testing has made it so that prevention programming has to compete against other required educational activities. However, in light of the enormity of this issue, we have to make time. We need, as a community, to realize that prevention works and it is a good starting point to combat this problem. Involving families, schools and churches will only make the message stronger. Together, with A.C.C.A.D.A., the schools, the community and families we can make a difference by giving kids the skills that they need to be successful, drug free, productive and healthy human beings. Please continue to support prevention efforts in your local schools. We also thank all the principals and teachers who have recognized the need for this kind of programming and welcomed us into their classrooms.

The Mental Health and Recovery Board of Ashland County has supported and funded the A.C.C.A.D.A. prevention effort for the last 28 years and continues to encourage further development of alcohol/drug prevention in Ashland County.

Start Talking Program by Wendy Lemon – Prevention Educator at ACCADA

Most of us are aware of the issues our country faces with opioid addiction, and Ashland County is no exception. We are now beginning to see a rise in methamphetamine use and alcohol addiction continues to be an issue.

In recent months Ashland County Council on Alcohol and Drug Abuse (A.C.C.A.D.A.) has been increasing its prevention efforts.  We hope to engage parents, guardians and mentors by encouraging them to use the Start Talking program.

In 2011, the state of Ohio adopted a multi-pronged approach to fighting against drug abuse. One approach has been the development of a website called, Start Talking. The effort was launched by Governor John R. Kasich, and is geared toward parents and guardians. This website has been designed to give adults the necessary tools to start conversations about the importance of making healthy life choices and living drug-free. One of the leading contributing factors adolescents give for remaining drug-free is attributed to conversations with parents or guardians.

One of the programs on the Start Talking website is called KNOW!, which was developed by the Prevention Action Alliance in Columbus. The goal of the KNOW! Program is to help parents develop communication habits with their children regarding a substance-free life. By signing up for this free program parents will receive two emails per month with tips for talking to children about drug use and refusing peer pressure, as well as current facts about tobacco, alcohol and other drugs. KNOW! places great emphasis on encouraging the habit of regular conversations about everyday life between parents and children. Regular conversations help develop relationships. It’s those relationships coupled with the habit of conversation about everyday life that make it much easier and more natural to move into deeper discussions with young people about drug use. As mentioned earlier, we find a positive correlation between adolescents who choose to remain drug-free and these regular conversations with parents.

Kris Hickey, A.C.C.A.D.A.’s Senior Prevention Educator, encourages everyone who has children or works with children to visit the Start Talking website. “As parents, educators or coaches, we’re pretty good about talking with kids about alcohol or marijuana. However, we often forget to talk to them about those medications we may have in our homes. One pill  can take anyone down a road they didn’t intend. Start Talking is an excellent resource for reminding us to talk with our kids about things we might forget or overlook unintentionally.”

A.C.C.A.D.A. would like to take this opportunity to encourage our Ashland County parents and guardians to visit the Start Talking website at: starttalking.ohio.gov.  Sign up for the twice monthly emails and engage with your children on this relevant and important topic. Once you’ve registered to receive the KNOW! emails, send us an email at preventionwendy@gmail.com and let us know you’ve signed up and your thoughts on the website.

State of the Opioid Epidemic in Ashland County

By DENNIS DYER

Published: June 12, 2017

What is the state of affairs regarding the opiate epidemic? Unfortunately in 2016 there were 9 accidental drug overdose deaths as reported by the Ashland County Office of the Coroner. The information from the coroner’s office indicates that 85% of those dying had opioids in their systems. Opioids include a number of opioid based drugs as well as Fentanyl and Carfentanil. In most cases there were also other drugs in the systems but it appears that opioids are the key element in the overdoses. The 9 deaths in 2016 was an increase of 4 over the 5 deaths in 2015. Our condolences go out to those who have lost loved ones.

Recent reporting done by the New York Times indicates that nationwide the number of overdose deaths has continued to rise. Official numbers have not been generated to date but the New York Times projects the overdoses nationwide may reach 59,000 to 65,000 by the end of 2017. Montgomery County (Dayton) is experiencing a surging overdose death rate that may reach 800 in 2017. The prior year was reported to have been around 375. Other urban counties are projected (based on current known death in 2017) to increase more in the range of 19% to 36% for 2017.

A.C.C.A.D.A. continues to see high numbers of Ashland residents present with Opioid Use Disorder. In the last year 172 person received outpatient treatment with another 39 treated who were using opioids as their secondary drug. Combined this was 43% of all clients getting services at A.C.C.A.D.A. This is similar to the last few years.

The Ashland Community seems to be increasingly aware of the opioid problem. In the last 2 years with support from the Mental Health and Recovery Board, A.C.C.A.D.A. has placed the “Heroin Hurts” billboards in the county. A number of related articles have been published by A.C.C.A.D.A. The Times-Gazette has written a number of articles and printed others from other newspapers and news services. Others have spoken out about this problem such as law enforcement and court authorities. Several doctors locally have advocated a more cautious approach to prescribing the potentially addictive opioid based drugs. It appears the community awareness of this problem is high. When I am in the community and the issue is mentioned, individuals express an awareness and concern about the opioid problem.

The county prosecutor, Chris Tunnell, has tried to address this problem through prosecution but early on recognized the importance of prevention and treatment efforts that parallel enforcement efforts. To his credit, early on in his tenure as County Prosecutor, he made a visit to A.C.C.A.D.A. to find out what is available as far as treatment. He has continued to advocate for related prevention and educational efforts. When I sought his input for this article he noted that “arrests are about the same but not because things are getting better”. He is seeing that the law providing immunity for overdoses has reduced arrests. He is also seeing that arrests are shifting to methamphetamine. There are indications that in some cases dealers are mixing cocaine with heroin. While at this point he has not seen laboratory evidence of this, he is of course concerned about this trend. He also notes increases in children in custody or Children Services related to drug problems in parents.

A.C.C.A.D.A. counselors have seen some situations where clients have switched to methamphetamine off of heroin. This may be in part because the heroin habit was unsupportable due to tolerance developing and making the heroin use unaffordable. The methamphetamine is cheaper and lasts longer.

Another disturbing trend is that Carfentanil and Fentanyl are showing up in the drug overdose victims. Most of the users know that these drugs are being mixed into the heroin to boost strength.

Since these drugs are so powerful, it increases the risk of overdosing.

It appears that the opioid epidemic is continuing and that the use of Fentanyl is causing an increase in nonfatal overdoses and overdose deaths.