The Opiate Epidemic

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The Opiate Epidemic What Works What Doesnt
By Fairfield County Sheriff, Dave
Phalen And Orman Hall, Executive
Director Fairfield County Alcohol, Drug Addiction
and Mental Health Board
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Fairfield County, Ohio
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Core Concept

• Crime slips into our community in places where we
  have let the fabric of our society wear thin.

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Criminal Activity

• Small percentage of the population
• Same locations
• 85 of theft-related crime is drug related.

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Important Dates

• 1979 1980 Crack Cocaine hits our communities
• 2006 2009 Heroin hits our communities

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Key Statistics Fairfield County Jail

• 127 - Increase in inmates between 2001 and 2008.
• 212 - Increase in drug arrests between 2003 and
  2008.
• 375 - Increase in heroin users among new arrests
  between 2003 and 2008.

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Fairfield County Jail

• 349,064 The estimated cost of incarcerating
  opiate addicts in 2003.

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Fairfield County Jail

• 349,064 The estimated cost of incarcerating
  opiate addicts in 2003.
• 2,501,786 The estimated cost of incarcerating
  opiate addicts in 2008.

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Causes of opiate addiction in our community

• Widespread use of opiate analgesics
• Increased availability of Heroin as a replacement
  drug
• Price

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Written in 1829

• The police are the public and the public are the
  police. The police are only members of the public
  who are paid to give full-time attention to the
  duties that are incumbent upon all citizens in
  the interest of community welfare and existence.
• Sir Robert Peel

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(No Transcript)
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What works

• Law enforcement
• Treatment
• Education
• Drug Court
• Non-conventional Grace Haven

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Police

• Enforcement
• Knock and Talk
• Landlord Training

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U.S. Opiate Treatment Admission Trends
Figure 1. Opiates as a Percent of Alcohol and
Other Drug Treatment Admissions in the United
States (2000 2007)1
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Ohio Opiate Treatment Admissions Trends
Figure 2. Opiates as a Percent of Alcohol and
Other Drug Treatment Admissions in the State of
Ohio (2000 2007)2
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Fairfield County, Ohio Opiate Treatment
Admission Trends
Figure 3. Fairfield County Ohio Opiate Treatment
Admission Trends (2002 2009)3
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Fairfield County, Ohio Opiate Treatment
Admissions by Township
Figure 4. Fairfield County Ohio Opiate Treatment
Admissions by township for 2008.4
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Fairfield County- Jail Days
Figure 5. Opiates as a proportion of total
Fairfield County jail days (2003 and 2008)5
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Fairfield County - Jail Days By Age and Opiate
Status
Table 1. Jail Admissions by age and Opiate
Status, Calendar Year 2008.6
No Opiates Opiates
  Present Present
Age Group    
18 - 25 40.4 53.6
26 - 35 38.3 25.0
36 - 45 11.7 16.1
46 - 55 7.4 5.4
56 -65 2.1 0.0
   100  100
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Fairfield County - Jail Days By Age and Opiate
Status
Figure 5. Opiates as a proportion of total
Fairfield County jail days by gender (2003 and
2008)7
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Components of the Fairfield County Drug Court
Program

• Judicial intervention and oversight
• Frequent drug screens
• Intensive outpatient therapy
• Case management and rehabilitative services
  (employment and housing).
• Suboxone for opiate addicted clients

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Phases of Municipal Drug Court - Continued

• Phase 1 three months
• Drug court participants meet weekly with judge to
  receive court orders and report on compliance.
  Participants must meet with probation and submit
  to three random drug tests weekly. Participants
  are not allowed to work but are required to
  attend intensive outpatient therapy and focus on
  recovery issues.

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Phases of Municipal Drug Court - Continued

• Phase 2 three months
• Participants report to the court bi-weekly. Focus
  on employment and other rehabilitative issues
  begins.

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Phases of Municipal Drug Court - Continued

• Phase 3 six months
• Participants report monthly to judge. Maintaining
  employment and abstinence are major priorities.
  Upon successful completion of phase three,
  participants graduate and are released from
  probation.

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Phases of Municipal Drug Court - Continued

• After Care four months
• This phase is voluntary. Participant checks in
  with probation and voluntarily submits to drug
  screens twice a month. The focal points of this
  phase are maintaining sobriety, maintaining
  employment, and avoiding new charges.

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Use of Suboxone in Opioid Addiction Treatment in
Fairfield County

• What Is Suboxone?
• Suboxone is a combination of buprenorphine and
  naloxone. To be taken only under the supervision
  of a qualified physician.
• How Does Suboxone Work? Suboxone provides the
  patient with a mild opiate effect, ideally just
  enough to reduce or eliminate opiate cravings.
  More importantly, It also blocks the effects of
  all other opiates.
• Fairfield County Philosophy
• To use the smallest amount of Suboxone required
  to eliminate opiate cravings and block the effect
  of other opiates. The goal of public AOD (alcohol
  and other drug) treatment in Fairfield County is
  complete recovery and eventual abstinence from
  the use of harmful drugs.
• Patient Recovery With cravings eliminated and
  withdrawal fears calmed, Suboxone permits a
  person to focus on recovery and treatment.
  Underlying treatment issues can be more
  effectively addressed once the effects of the
  opioid are no longer present.

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Important Fairfield County Statistics

• 75 of all Adult Drug court clients in Fairfield
  County have an opiate addiction.
• In 2008 there were an estimated 44,725 jail days
  accounted for by opiate addicts in the Fairfield
  County Jail.
• Over two years, 14,000 days of jail for drug
  court were participants suspended for a total
  cost savings of 910,000.
• Medication costs at the jail for drug court
  participants have decreased by 66.

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Important Fairfield County Statistics - Continued

• Among opiate addicted clients receiving Suboxone
  - 62 successful treatment and discharge rate.
• Among opiate addicted clients not receiving
  Suboxone, 87 relapse and are terminated
  unsuccessfully.

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Bibliography

• Myers, Rhonda. (June, 2009). Unpublished
  presentation from the National Association of
  Drug Court Professionals Annual Meeting.
  Anneheim, CA. The Treatment Episode Data Set
  (TEDS),
• Office of Applied Studies, Substance Abuse and
  Mental Health Services Administration (SAMHSA).
  United States Department of Heath and Human
  Services.
• 2007
• http//oas.samhsa.gov/teds2k7highlights/TEDSHighl
  2k7Tbl6a.htm
• http//oas.samhsa.gov/teds2k7highlights/TEDSHighl
  2k7Tbl6b.htm
• 2006
• http//oas.samhsa.gov/teds2k6highlights/Tbl6a.ht
  m
• http//oas.samhsa.gov/teds2k6highlights/Tbl6b.ht
  m
• 2005
• http//oas.samhsa.gov/teds2k5/TEDSHi2k5Tbl6a.htm
  
• http//oas.samhsa.gov/teds2k5/TEDSHi2k5Tbl6b.htm
  
• 2004
• http//oas.samhsa.gov/TEDS/2k4TEDS/TEDSHi2k4Tbl6a
  .htm
• http//oas.samhsa.gov/TEDS/2k4TEDS/TEDSHi2k4Tbl6b
  .htm
• 1993-2003 http//oas.samhsa.gov/2k5TEDS/teds_03_
  tbl2.1a.htm
• http//oas.samhsa.gov/2k5TEDS/teds_03_tbl2.1b.htm
  
• http//oas.samhsa.gov/2k5TEDS/teds_03_tbl4.2a.htm
  
• The Treatment Episode Data Set (TEDS), Office of
  Applied Studies, Substance Abuse and Mental
  Health Services
• Administration (SAMHSA). United
  States Department of Heath and Human Services.

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Bibliography - Continued

• Public-Private Solutions. 108 W. Main Street
  Suite A. Lancaster, Ohio 43130. Jim Averill,
  PPS Director. Robert Peare, Programmer/Analyst.
  c/o http//www.fair-mh.org [phone].
• Ibid.
• Phalen, Dave and Orman Hall. (May 2009)
  Unpublished Utilization Review Study of Fairfield
  County Jail Admissions. Lancaster, Ohio 43130.
• Ibid.
• Ibid.