Increase Awareness of the Crisis and Urgency for Action

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The Importance of Increasing Awareness of the Crisis and Risks

In spite of a lot media coverage in recent years, the awareness of the magnitude of the crisis and the facts around the crisis is not as high as it needs to be. (Stats and sources should be added here.)

There are multiple reasons that a widespread and accurate understanding of the crisis and the risks of the opioid crisis are key to ending the crisis and saving lives.

Awareness of the Nature and Magnitude of the Crisis

A comprehensive multi-sector response to the opioid crisis will be more effective if there is broad awareness and accurate knowledge about the seriousness of the crisis and the impact it is having on lives, communities and the nation.
  As accurate awareness spreads, it should be easier to:

  • engage many different types of organizations in becoming part of the solution;
  • develop stronger political support to take and fund appropriate actions;
  • reduce the misconceptions which lead to greater stigma that can hinder people getting help.

Awareness of the Risks of Taking Opioid Prescription Drugs

In far too many cases, people who become addicted to prescription drugs (whether they are actually prescribed the drugs or whether they use prescription drugs obtained in other ways) often state that they had no idea how easy it would be to become addicted and on the path to heroin addiction and worse. An effective education and awareness campaign could help people not start to use or misuse prescription drugs or it could motivate those who have started to misuse to quit before they develop a dependence.

Parents have often approved of their children being given opioid drugs (e.g. after wisdom teeth are removed) because they trust the doctors and were not aware of the risks. A greater awareness could lead to parents advocating to using alternate approaches to pain management.

Friends of people who are are in the early stages of non-medical use of prescription opioids may be able to influence those people to stop the misuse if the friends have a solid understanding of the risks.

Opioid Use in the Elderly

Opioid drug abuse isn't commonly thought of occurring in the elderly. While opioid abuse declined in younger groups between 2002 and 2014, even sharply among those 18 to 25 years old, the epidemic almost doubled among Americans over age 50, according to the Substance Abuse and Mental Health Services Administration.[1] "Older Americans are among those unseen in this epidemic," said Senator Robert P. Casey Jr., Pa., the top Democrat on the panel. "In 2016, one in three people with a Medicare prescription drug plan received an opioid prescription. This puts baby boomers and our oldest generation at great risk."[2]

Unintentionally, Medicare compounds the epidemic by covering opioids needed by patients that can be abused. However, they generally don't fund the care and medicines needed to fight opioid addiction. "Overall, one in three older Americans with Medicare drug coverage are prescribed opioid pain killers.[3] However, while Medicare pays for opioid painkillers, Medicare does not pay for drug and alcohol treatment in most instances, nor does it pay for all of the medications that are used to help people in the treatment and recovery process," said William D. Stauffer, executive director of the Pennsylvania Recovery Organizations Alliance.[4]

Gary Cantrell, a deputy inspector general at the Department of Health and Human Services, said "our nation is in the midst of an unprecedented opioid epidemic."[5]He focused on Medicare Part D, which is the prescription drug section of Medicare. About half-million Part D recipients "received high amounts of opioids" in 2016, Cantrell said.[6] Almost 20 percent of that group are at "serious risk of opioid misuse or overdose," Cantrell warned, placing the high risk in two categories - those receiving "extreme amounts of opioids" and some "who appeared to be 'doctor shopping.' "[7]Doctor shoppers "each received high amounts of opioids and had four or more prescribers and four or more pharmacies for opioids," Cantrell explained.[8] "While some of these beneficiaries may not have been doctor shopping, receiving opioids from multiple prescribers and multiple pharmacies may still pose dangers from lack of coordinated care. Typically, beneficiaries who receive opioids have just one prescriber and one pharmacy."[9]
 

"Older adults are at high risk for medication misuse due to conditions like pain, sleep disorders/insomnia, and anxiety that commonly occur in this population," said Stauffer, who is in long-term recovery. "They are more likely to receive prescriptions for psychoactive medications with misuse potential, such as opioid analgesics for pain and central nervous system depressants like benzodiazepines for sleep disorders and anxiety. One study found that up to 11 percent of women older than age 60 misuse prescription medications.[10] The combination of alcohol and medication misuse has been estimated to affect up to 19 percent of older Americans."[11]
 

Examples of Outreach and Awareness Strategies

DEA 360 Community Outreach Program

"The community outreach portion of this initiative [DEA 360] is critical to long term success in reducing drug use and addiction. We have to continue working to find ways to effectively communicate to our community members the risks and dangers of substance abuse to curb the rates of addiction, overdose and death."
-Timothy J. Plancon, Special Agent in Charge of the DEA’s Detroit Field Division[12]
 

SafeHomes

SafeHomes Coalition helps communities start programs to raise awareness of the proper use, storage and disposal of prescription drugs. (They can help your community start a chapter.) This SafeHomes PSA provides more information.
[13]
According to surveys from the National Institute on Drug Abuse, 20 percent of teens say they have taken a prescription drug without having a prescription for it themselves, and 5 percent report abusing OTC cough medicine to get high." - CADCA

In order to prevent teen medicine abuse, CADCA advises to TALK to your teen, SAFEGUARD your medicine cabinets, SHARE what you learn, and SPEAK UP at school meetings, community events, etc.

Resources for Student Athletes, Coaches and Trainers

Research shows that participation in sports can increase protective factors that reduce substance abuse, but student athletes in high-contact sports, such as football, may be at increased risk for addiction due to greater risk of injury and being prescribed opioid pain medication.[14]
The Massachusetts Technical Assistance Partnership for Prevention Website includes tip sheets for students, coaches and parents that can be widely distributed.

Operation Prevention

The DEA and the Discovery Channel combined their expertise and resources to create a outstanding set of educational materials that are available for free through Operation Prevention.
 

Not Prescribed

A robust curriculum designed for youth and schools is Not Prescribed. This curriculum for teens was developed by Rise Above Colorado, a statewide effort to empower teens.

Engaging Diverse Community Partners in a Community-wide Awareness Campaign

Community awareness can be greatly improved if a wide range of community organizations across different sectors all take steps to provide different types of educational materials to the people that they work with. This section of the OCRH can be used to find examples of how different organizations have played a unique role in raising awareness and understanding.

Employers

  • Employers of all types have a lot at stake with regard to the impact of the opioid crisis on their employees and the community at large. Employers have the ability to reach a large number of the citizens in any community, so they should be tapped as a key conduit for getting different types of information to their employees.
  • See Examples and Ideas of Employers Raising Awareness

Faith Communities

Chiropractors

Associations of Primary Care Physicians

  • Primary Care physicians were contributing actors in the cause of the opioid crisis, and they can be important actors in spreading awareness of the crisis and the risks of using opioids. Associations of primary care physicians have the potential of outreach to many of a region's physicians to engage them in appropriate steps for education and awareness of the crisis and individual risks.
  • See Examples and Ideas of Associations of Primary Care Physicians Raising Awareness

Associations of Dental and Oral Surgeons

  • Since many people, especially young people, are first prescribed an opioid by a dental or oral surgeon, it is appropriate for these healthcare professionals to be a part of spreading awareness of the crisis and the risks of opioids. Associations of these health professionals can be key ways to engage the individual professionals.
  • See Examples and Ideas of Associations of Dental and Oral Surgeon

Public Libraries

  • Public Libraries reach a broad spectrum of people in a community, and libraries are ideal organizations to spread this information in a variety of ways. Libraries could provide a variety of ways of educating the public, including showing documentaries, hosting presentations by local anti-drug coalitions, distributing materials provided by local or national coalitions, and more. A wide range of other community organizations could direct people to the events at the libraries (benefiting the the libraries by bringing in people who may not otherwise regularly visit the libraries).
  • See Examples and Ideas of Libraries Raising Awareness

Restaurants

Restaurants offering delivery or take-out have a unique opportunity to help spread the word. They could follow the example of the pizza vendors who put stickers provided by Steered Straight on thousands of pizza boxes to help spark discussions about drug use[15] . Similar stickers could point to a variety of on-line resources such as those provided by www.drugfree.org See Examples and Ideas of Restaurants Raising Awareness

Civic Organizations (Rotary Clubs, Lions Clubs, etc.)

Civic organizations exist to bring benefits to their communities, so they should be easy to contact and engage in steps to increase awareness of the crisis and risks. Civic organizations could promote educational events at libraries or provide funding to pay for different types of educational materials (such as stickers put on pizza and restaurant take-out boxes that point people to Websites that have valuable information on the crisis and risks.) Civic organizations often have members who are leaders in a wide range of community organizations. So, if the civic organizations get involved with raising awareness and educating the public on the opioid crisis, then the reach to engaged other organizations should be enhanced. See Examples and Ideas of Civic Organizations Raising Awareness

Apartment Owners and Managers

Apartment owners and managers See Examples and Ideas Apartment Owners and Managers Raising Awareness

Barbershops and Hair Salons

There have been success stories of barbershops becoming valuable pathways of educating black males on issues related to chronic diseases, so it is reasonable to think they could play a valuable role in different aspects of a comprehensive community-wide campaign to raise awareness and help end the opioid crisis. See more Examples and Ideas of Barbershops and Hair Salons Raising Awareness

K-12 Schools

K-12 Schools reach most of the youth in a community along with their families, so they could be valuable conduits for a variety of types of information to students and their families. See moreExamples and Ideas of K-12 Schools Raising Awareness

Real Estate Professionals

  • Real Estate Professionals have a significant economic stake in the stability of communities, and they value relationships with community members.
  • Realty4Rehab, a non-profit established in the Atlanta area by a Realtor who lost her son to a fake pill is doing exciting work and raising funds to address the opioid crisis.
  • See moreExamples and Ideas of Real Estate Professionals Raising Awareness

Sports Teams

In most communities, sports teams (especially professional teams and their players) have the ability to get an audience and get messages out to community members. See more Examples and Ideas of Sports Teams Raising Awareness

Movie Theaters

Movie theaters can chose to show documentaries on different aspects of the opioid crisis or underlying issues (like ACEs) at their theaters and then host discussions after the documentary showings. Other Community organizations (employers, faith communities, civic organizations, schools, etc.) could promote those events, creating extra revenue for the theater--some of which could be donated to other prevention and recovery efforts. See more Examples and Ideas of Movie Theaters Raising Awareness

High School Improvisation Clubs

A growing number of high school improv clubs bring entertaining improv shows to a variety of community audiences and the follow-up the shows with discussions that raise awareness and reduce stigma. See more Examples and Ideas of High School Improv Groups Raising Awareness

Local Media Companies

Brief description See Examples and Ideas of Raising Awareness

Social Media Users

Brief description See Examples and Ideas of Raising Awareness

Colleges and Universities

Brief description See Examples and Ideas of Raising Awareness

 

Changes in the Workforce

Currently about half of employers have mandatory drug screenings for employees. In 2015 9% of employees tested positive. This has serious economic consequences. In big factories they are replacing employees who failed the drug test with refugees. Increasing failure rates are a concern to employers in workplaces where safety is a major concern. Some communities are having trouble hiring drug-free workers.[16] Although employers continue to drug test employees to ensure workplace safety, there is no conclusive evidence that it's necessary for all jobs or that it lowers risks or reduces drug use.[17]
 

Community Examples

Erie, PA - Sterling Technologies

  • 20% of employees failing
  • Positions are being filled by refugees

Louisville, KY

  • Methamphetamine use is so high in Louisville that the number of people testing positive for meth in workplace drug tests is 47% higher than the national average

Colorado

  • Because marijuana is legal, some business see employees smoking pot on their lunch break and then going back to work
  • One oil and trucking company in Colorado did random drug screening last year and flunked 80% of their employees, mostly for marijuana and all employees had to be replaced.

 

Dose of Reality

DoseofRealityHomepage.png
The state of Wisconsin, specifically the Department of Justice and the Attorney General's office, launched a successful prevention campaign called Dose of Reality. The initial cost to develop, with funding from the DOJ and health services, was approximately $400,000. This cost included the public information development, information testing, etc. States can pick and choose elements of the Wisconsin site based on their budget and replicate the site with facts relevant to their state and a portal with media that is state-specific. This budget can be anywhere from $5,000 to $15,000 with the option to add more elements later to the site with future funding. Having access to these materials has made significant progress in unifying the message across the state.

Site Elements

Depending on the budget, states can pick and choose elements that they want to add to their dose of reality site.

  • Facts
  • Media Materials
    • TV commercials, Radio commercials, online ads
  • Support Pages for specific populations (medical providers, parents, educators, students, coaches, anyone who needs help and treatment.
  • Online Ordering Portal: People throughout the state can order and make use of most materials and no charge
  • Searchable drug take back map
  • Customizable media: media material has been designed so that partnering organizations can add their logo to media materials
  • Custom tv commercials

 

Successful Replication

State of Maine - doseofrealitymaine.org - It cost the State of Maine about $2,000 to convert the pieces of the campaign to a Maine-specific campaign, saving lots and lots of money.

Contact

To inquire about replicating this site in your state, please contact Johnny Koremenos ([[1]]) at the Wisconsin DOJ.

Promising Programs

 

Awareness

 

  1. Heroin Education Action Team: "The mission of the U.S. Attorney’s Heroin Education Action Team (USA HEAT) is to reduce the growing harm to Kentucky families and communities caused by heroin/opiate abuse by increasing community understanding of this epidemic. USA HEAT is a partnership between the United States Attorney’s Office for the Eastern District of Kentucky and families who have lost a loved one to opiate overdose. These courageous moms, dads, brothers, sisters and children share their story in order to help others avoid the grief of losing a family member to a drug overdose." CONTACT[[2]] links icon or call 859-685-4906.
  2. City of Peoria, IL: held two community forums in July 2016. At each forum, Mayor Ardis addressed the community, explained the scope and nature of the heroin problem, and introduced the DEA/FBI documentary Chasing the Dragon (2016). After the documentary played, a young woman working to recover from heroin addiction addressed the crowd. According to the account in the September 2016 U.S. Attorney's bulletin the impact of this address was "tremendous. People were clearly moved." In addition to these forums, the Peoria Public library selected Sam Quinones' Dreamland: The True Tale of America's Opiate Epidemic (2015) for it's community wide Peoria Reads program.[18]
  3. Sink or Swim - An information resource for those affected by drug use, including over-the-counter, prescription, and street drugs. This initiative has the mission to build awareness about issues related to drug addiction.

5. Esri provides a GIS tool that helps practitioners understand how the opioid crisis has affected their area.

Educational Curriculum

 

  1. Operation Prevention: Part of the DEA's 360 Strategy, Operation Prevention is a collaboration between the DEA and Discovery Communications to develop and distribute a prescription opioid and heroin education curriculum to middle and high school students, their teachers, and parents nationwide. This program, which began in Fall 2016 will run for three consecutive school years up through Spring 2019, and will be available free of charge for all law enforcement, prevention, treatment, and community groups to use and distribute.[19]

 

Educational Workshops

 

  1. Drug Abuse Dialogues: Founded by Carol Falkowski, Drug Abuse Dialogues provide educational workshops that can be geared towards health professionals or the general community. Topics can include: The prevalence of drug and alcohol abuse, emerging drugs of abuse, effects of new drugs, demographics of new user groups, addiction defined, addiction treatment , substance abuse prevention, steps to address substance abuse.
  2. OpioidX HHP100 The Opioid Crisis in America HarvardX free on-line course Syllabus


 

Health Risks of Opioid Addiction

 

Heart infections is a little discussed consequence to intravenous (IV) drug use. "The biggest concern when using IV drugs is using dirty needles," said Dr. Evelyn Cusak, a cardiologist at Stamford Hospital. "What's happening in a lot of communities all over the country is that people are sharing needles or using dirty needles to inject drugs, and unfortunately, when you use a needle that potentially has bacteria on it, that bacteria can travel into the body, and attach to and destroy the valves of the heart."[20] Those who abuse injectable drugs are at increased risk for acquiring invasive bacterial infections, including endocarditis, according to a study done by the CDC.[21] "We have seen a fairly significant number of patients that have had not one, not two, but three or four heart valve replacement surgeries related to repeated (drug) use, primarily due to relapse and re-infection."[22]

 

Tools & Resources

TR - Increase Awareness of the Risks & the Crisis



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Sources

 

 

 

  1. ^ [1]Unseen face of the opioid epidemic: Drug abuse among the elderly grows—San Antonio Express-News. (n.d.). Retrieved December 3, 2019, from https://m.mysanantonio.com/news/article/Unseen-face-of-the-opioid-epidemic-Drug-abuse-12943266.php#item-85307-tbla-5
  2. ^ [2]Unseen face of the opioid epidemic: Drug abuse among the elderly grows—San Antonio Express-News. (n.d.). Retrieved December 3, 2019, from https://m.mysanantonio.com/news/article/Unseen-face-of-the-opioid-epidemic-Drug-abuse-12943266.php#item-85307-tbla-5
  3. ^ [3]Unseen face of the opioid epidemic: Drug abuse among the elderly grows—San Antonio Express-News. (n.d.). Retrieved December 3, 2019, from https://m.mysanantonio.com/news/article/Unseen-face-of-the-opioid-epidemic-Drug-abuse-12943266.php#item-85307-tbla-5
  4. ^ [4]Unseen face of the opioid epidemic: Drug abuse among the elderly grows—San Antonio Express-News. (n.d.). Retrieved December 3, 2019, from https://m.mysanantonio.com/news/article/Unseen-face-of-the-opioid-epidemic-Drug-abuse-12943266.php#item-85307-tbla-5
  5. ^ [5] Unseen face of the opioid epidemic: Drug abuse among the elderly grows—San Antonio Express-News. (n.d.). Retrieved December 3, 2019, from https://m.mysanantonio.com/news/article/Unseen-face-of-the-opioid-epidemic-Drug-abuse-12943266.php#item-85307-tbla-5
  6. ^ [6]Unseen face of the opioid epidemic: Drug abuse among the elderly grows—San Antonio Express-News. (n.d.). Retrieved December 3, 2019, from https://m.mysanantonio.com/news/article/Unseen-face-of-the-opioid-epidemic-Drug-abuse-12943266.php#item-85307-tbla-5
  7. ^ [7] Unseen face of the opioid epidemic: Drug abuse among the elderly grows—San Antonio Express-News. (n.d.). Retrieved December 3, 2019, from https://m.mysanantonio.com/news/article/Unseen-face-of-the-opioid-epidemic-Drug-abuse-12943266.php#item-85307-tbla-5
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  10. ^ [10]Unseen face of the opioid epidemic: Drug abuse among the elderly grows—San Antonio Express-News. (n.d.). Retrieved December 3, 2019, from https://m.mysanantonio.com/news/article/Unseen-face-of-the-opioid-epidemic-Drug-abuse-12943266.php#item-85307-tbla-5
  11. ^ [11]Unseen face of the opioid epidemic: Drug abuse among the elderly grows—San Antonio Express-News. (n.d.). Retrieved December 3, 2019, from https://m.mysanantonio.com/news/article/Unseen-face-of-the-opioid-epidemic-Drug-abuse-12943266.php#item-85307-tbla-5
  12. ^ [12]Unseen face of the opioid epidemic: Drug abuse among the elderly grows—San Antonio Express-News. (n.d.). Retrieved December 3, 2019, from https://m.mysanantonio.com/news/article/Unseen-face-of-the-opioid-epidemic-Drug-abuse-12943266.php#item-85307-tbla-5
  13. ^ [13]Unseen face of the opioid epidemic: Drug abuse among the elderly grows—San Antonio Express-News. (n.d.). Retrieved December 3, 2019, from https://m.mysanantonio.com/news/article/Unseen-face-of-the-opioid-epidemic-Drug-abuse-12943266.php#item-85307-tbla-5
  14. ^ [14]DEA Announces “360 Degree Strategy” to Address Opiate Epidemic in Louisville. (2016, September 21). Retrieved December 3, 2019, from https://www.justice.gov/usao-wdky/pr/dea-announces-360-degree-strategy-address-opiate-epidemic-louisville
  15. ^ [15]HealthITSecurity. (2016, November 2). Addressing Opioid Abuse with Analytics, Population Health Strategies. Retrieved December 3, 2019, from HealthITAnalytics website: https://healthitanalytics.com/features/addressing-opioid-abuse-with-analytics-population-health-strategies
  16. ^ [16]Veliz, P., Boyd, C. J., & McCabe, S. E. (2016). Nonmedical Prescription Opioid and Heroin Use Among Adolescents Who Engage in Sports and Exercise. Pediatrics, 138(2). https://doi.org/10.1542/peds.2016-0677
  17. ^ [17]Police: Dinner table talks send message about teen drug use. (n.d.). Retrieved December 3, 2019, from https://www.thedailyjournal.com/story/news/2016/02/09/best-defense-against-teen-drug-use-conversation-police-say-urging-parents-raise-issue-dinner-table/80088942/
  18. ^ [18]As Americans fail drug tests, employers hire refugees—CNN. (n.d.). Retrieved December 3, 2019, from https://www.cnn.com/2017/03/27/us/refugees-jobs-drug-testing/index.html
  19. ^ [19]Workplace drug testing is widespread but ineffective. (n.d.). Retrieved December 3, 2019, from http://www.slate.com/articles/health_and_science/cover_story/2015/12/workplace_drug_testing_is_widespread_but_ineffective.html
  20. ^ [20]Wilkinson, M (2016), Addressing the Heroin and Opioid Crisis, United States Department of Justice Executive Office for United States Attorneys, Retrieved from: https://www.justice.gov/usao/file/895091/download
  21. ^ [21]Operation Prevention. (n.d.). Retrieved December 3, 2019, from https://www.operationprevention.com/
  22. ^ [22]Study: Opioid addiction could lead to spike in heart infections—San Antonio Express-News. (n.d.). Retrieved December 3, 2019, from https://m.mysanantonio.com/local/article/Study-Opioid-addiction-could-lead-to-spike-in-12937348.php?ipid=artem