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''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]]''<br />
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To minimize diversion, it is essential that people who have prescription medications in their homes store them safely.&nbsp; When people begin to misuse prescription drugs, they often acquire them by stealing them from family, relatives, friends or from homes that they enter for other reasons (work, open houses, breaking and entering).&nbsp; If prescription drugs are safely stored, misuse can be stopped earlier, because people who have not yet developed a dependence on opioids usually do not go directly to illegal opioids like heroin or fentanyl.&nbsp;&nbsp;&nbsp;__TOC__Prescription drugs that are not safely stored can also be accidentally taken by young children or by curious pre-teens.<br />
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= Background =<br />
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Safe storage of prescription drugs within the home has been identified as key priority strategy by many organizations and coalitions.<ref>https://www.end-opioid-epidemic.org/storage-and-disposal/</ref><ref>http://www.rxsafetymatters.org/families-and-communities/safe-storage-and-disposal/</ref>&nbsp; Even if a community does an excellent job of reducing prescriptions and taking back or disposing of unused opioids, there will still be a lot of opioids in communities. Researchers estimated that in 2005, 3-4% of people were being prescribed opioids for chronic pain<ref>https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm</ref>&nbsp;<span style="font-size: 13px;">and many others are legitimately being prescribed opioids for short-term pain management, and many others who are prescribed other drugs that can be misused, stolen or accidentally consumed by children.</span><br />
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Failure to securely store prescription drugs contributes to the opioid epidemic and other health hazards in several ways.<br />
<br />
#Easy access to prescription drugs can lead to initial experimentation, especially by teens.<ref>http://makeitasafehome.org/the-problem/</ref> <br />
#Stealing prescription drugs, which is much easier when they are commonly available in unlocked medicine cabinets, is often a step toward more destructive misuse. <br />
#Easy access to unsecured opioids or other prescription drugs contributes to theft by people who sell them or give them away. <br />
#Children who access unsecured drugs sometimes take them, thinking they are candy. <br />
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= Staggering Statistics =<br />
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*Only 2 in 10 who have dangerous medications—such as opioid pain pills, stimulants used to treat ADHD, and sedatives—lock them up <br />
*Nearly 70% of prescription opioid medications kept in homes with children are not stored safely<ref>https://www.jhsph.edu/news/news-releases/2017/majority-of-opioid-medications-not-safely-stored-in-home-with-children-survey-finds.html</ref> <br />
*A recent study of adults living in households with children, prescription opioids were stored in a locked or latched place in only 32.6% of households with young children and 11.7% with older children.<ref>https://pediatrics.aappublications.org/content/139/3/e20162161</ref> <br />
*More than 1,600 teens begin abusing prescription drugs each day.<ref>http://www.rxsafetymatters.org/families-and-communities/facts-and-figures/</ref> <br />
*Almost 1 in every 4 teens in America say they have misused or abused a prescription drug.<ref>http://www.rxsafetymatters.org/families-and-communities/facts-and-figures/</ref> <br />
*60,000 kids under the age of 5 accidentally ingest these dangerous drugs every year and wind up in emergency rooms, according to data from the CDC<ref>http://www.consumerreports.org/drugs/best-ways-to-protect-kids-accidental-drug-poisoning-/</ref> <br />
*12-17 year olds abuse prescription drugs more than ecstasy, heroin, crack/cocaine and methamphetamines combined.<ref>http://www.rxsafetymatters.org/families-and-communities/facts-and-figures/</ref> <br />
*In one study, respondents reported storing their opioid medication in a locked (8.6%) or latched (20.9%) location.<ref>Kennedy-Hendricks A, et al. “Medication sharing, storage and disposal practices for opioid medications among US adults.” JAMA Intern Med 2016; 176:1027-29.</ref> <br />
*San Diego's SafeHomes Coalition reports that more than 70% of misused prescription drugs come from someone's medicine cabinet, not from a dealer on the street. <ref>http://makeitasafehome.org/the-problem/</ref> <br />
*The National Drug Intelligence Center reported that $184 million in prescription drug thefts occurred in 2010—a 350 percent increase since 2007<ref>https://www.nnw.org/publication/medication-theft-protecting-our-most-vulnerable-neighbors</ref>. &nbsp;They note that older people are especially vulnerable to theft of prescription drugs. <br />
*Over half of teens, ages 12 and up, obtained prescription drugs from a friend or family member "for free" <br />
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= Programs to Encourage Safe Storage and Reduce the Theft of Prescription Drugs =<br />
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== Examples of Campaigns and Organzations Supporting Safe Storage ==<br />
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'''Safe Homes Coalition'''<br/> [http://makeitasafehome.org/ 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 [https://www.youtube.com/watch?v=m7C01hibtBg&feature=youtu.be SafeHomes PSA] provides more information.<br/> <br/> '''Up and Away Campaign'''<br/> This [http://www.upandaway.org/#about campaign] is designed to remind families about the importance of safe medicine storage. See [[TR_-_Improve_Safe_Storage_of_Prescription_Drugs|Tools & Resources]] for resources to distribute in your community.<br/> &nbsp;<br />
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== Launching Community-wide Collaborative Campaigns ==<br />
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=== Drug Disposal and Safe Storage Campaign ===<br />
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Many communities have done some education and awareness efforts to increase prescription drug disposal and safe storage, but there is potential to reach significantly more people by engaging a diverse group of cross-sector partners in a campaign.<br />
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'''See Details:&nbsp;&nbsp;'''[[Community_Safe_Storage_Campaign|Collaborative campaign to increase safe storage and prescription drug disposal]].<br/> &nbsp;<br />
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=== Self-Funding Program for Safe Storage Caps (TimerCaps) ===<br />
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A local coalition, hospital, insurance company or non-profit can sponsor a program to distribute TimerCaps to people using prescription drugs. Sponsors have their logo imprinted on the cap and the label and can give them away at community events or via partners like pharmacists, community groups for seniors, or the prescribing doctors.<br />
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'''See Details:'''&nbsp;[[Details_for_a_Self-Funding_Safe_Storage_campaign|Self-Funding Safe Storage campaign]].<br/> &nbsp;<br />
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'''Case Study of Successful Coalition Campaign with TimerCaps'''<br />
South Kingston Program for Prevention and Rebels Inspiring Positive Lifestyles joined forces to raise funds to send youth leaders to CADCA training. The coalition held community awareness events and garnered local news publicity for their cause. For further details, see <div class="objectEmbed">&nbsp;</div> <br />
= Safe Storage Products =<br />
<div class="_">Below are list of products that can either be distributed within your community or advertised by community coalitions for families to purchase.</div> <div class="_">&nbsp;</div> <br />
== TimerCaps ==<br />
<br />
[[File:Orange-TimerCap.jpg|Orange-TimerCap.jpg]]<br/> [https://timercap.com/ TimerCap] has a built-in LCD stopwatch timer. Like a stopwatch, the display on the cap counts-up, first the seconds, then minutes and hours since the cap was replaced.<br/> Timer caps come in different sizes, and they can replace an existing medicine bottle cap (or you can get a cap and bottle combination). Using a TimerCap helps accomplish all [[Six_principles_of_prescription_abuse_prevention|six principles of prescription abuse prevention]]. TimerCaps are easy to use and don't require a change in patient behavior.<br/> <br/> '''Improve Patient Safety'''<br />
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*Provide the PEACE OF MIND of knowing they did or did not take their medication. <br />
*Help seniors avoid accidental overdoses and emergency room visits due to accidentally taking medications multiple times. <br />
*Easily know how long it has been since taking medication (to check before driving) <br />
*Tracker form to help monitor their intake and pain levels or other information <br />
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<br/> '''Deter Theft of Pills'''<br />
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*Easily detect unwanted openings to the exact minute it happened <br />
*Deters kids or neighbors from sneaking a few pills--as they would be caught by the new time <br />
*Solution to measure, monitor, manage, detect,and deter opioids abuse. <br />
<br/> '''Economical Enough to Give Away at Events or by Partners'''<br/> TimerCaps are a low-cost option for improving safe storage (as low as $2.49 each), so they are economical as a give-away at educational events, or they can be given to people by community partners. Since the TimerCap lids and labels can be customized with a logo or other branding information, sponsors who make donations to fund the program receive valuable recognition for their support. See coalition testimonials: <div class="objectEmbed">[[File/view/Testimonials.pages/628136277/Testimonials.pages|[File:http://www.wikispaces.com/i/mime/32/empty.png Testimonials.pages]]] <div>[[File/view/Testimonials.pages/628136277/Testimonials.pages|Testimonials.pages]] <br />
*[[File/detail/Testimonials.pages|Details]] <br />
*[[File/view/Testimonials.pages/628136277/Testimonials.pages|Download]] <br />
*743 KB <br />
</div> </div> <br/> <br/> Visit [http://www.timercap.com www.timercap.com] or Contact: 800-557-4072 ext. 106<br/> &nbsp; <br />
== Locking Storage Devices ==<br />
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'''Ikeyp'''<br/> [[File:Ikeyp Product.png|Ikeyp Product.png]]<br/> The world's first smart storage device for personal items that need to be securely stored yet regularly accessed. See [https://ikeyp.com/ website] for a comprehensive list of uses and products.<br/> Introductory video from a tech review: [https://vimeo.com/184531456 [1]]<br/> Gadgetgram Review including a video created by the manufacture of the product for CES 2018: [http://www.gadgetgram.com/2017/12/27/ikeyp-pro-smart-safe/ [2]]<br/> Retail price is $149.00 but a coordinated community-wide effort to promote safe storage of prescription drugs, bulk purchase discounts may be available.<br/> ''Contact for bulk purchasing'': 1-800-485-8904<br/> <br/> <span style="color: #67677e; font-size: 1.2em; letter-spacing: 0.5px">'''Lockable Caps'''</span><br/> '''Safer Lock'''<br/> [[File:Safer Lock Product.png|Safer Lock Product.png]]<br/> [https://saferlockrx.com/ Safer Lock] is a patented 4-digit combination locking cap. This could be purchased by communities at wholesale prices and distributed to community members at lower prices.<br/> <br/> Products:<br />
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#[https://saferlockrx.com/product/safer-lock/ Safer Lock] <br />
#[https://saferlockrx.com/product/medication-lock-box/ Safer Lock Box] <br />
#[https://saferlockrx.com/product/safer-lock-cases/ Safer Lock Multi-Packs & Case]s <br />
#[https://saferlockrx.com/product/book-safe/ Book Safe] <br />
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<br/> ''Contact for wholesale pricing'': (844) 209-5044<br/> &nbsp;<br />
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== Changing Drug Packaging ==<br />
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*Packaging opioid drugs in [https://en.wikipedia.org/wiki/Blister_pack blister packs] , or in single-dose packages, instead of having an entire bottle filled with prescription pills have been shown to help prevent accident poisonings in children<ref>http://www.livescience.com/58351-kids-opioids-ingestion.html</ref> <br />
*One vendor of Single-dose packets is [https://pack4u.com/ Pack4U]. They provide a sophisticated, personalized option that allows pharmacies to deliver higher value to patients needing any prescriptions, including opioids. <br />
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= Education Topics =<br />
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== Educate Parents on Key Points ==<br />
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*The most secure way to keep prescription medications is in a locked storage box up and away <br />
*If locking them is not an option keep them stored in a secured place in your home that is up and away from children. <br />
*Keep a medication log so you know what medications you have and how many you have of each medication. <br />
**You should try to do an inventory of all the medicines you have at least once a year, preferably every six months.<ref>http://www.youthconnectionscoalition.org/content/wp-content/uploads/2015/04/safe_storage.pdf</ref> <br />
*Medications whose labels specify that refrigeration is necessary should always be kept in the refrigerator. <br />
*The medicine cabinet in a bathroom is often not the best place to store prescriptions. They should be stored in a cool dry place. Humidity, heat, and the change in temperatures in the bathroom can alter the potency of some medications.<ref>http://www.youthconnectionscoalition.org/content/reduce-rx-abuse-2/the-proper-storage-of-prescription-drugs/</ref>&nbsp;Some storage devices, such as iKeyp, can help protect medications from humidity, even if stored in bathrooms. <br />
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= Tools & Resources =<br />
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[[TR_-_Improve_Safe_Storage_of_Prescription_Drugs|TR - Increase Safe Storage of Prescription Drugs]]<br />
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= Actions to Take =<br />
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[[PA_-_Improve_Safe_Storage_of_Prescription_Drugs|Potential Actions and Partners]]<br />
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Actions for Individuals<br />
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Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Shift_from_Punishment_to_Treatment_Approach_for_Opioid_Users|Zoom Map - (Shift from Punishment to Treatment Approach for Opioid Users)]]<br/> &nbsp;<br />
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= Overview =<br />
<br />
<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Research has shown that a vast amount of the inmate population, on both the state and federal level, suffer from substance use disorder, a psychological disorder, or a combination of the two. Studies have shown that proper treatment during incarceration that is followed through to post release, significantly lowers their risk for relapse, criminality, inmate misconduct, and recidivism.</font></span><br />
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= Prison Treatment Programs =<br />
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The Criminal Justice System has supported treatment during incarceration by offering&nbsp;<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">psychotherapy sessions, religious ministry meetings and 12-step programs such as Alcoholics Anonymous to inmates with substance use problems.&nbsp;<ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref></font></span><br />
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While there is significant need for more availability, federal prisons offer a number of programs designed to assist inmates in overcominig a substance use disorder such as:<br />
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*'''<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Drug Abuse Education</font></span>''' <br />
**E<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">ntails a series of classes that educate inmates on substance use disorder and the effects it has on your body and mind&nbsp;<ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref></font></span> <br />
*'''<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Nonresidential Drug Abuse Treatment</font></span>''' <br />
**A<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">12 week CBT (cognitive-behavioral therapy) program that is organized in group sessions</font></span> <br />
**<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">This program addresses criminal lifestyles while also giving inmates the opportunity to increase skills in the areas of rational thinking, communication, and institution to community adjustment</font></span> <br />
**<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Inmates that are enrolled in this program normally have short sentences, do not meet the Residential Drug Abuse Program, are waiting to be enrolled in RDAP, are in transition back into the community or have a positive urinalysis test&nbsp;</font></span><ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref> <br />
*'''<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Residential Drug Abuse Program (RDAP)</font></span>''' <br />
**T<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">he most intensive program that the Bureau provides</font></span> <br />
**<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Inmates in this program live in their own separate community from the rest of the population. Inmates take part in daily half-day programming and half-day of work, school, or vocational activities; this program is normally nine months in length</font></span> <br />
**<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Research shows inmates that take part in RDAP are less likely to recidivate and relapse to drug use by significant amounts compared to those inmates who do not take part in RDAP&nbsp;</font></span><ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref> <br />
*'''<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Community Treatment Services (CTS)</font></span>''' <br />
**<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Provides continued care to inmates who have been released and put into Residential Reentry Centers or on Home Confinement</font></span> <br />
**<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Evidence shows that the period after being released is the most vulnerable time for inmates to relapse back to drug use or criminal activity; continued treatment after release is vital to the success of the offender completing their treatment&nbsp;</font></span><ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref> <br />
<br />
= Benefits of Successful Prison Treatment Programs =<br />
<div><span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Well-designed prison treatment programs reduce relapse, criminality, inmate misconduct and recidivism — the likelihood that a convicted criminal will reoffend. They also increase levels of education, mend relationships, boost employment opportunities upon release and improve overall health.&nbsp;<ref>https://doi.org/10.1007/s11920-013-0414-z</ref></font></span></div> <div>&nbsp;</div> <div><span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Research shows that residential prison treatment is cost-effective if prisoners continue treatment after their release. The cost of treatment pales in comparison to the cost of incarceration. Rehab helps prisoners overcome drug use and reduces the economic burden of recidivism.&nbsp;</font></span><ref>https://doi.org/10.1007/s11920-013-0414-z</ref></div> <br />
= Issues Affecting the Availability of Effective Treatment =<br />
<br />
== Overcrowding of Jails and Prisons ==<br />
<br />
O<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">vercrowding of jails and prisons is a leading factor as to why inmates with drug dependency problems are not enrolled in these programs. The overcrowding of jails leads to an increase in the length of the waiting lists to enter drug treatment programs. In addition to overcrowding, staff shortages and limited resources are part of the issue of low enrollment in drug treatment programs.<ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref></font></span><br />
<br />
== Need for Trauma-Informed Care ==<br />
<br />
<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Incarcerated prisoners are marked by considerable diversity, yet they share a common experience of incarceration. Prisons can be violent, harsh, psychologically damaging environments; incarcerated people live in an environment that is both depersonalizing and dehumanizing. Moreover, the social stigma associated with incarceration, combined with the depersonalizing effects of imprisonment, may result in a sense of hopelessness and powerlessness, as well as deeply internalized shame and guilt. Thus, in addition to treating substance abuse and other mental disorders, the consensus panel recommends that in-prison treatment also address the trauma of the incarceration itself as well as a prison culture that conflicts with treatment goals.<ref>https://www.ncbi.nlm.nih.gov/books/NBK64123/</ref></font></span><br />
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&nbsp;<br />
<br />
= Training =<br />
<br />
Residential Substance Abuse Training RSAT training and technical assistance tool<br />
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= Tools & Resources =<br />
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[[TR_-_Enhance_Treatment_During_Incarceration|TR - Enhance Treatment During Incarceration]]<br />
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<br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span><br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span><br />
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= Sources =<br />
</div> </div> </div> </div> </div> </div> </div> </div> </div> <br />
[[Category:SAFE-Law Enforcement and Criminal Justice]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Enhance_Treatment_During_Incarceration&diff=20398Enhance Treatment During Incarceration2021-02-08T19:16:55Z<p>Rwashington: Rwashington moved page Enhance Treatment During Incarceration to Enhance Treatment and Recovery Support During Incarceration</p>
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<div>#REDIRECT [[Enhance Treatment and Recovery Support During Incarceration]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Expand_Law_Enforcement_Assisted_Diversion_and_Deflection_Programs&diff=20395Expand Law Enforcement Assisted Diversion and Deflection Programs2021-02-08T19:13:05Z<p>Rwashington: Rwashington moved page Expand Law Enforcement Assisted Diversion Programs to Expand Law Enforcement Assisted Diversion and Deflection Programs</p>
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<div><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">''Return to [[ZOOM_MAP_-_Prioritize_SUD_Treatment_Over_Incarceration|Zoom Map - Prioritize SUD Treatment Over Incarceration]]&nbsp;'' <br />
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<br />
The most common phrase you will hear from law enforcement leadership across the country is, “We recognize we cannot arrest our way out of this problem.” We must provide our first responders and criminal justice system with the tools, resources, and support to ensure those fighting substance use disorder receive treatment and those profiting from their addiction and tragic deaths face harsh justice.&nbsp;Whether in the aftermath of an opioid overdose reversal or while transitioning in and out of incarceration, those battling addiction must be presented with the opportunity for treatment so they can begin their road to recovery.<br />
<br />
= Strengths of Pre-Arrest Diversion =<br />
<div>Pre-arrest Diversion programs&nbsp; provide law enforcement with an alternative to having to make arrests. Instead, as long as a person meets certain criteria, they can avoid a police record, stay out of the criminal justice system, and modify future behavior, all the while attempting to also uncrowd U.S. correctional facilities.</div> <div class="_" style="color: rgb(51, 51, 51); font-family: sans-serif,arial,verdana,"><div class="mw-parser-output"><br />
= Goal of Pre-Arrest Diversion =<br />
<div><br />
Depending on local community needs and behavioral health capacity, police diversion programs across the country have varying designs, but their goals are consistent:<br />
<br />
*To continue to promote and enhance public safety while also responding more effectively to substance use and mental health problems <ref>http://www2.centerforhealthan djustice.org/content/project/police-deflection</ref> <br />
*'''<span style="font-size:10.5pt;font-family:arial;color:#323232;background-color:#ffffff;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap;">To low-level offenses, pre- arrest diversion helps to reverse the tide of people with nonviolent offenses entering the justice system</span>'''<ref>http://www2.centerforhealthan djustice.org/content/project/police-deflection</ref> <br />
</div> </div> <br />
= Pre-Arrest Diversion Frameworks =<br />
<div><br />
The variety of operational characteristics of pre-arrest diversion programs creates nearly unlimited possibilities for the final program design, some common themes can be observed in deflection programs currently operating.<ref>http://www2.centerforhealthandjustice.org/sites/www2.centerforhealthandjustice.org/files/publications/DeflectionFramework-excerpt_Final.pdf</ref><br />
<br />
Naloxone Plus: Engagement with treatment occurs following&nbsp;<br />
<br />
'and overdose response and crisis-level treatment is readily available. Examples: opiate response teams, STEER (MD)&nbsp;'<ref>http://www2.centerforhealthandjustice.org/sites/www2.centerforhealthandjustice.org/files/publications/DeflectionFramework-excerpt_Final.pdf</ref> &nbsp; Active Outreach: Participants are identified by law enforcement, but are engaged primarily by a treatment expert who actively contacts them and motivates them to engage in treatment. Example: Arlington Model (MA)&nbsp;&nbsp;'<ref>http://www2.centerforhealthandjustice.org/sites/www2.centerforhealthandjustice.org/files/publications/DeflectionFramework-excerpt_Final.pdf</ref>&nbsp; Self-Referral: Drug-involved individuals initiate engagement with law enforcement without fear of arrest, and an immediate treatment referral is made. Example: Angel (MA)&nbsp;&nbsp;'<ref>http://www2.centerforhealthandjustice.org/sites/www2.centerforhealthandjustice.org/files/publications/DeflectionFramework-excerpt_Final.pdf</ref><br />
<br />
<u>Officer Prevention Referral</u>: Law enforcement initiates the treatment engagement, but no charges are filed. Examples: LEAD (WA), STEER (MD)''''<span style="background-color: rgb(255, 255, 255); color: rgb(50, 50, 50); font-family: arial; font-size: 10.5pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><ref>http://www2.centerforhealthandjustice.org/sites/www2.centerforhealthandjustice.org/files/publications/DeflectionFramework-excerpt_Final.pdf</ref></span>'''<br />
<br/> <u>Officer Intervention Referral</u>: Law enforcement initiates the treatment engagement, and charges are held in abeyance or citations issued. Examples: Civil Citation (FL), STEER (MD)”'<ref>http://www2.centerforhealthandjustice.org/sites/www2.centerforhealthandjustice.org/files/publications/DeflectionFramework-excerpt_Final.pdf</ref>'</div> <br />
= LEAD Program =<br />
<div>LEAD is a pre-booking diversion program that allows officers to redirect low-level offenders engaged in drugs or prostitution activity to community-based services instead of jail and prosecution. LEAD participants begin working immediately with case managers to access services.</div> <div>&nbsp;</div> <div>According to a 2015 report by the International Centre for the Prevention of Crime (ICPC), "One of the [ONDCP] strategy's objectives for 2015 is to break the cycle of drug use, crime, delinquency, and incarceration by increasing by 5% the number of residential juvenile justice facilities offering substance abuse treatment, and increasing by 2.6% the number of treatment plans completed by individuals referred by the Criminal Justice System (ONDCP, 2012, p.18)."<ref>https://www.unodc.org/documents/ungass2016/Contributions/Civil/ICPC/Rapport_FINAL_ENG_2015.pdf</ref></div> <div class="_">&nbsp;</div> <br />
= Other Programs =<br />
<br />
== <u>The S.M.A.R.T. Approach</u> ==<br />
SMART supports chronic misdemeanor offenders, particularly those who are otherwise resistant to intervention, with a case manager and offers individualized treatment and tailored housing placements. SMART prioritizes chronic misdemeanor offenders with acute drug addictions and complex social service needs.<br/> See fact sheet here: <div>[[File/view/SMART_Fact_Sheet.pdf/623773107/SMART_Fact_Sheet.pdf|[File:http://www.wikispaces.com/i/mime/32/application/pdf.png SMART Fact Sheet.pdf]]] <div>[[File/view/SMART_Fact_Sheet.pdf/623773107/SMART_Fact_Sheet.pdf|SMART Fact Sheet.pdf]]</div> </div> <br />
== <u>STEER</u> ==<br />
<br />
STEER is a police deflection initiative that incorporates prevention deflection and intervention deflection. The priority is to improve public safety by police and human services working together. It operates around the core value proposition of deflection, namely ensuring the proper placement of citizens either into the criminal justice system or away from it and towards the human services system. This results in reducing crime, building community relations, reducing drug use, and restoring the lives of citizens. STEER deflection provides a natural strategy to improve community relations by showing citizens the police know when a citizen needs help inistead of needing to be arrested. STEER makes clear that the police are indeed here to help and not just to arrest.<ref>http://www2.centerforhealthandjustice.org/sites/www2.centerforhealthandjustice.org/files/publications/STEER-FactSheet.pdf</ref><br />
<br />
== <u>DTAP - Drug Treatment Alternative To Prison</u> ==<br />
<br />
This program had a high rate of success.&nbsp; See this [https://www.centeronaddiction.org/addiction-research/reports/crossing-bridge-evaluation-drug-treatment-alternative-prison-dtap-program evaluation report] from 2003 for impressive statistics.&nbsp;<br />
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= Tools & Resources =<br />
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[[TR_-_Expand_Law_Enforcement_Assisted_Diversion_Programs|TR - Expand Law Enforcement Assisted Diversion Programs]]<br />
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<br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span><br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span><br />
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= Sources =<br />
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</div> </div> </div> </div> </div> </div> <br />
[[Category:SAFE-Law Enforcement and Criminal Justice]] [[Category:SAFE-Treatment and Recovery]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Expand_Law_Enforcement_Assisted_Diversion_Programs&diff=20396Expand Law Enforcement Assisted Diversion Programs2021-02-08T19:13:05Z<p>Rwashington: Rwashington moved page Expand Law Enforcement Assisted Diversion Programs to Expand Law Enforcement Assisted Diversion and Deflection Programs</p>
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<div>#REDIRECT [[Expand Law Enforcement Assisted Diversion and Deflection Programs]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Disrupt_the_Supply_of_Illegal_Drugs&diff=20389Disrupt the Supply of Illegal Drugs2021-02-08T17:03:03Z<p>Rwashington: Rwashington moved page Disrupt the Supply of Heroin and Synthetic Opioids to Disrupt the Supply of Illegal Drugs</p>
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<div><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]&nbsp;<span style="font-size: 13px;">or </span>[[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]] <br />
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= Background =<br />
<br />
Key to any strategy to reduce opioid misuse is preventing illicit opioids, including heroin and synthetic opioids, from ever reaching communities. This role is almost exclusively the role and responsiblity of law enforcement at both the federal and state level, and requires cooperation between jurisdictions and federal partners to ensure success.<br />
<br />
<font style="background-color:#ffffff">In the United States, fentanyl is classified as a Schedule II controlled substance, meaning there is a potential for misuse and dependence, but it does have an accepted medical use and can be prescribed for restricted use. Although prescribed synthetic opioids are sometimes diverted to the illicit market, the main reason for the surge in high purity synthetic opioids are from the increase in manufacturing from clandestine labs, which are either pressed into pills or left in powder form and mixed with heroin.&nbsp;<ref name="Drug Policy">https://drugpolicy.org/drug-facts/are-synthetic-opioids-legal</ref></font><br />
<br />
== <font style="background-color:#ffffff">Law Enforcement, State, and Federal Response</font> ==<br />
<br />
<font style="background-color:#ffffff">Increasing seizures of synthetic opioid-laced heroin by law enforcement, calls from politicians to increase punishment for possession and/or sale of illicit fentanyl included escalating mandatory minimum sentencing, and even capital punishment for sale of heroin.There is no evidence that escalating criminal punishment will have any effect on reducing risk of overdose or use in general. Research has suggested that these policies will fail to address the issues involving fentanyl and will continue the harmful trend of mass incarceration in the US.&nbsp;</font><ref name="Drug Policy">https://drugpolicy.org/drug-facts/are-synthetic-opioids-legal</ref><br />
<br />
<br/> <font style="background-color:#ffffff">Individual states and the federal government’s efforts are centered around placing individual synthetic opioids and opiate-like NPS into Schedule I of the Controlled Substances Act (CSA).&nbsp;</font><ref name="Drug Policy">https://drugpolicy.org/drug-facts/are-synthetic-opioids-legal</ref><br />
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== Perceived Dangers of Accidental Overdoses ==<br />
<br />
With the distribution of [[Additional_Info_on_Fentanyl|fentanyl]], a powerful opioid that can be lethal in small amounts,&nbsp;overdoses have been reported by law enforment personnel as having&nbsp;occured&nbsp;through inhalation&nbsp;or absorption&nbsp;through the skin during routine encounters.<ref>http://www.cnn.com/2017/05/16/health/police-fentanyl-overdose-trnd/?iid=ob_article_footer_expansion]</ref>&nbsp;These instances, however, are more myth than reality,<ref>_</ref> and can lead to misplaced fear when law enforement and emergency responders come upon a suspected overdose. Any delay in responding to an overdose could cause brain damage and even death.<br />
See page on [[Support_Strategies_to_Address_Fentanyl|Support Strategies to Address Fentanyl]]</div> </div> </div> <br />
= National Programs =<br />
<br />
== DEA 360 Strategy ==<br />
<br />
'''Target Drug Trafficking Organizations'''<br/> In the past, the DEA has targeted low-level, first time non-violent offenders who usually are selling to get high themselves.<sup class="reference">[6]</sup> This new strategy will target all drug deals, but start from the top down.<sup class="reference">[7]</sup><br/> <br/> "''These drug trafficking organizations are predators. There's no other way to describe it. They look for the vulnerable, they exploit them by finding them while they are trying to get treatment; that's how severe, how bad these drug trafficking organizations are to find their customer and peddle their poison. We're going to put together a task force and this task force is going to put together building federal cases based on these overdoses, and there is significant sentencing around and this is a way to impact straight into the organization and take out upper level members of an organization that directly impact the flow of drugs''.”<sup class="reference">[8]</sup><br/> <br/> -Thomas Gorman, Assistant Special Agent in Charge, DEA<br />
<br />
== Organized Crime Drug Enforcement Task Force ==<br />
<br />
'''Organized Crime Drug Enforcement Task Force (OCTDEF) National Heroin/Fentanyl and Opioid Initiative'''<br/> Since its inception in December of 2014, the ultimate goal of this initiative has been to develop multi-agency, multi-jurisdictional cases against criminal organizations. The Initiative leverages the national structure, resources and information sharing capabilities to identify the local street level distributors who are responsible for overdose deaths, as well as their network of suppliers at the local and regional level. In the last several years, OCDETF investigators and prosecutors attacked the opioid epidemic by prosecuting rogue physicians, pharmacists, internet sales, and pill mill operations. Their traditional diversion investigations involved overwriting of oxycodone by doctors, and misuse of fentanyl patches by users who clipped the edges to consume the gel inside. Today, OCTDEF funds 60 Heroin/Fentanyl and Opioid Initiatives across the country. <sup class="reference">[9]</sup><br/> <br/> '''Working With China to Stop Export of Controlled Substances'''<br />
<br />
*A large number of synthetic opioids, specifically fentanyl, come to the US from China. <sup class="reference">[10]</sup> <br />
*China has agreed to crack down on the exports of substances that are controlled in the US, but not in China.<sup class="reference">[11]</sup> <br />
*The US and China will work together to exchange more law enforcement and scientific information to coordinate actions.<sup class="reference">[12]</sup> <br />
*Cooperation between the U.S. Drug Enforcement Agency (DEA) and the China Ministry of Public Security (MPS) and recognized China’s actions toward combating global synthetic drug trafficking.<sup class="reference">[13]</sup> <br />
*On October 1, 2015, China took an important step in international coordination by controlling a list of 116 synthetic drugs that were widely abused in the U.S.<sup class="reference">[14]</sup> <br />
*When evaluating a substance for control, the new provision also allows China to consider harm to the public in countries other than China.<sup class="reference">[15]</sup> <br />
*DEA continues to share information with Chinese officials to secure scheduling of additional fentanyl-class substances in China due to the wave of recent deaths in the United States from these synthetic opioids. <sup class="reference">[16]</sup> <br />
*At a time of massive growth in postal shipments from China due to e-commerce, the investigators found that the postal system received the electronic data on just over a third of all international packages, making more than 300 million packages in 2017 much harder to screen. Data in the Senate report shows no significant improvement during 2017 despite the urgency. <sup class="reference">[17]</sup> <br />
*The U.S. Postal Service said it has made dramatic progress in the last year in total packages with opioids seized by U.S. Customs and Border Protection... implementing the use of electronic data is slowed by the need to negotiate with international partners, but the service is making progress. <sup class="reference">[18]</sup> <br />
<br />
= General Strategies =<br />
<br />
== <font style="background-color:#ffffff">Better Addiction Prevention, Treatment, and Recovery Services</font> ==<br />
<br />
<font style="background-color:#ffffff">Improve access to prevention, treatment, and recovery support services to prevent the health, social, and economic consequences associated with opioid misuse and addiction, and to enable individuals to achieve long-term recovery.<ref name="HHS">https://www.hhs.gov/opioids/sites/default/files/2018-09/opioid-fivepoint-strategy-20180917-508compliant.pdf</ref></font><br />
<br />
== <br/> <font style="background-color:#ffffff">Better Data</font> ==<br />
<br />
<font style="background-color:#ffffff">Strengthen public health data reporting and collection to improve the timeliness and specificity of data, and to inform a real-time public health response as the epidemic evolves.</font><ref name="HHS">https://www.hhs.gov/opioids/sites/default/files/2018-09/opioid-fivepoint-strategy-20180917-508compliant.pdf</ref><br />
<br />
== <br/> <font style="background-color:#ffffff">Better Pain Management</font> ==<br />
<br />
<font style="background-color:#ffffff">Advance the practice of pain management to enable access to high-quality, evidence-based pain care that reduces the burden of pain for individuals, families, and society while also reducing the inappropriate use of opioids and opioid-related harms.</font><ref name="HHS">https://www.hhs.gov/opioids/sites/default/files/2018-09/opioid-fivepoint-strategy-20180917-508compliant.pdf</ref><br />
<br />
== <font style="background-color:#ffffff">Better Targeting of Overdose Reversing Drugs</font> ==<br />
<br />
<font style="background-color:#ffffff">Target the availability and distribution of overdose-reversing medications to ensure the broad provision of these drugs to people likely to experience or respond to an overdose, with a particular focus on targeting high-risk populations.</font><ref name="HHS">https://www.hhs.gov/opioids/sites/default/files/2018-09/opioid-fivepoint-strategy-20180917-508compliant.pdf</ref><br />
<br />
== <font style="background-color:#ffffff">Better Research</font> ==<br />
<br />
<font style="background-color:#ffffff">Support cutting-edge research that advances our understanding of pain, overdose and addiction, leads to the development of new treatments, and identifies effective public health interventions to reduce opioid-related health harms.</font><ref name="HHS">https://www.hhs.gov/opioids/sites/default/files/2018-09/opioid-fivepoint-strategy-20180917-508compliant.pdf</ref><br />
<br />
= Tools & Resources =<br />
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[[TR_-_Expand_Efforts_to_Disrupt_the_Supply_of_Heroin_&_Synthetic_Opioids_to_the_Community|TR - Expand Efforts to Disrupt the Supply of Heroin & Synthetic Opioids to the Community]]<br />
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<br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span><br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span><br />
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{| class="wiki_table"<br />
|-<br />
| '''Reviewer'''<br />
| '''Date'''<br />
| '''Comments'''<br />
|-<br />
| &nbsp;<br />
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= Sources =<br />
<br />
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#[https://www.dea.gov/divisions/hq/2016/hq061016.shtml [https://www.dea.gov/press-releases/2016/06/10/dea-warning-police-and-public-fentanyl-exposure-kills]] <br />
#[https://www.dea.gov/divisions/hq/2016/hq061016.shtml [2]] <br />
#[https://www.dea.gov/divisions/hq/2016/hq061016.shtml [3]] <br />
#[https://www.dea.gov/divisions/hq/2016/hq061016.shtml [4]] <br />
#[https://www.dea.gov/divisions/hq/2016/hq061016.shtml [5]] <br />
#[http://www.wdrb.com/story/33150219/dea-announces-new-strategy-to-stop-drug-trafficking-drug-violence-and-drug-abuse [6]] <br />
#[http://www.wdrb.com/story/33150219/dea-announces-new-strategy-to-stop-drug-trafficking-drug-violence-and-drug-abuse [7]] <br />
#[http://www.wdrb.com/story/33150219/dea-announces-new-strategy-to-stop-drug-trafficking-drug-violence-and-drug-abuse [8]] <br />
#[https://www.justice.gov/usao/file/895091/download [9]] <br />
#[https://www.statnews.com/2016/09/03/us-china-fentanyl/ [10]] <br />
#[https://www.statnews.com/2016/09/03/us-china-fentanyl/ [11]] <br />
#[https://www.statnews.com/2016/09/03/us-china-fentanyl/ [12]] <br />
#[https://www.dea.gov/divisions/hq/2017/hq011317.shtml [13]] <br />
#[https://www.dea.gov/divisions/hq/2017/hq011317.shtml [14]] <br />
#[https://www.dea.gov/divisions/hq/2017/hq011317.shtml [15]] <br />
#[https://www.dea.gov/divisions/hq/2017/hq011317.shtml [16]] <br />
##<br />
##*<br />
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##***<br />
##****<br />
##*****<br />
##******<br />
##*******[http://time.com/5117820/china-opioids-postal-service-drugs/ [17]] <br />
##*******[http://time.com/5117820/china-opioids-postal-service-drugs/ [18]] <br />
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[[Category:SAFE-Law Enforcement and Criminal Justice]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Disrupt_the_Supply_of_Heroin_and_Synthetic_Opioids&diff=20390Disrupt the Supply of Heroin and Synthetic Opioids2021-02-08T17:03:03Z<p>Rwashington: Rwashington moved page Disrupt the Supply of Heroin and Synthetic Opioids to Disrupt the Supply of Illegal Drugs</p>
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<div>#REDIRECT [[Disrupt the Supply of Illegal Drugs]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Expand_%26_Enhance_Prescription_Drug_Monitoring_Program_(PDMP)&diff=20383Expand & Enhance Prescription Drug Monitoring Program (PDMP)2021-02-08T16:14:43Z<p>Rwashington: Rwashington moved page Expand & Enhance Prescription Drug Monitoring Program to Expand & Enhance Prescription Drug Monitoring Program (PDMP)</p>
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'''''Return to '''[[ZOOM_MAP_-_Expand_&_Enhance_Prescription_Drug_Monitoring_Program|Zoom Map (Expand & Enhance PDMP)&nbsp;]]&nbsp;or [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]]&nbsp;or [[ZOOM_MAP_-_Minimize_Diversion_of_Prescription_Drugs|Zoom Map (Minimize Diversion of Prescription Drugs)]]&nbsp;or [[ZOOM_MAP_-_Reduce_Prescription_of_Opioids|Zoom map - Reduce Prescription of Opioids]]''<br />
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= Background =<br />
<br />
(PDMP) allows pre-registered users including licensed healthcare prescribers eligible to prescribe controlled substances, pharmacists authorized to dispense controlled substances, law enforcement, and regulatory boards to access timely patient controlled substance history information.<sup class="reference"><ref>[1]PDMP/CURES. (n.d.). Retrieved November 24, 2019, from https://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs/PDMP-CURES.html</ref></sup><br/> <br/> PDMPs are designed to collect, monitor, and analyze electronically transmitted prescribing and dispensing data submitted by pharmacies and dispensing practitioners. This information is used to assist prescribers, dispensers, and other health care professionals in making clinical decisions for their patients. PDMPs also have been shown to reduce adverse drug interactions, and help health care professionals identify patients who may be in need of substance use treatment. Law enforcement and regulatory/licensing board officials utilize PDMP information, under appropriate circumstances, to further their investigations of suspected violations of controlled substance laws and compliance with regulatory/licensing board practice standards. Many states have also begun to use PDMPs as a public health surveillance tool. PDMPs continue to be among the most promising state-level interventions to improve opioid prescribing, inform clinical practice, and protect patients at risk.<sup class="reference"><ref>[2]Comprehensive Opioid Abuse Site-based Program FY 2017 Competitive Grant Announcement, U.S. Department Of Justice, Office of Justice Programs, Bureau of Justice Assistance, Retrieved from chrome-extension://cdonnmffkdaoajfknoeeecmchibpmkmg/assets/pdf/web/viewer.html?file=https%3A%2F%2Fwww.bja.gov%2FFunding%2FCARA17.pdf</ref></sup><br />
<br />
= The Purpose of PDMPs =<br />
<br />
The main objectives of PDMP programs are to:<br />
<br />
*Improve patient safety. <br />
*Build a data collection and analysis system at a state level. <br />
*Enhance existing programs' ability to analyze and use collected data. <br />
*Facilitate the exchange of collected prescription data among states. <br />
*Assess the efficiency and effectiveness of the programs funded under this initiative.<sup class="reference"><ref>[3]Bureau of Justice Assistance—Comprehensive Opioid Abuse Program (COAP). (n.d.). Retrieved November 24, 2019, from https://www.bja.gov/ProgramDetails.aspx?Program_ID=72#horizontalTab1</ref></sup> <br />
<br />
<br/> PDMPs can alert Healthcare Providers to provide potentially lifesaving information and interventions.<br />
<br />
*They DO for those using prescription opioids <br />
**Help collaborate with the patient to taper to a safer dosage <br />
**Consider offering naloxone <br />
**Communicate with other providers managing the patient <br />
**Weigh patient goals, needs, risks <br />
*They DO for those who they consider to have opioid use disorder, discuss safety concerns and treatment options<sup class="reference"><ref>[4]What Healthcare Providers Need to Know about PDMPs | Drug Overdose | CDC Injury Center. (2019, July 12). Retrieved November 24, 2019, from https://www.cdc.gov/drugoverdose/pdmp/providers.html</ref></sup> <br />
*They DO NOT dismiss patients from care <br />
<br />
<br/> With this in mind, states are trying to find ways to increase use of PDMPs by prescribers so they avoid having a mandate. In some states, you are automatically registered when practitioners apply for a license. There are also efforts to integrate PDMP data into electronic medical record systems so the information is available at the point of care.<sup class="reference"><ref>[5]How to monitor prescription drugs | Psychiatry & Behavioral Health Learning Network. (n.d.). Retrieved November 24, 2019, from https://www.psychcongress.com/article/how-monitor-prescription-drugs</ref></sup><br/> &nbsp; [https://www.cdc.gov/drugoverdose/pdmp/ Prescription Drug Monitoring Programs]<br />
<br />
__TOC__<br />
<br />
== Examples of Positive Impact ==<br />
<br />
*Between the years of 2010-2012 Florida implemented a PDMP and other "pill mill" policies that had an positive impact on the opioid epidemic. According to the CDC, Florida recorded a 26.1% decrease in opioid analgesic overdose deaths, after these policies were implemented.<sup class="reference"><ref>[6]Decline in Drug Overdose Deaths After State Policy Changes—Florida, 2010–2012. (n.d.). Retrieved November 24, 2019, from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6326a3.htm</ref></sup> The Florida Department of Health said that from 2010 to 2013, oxycodone overdose deaths fell from 1,516 to 534—a 65% decrease.<sup class="reference"><ref>[7]Rutkow, L., Chang, H.-Y., Daubresse, M., Webster, D. W., Stuart, E. A., & Alexander, G. C. (2015). Effect of Florida’s Prescription Drug Monitoring Program and Pill Mill Laws on Opioid Prescribing and Use. JAMA Internal Medicine, 175(10), 1642–1649. https://doi.org/10.1001/jamainternmed.2015.3931</ref></sup> <br />
*New York Experienced a 75% decrease in prescriptions issued through "doctor shopping" as a result of a 2012 requirement that prescribers check the PDMP before writing a prescription.<sup class="reference"><ref>[8]Do prescription drug monitoring programs work? | Insurance Fraud News Service. (n.d.). Retrieved November 24, 2019, from http://www.insurancefraud.org/IFNS-detail.htm?key=22343</ref></sup> <br />
*74% of California physicians reportedly changed their prescribing practice as a result of patient activity reports created using the state's PDMP<sup class="reference"><ref>[9]Do prescription drug monitoring programs work? | Insurance Fraud News Service. (n.d.). Retrieved November 24, 2019, from http://www.insurancefraud.org/IFNS-detail.htm?key=22343</ref></sup> <br />
*After establishing a PDMP, Tennessee saw a reduction in the morphine milligram equivalents dispensed, a reduction in the number of doctor and pharmacy shoppers going to multiple outlets to obtain drugs, an increase in queries to the State's Controlled Substance Monitoring Database Program by prescribers and extenders, and a change in practices, with some 41.4% less likely to prescribe certain controlled substances.<sup class="reference"><ref>[10]Do prescription drug monitoring programs work? | Insurance Fraud News Service. (n.d.). Retrieved November 24, 2019, from http://www.insurancefraud.org/IFNS-detail.htm?key=22343</ref></sup> <br />
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&nbsp;<br />
<br />
== Examples of Negative Impact ==<br />
<div class="_">The existence of a Prescription Drug Monitoring Program within a state, however, '''appears to increase drug diversion activities in contiguous non-PDMP states'''. When states begin to monitor drugs, drug diversion activities tend to spill across boundaries to non-PDMP states. One example is provided by Kentucky, which shares a boundary with seven states, only two of which have PDMPs -- Indiana and Illinois. As drug diverters became aware of Kentucky PDMP's ability to trace their drug histories, they tended to move their diversion activities to nearby nonmonitored states. OxyContin diversion problems have worsened in Tennessee, West Virginia, and Virginia -- all contiguous non-PDMP states -- because of the presence of Kentucky's PDMP, according to a joint federal, state, and local drug diversion report.<sup class="reference"><ref>[11]Diversion of Prescription Drugs. (n.d.). Retrieved November 24, 2019, from Drug War Facts website: https://www.drugwarfacts.org/chapter/diversion</ref></sup></div> <div class="_">&nbsp;</div> <br />
== Legislation ==<br />
<div class="_">The Prescription Drug Monitoring Program was created by the FY 2002 U.S. Department of Justice Appropriations Act (Public Law 107-77). <sup class="reference"><ref>[12]Bureau of Justice Assistance—Comprehensive Opioid Abuse Program (COAP). (n.d.). Retrieved November 24, 2019, from https://www.bja.gov/ProgramDetails.aspx?Program_ID=72#horizontalTab1<br />
</ref></sup><br/> <br/> Opportunities to Enhance PDMPs</div> <br />
== TTAC ==<br />
<br />
[http://www.pdmpassist.org/ Training Technical Assistance Center ]: Brandeis University, in partnership with the Bureau of Justice Assistance, has developed the PDMP TTAC to provide services, support, resources and strategies to improve the effectiveness of state PDMPs. Call 781-609-7741 for more information.<br />
<br />
== Third Party Patient Monitoring ==<br />
<br />
'''GuideMed Monitoring''' is a management program for prescription narcotics monitoring. It helps provider networks prevent prescription drug misuse and it helps to protect the network and its practitioners from liabilities associated with prescription narcotics.<sup class="reference"><ref>[17] Can't find the source ( Error 525)</ref></sup> Patient service stations are established on-site or freestanding in locations determined by the physician, where GuideMed nurses will staff and manage the monitoring activities chosen by the physician (Risk Assessments, PDMP Checks, CSA Reviews, Pill Counts, Toxicology Testing). After the nurse gathers all the necessary information, a report is prepared and sent to the patient's physician via a PDF file attached to that patient's record. GuideMed also provides any data needed for a compliance officer.<sup class="reference"><ref>[18]Can't find source ( error 525) https://guidemed.com/about-guidemed/</ref></sup><br />
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== Provider Challenges to Effective Use of PDMPs ==<br />
<br />
*<u>Insufficient Resources:</u> Providers lack the time within their practice to perform all activities (not staffed sufficiently, not reimbursed, not value-added). Virtually every knowledge and use survey for PDMPs, for example, shows only half of physicians use the PDMP and the reasons cited for not using it are "it's too time consuming" and "its too difficult to use." ("I need to see a patient every 12 minutes to make ends meet, I do not have the time or capacity to do all of this work.") <br />
*<u>Patient Provider Relationship:</u> The design of many programs tends to compromise the trust between patients and physicians because the providers are required to police their patients, and this is not something physicians see as part of their role as care providers. ("I did not go to medical school for this. I need a trusting relationship with the patient, which is not possible when I ask to count their pills.") <br />
*<u>Data Management:</u> There is no automation support for any of this activity today, no field within the EMR to enter the risk-adjusted monitoring protocols or schedule patient activities according to risk levels, there is no place to store the results of a pill count or PDMP check or alert the physician when a treatment agreement needs to be updated. <br />
*<u>Consistency:</u> Whether it is patients within a practice, practices within a network, or health systems within the state -- getting everyone to establish and adhere to protocols consistently is a challenge, yet inconsistent application of protocols is one of the greatest liabilities for any provider.<sup class="reference"><ref>[19]Preventing Chronic Opioid Therapy Addiction: PDMP’s alone are not the answer! | LinkedIn. (n.d.). Retrieved November 24, 2019, from https://www.linkedin.com/pulse/preventing-chronic-opioid-therapy-addiction-pdmps-alone-ron-frost/</ref></sup> <br />
<br />
<br/> '''Prescription Drug Monitoring Information Exchange (PMIX)''' Architecture enables nationwide information sharing by the use of free, open, and consensus-based solutions; common formatting of shared data; security and privacy protocols to protect sensitive information; and preserving the state choice of interstate sharing solutions.<sup class="reference"><ref>[20]Prescription Drug Monitoring Programs: Critical Information Sharing Enabled by National Standards, Retrieved from : chrome-extension://cdonnmffkdaoajfknoeeecmchibpmkmg/assets/pdf/web/viewer.html?file=https%3A%2F%2Fwww.bja.gov%2Fprograms%2Fpmixarchitecture.pdf</ref></sup><br />
<br />
== Use PDMPs to Improve Patient Safety ==<br />
<br />
== National Alliance for Model State Drug Laws ==<br />
<div class="_">View [http://www.namsdl.org/prescription-monitoring-programs.cfm model PDMP laws ] and documents from states with prescription drug monitoring programs</div> <div class="_">&nbsp;</div> <br />
*Annual summaries or highlights <br />
*Administration of PDMPs <br />
*Data Reporting and Retention <br />
*Types of Authorized Recipients <br />
*Access and Registration <br />
*PDMPs and Privacy <br />
*Miscellaneaous Documents <br />
<br />
= State PDMPs =<br />
<br />
#<span style="background-color: #ffffff">[https://oag.ca.gov/cures CURES ]: California's state PDMP. Learn more at [https://oag.ca.gov/cures/faqs CURES FAQs]</span> <br />
#<span style="background-color: #ffffff">[http://www.orhealthleadershipcouncil.org/our-current-initiatives/emergency-department-information-exchange-edie EDIE ]: Oregon and Washington use the Emergency Department Information Exchange (EDIE) system. This technology allows ED practicioners to identify patients with more than 5 ER visits in a one year period or those with complex care needs who can be directed to appropriate care. This system allows for alerts to hospitals as soon as patient visits ER.</span> <br />
#<span style="background-color: #ffffff">[http://www.floridahealth.gov/statistics-and-data/e-forcse/ EFORSCE ]: Florida's PDMP. This database has been in effect since 2010 and there are [http://www.floridahealth.gov/statistics-and-data/e-forcse/news-reports/index.html annual reports ] for each year. The website also includes a list of it's [http://www.floridahealth.gov/statistics-and-data/e-forcse/funding/index.html funding sources ].</span> <br />
#<span style="background-color: #ffffff">[https://pharmacypmp.az.gov/ Arizona State Board of Pharmacy Controlled Substances Prescription Monitoring Program (CSPMP) ]- Allows practitioners and pharmacists to look up, view, and print controlled substance dispensing information on their specific patients directly via user name and password.</span> <br />
#<span style="color: #fa1048">[http://www.worxpdmp.com/ WORx]</span><span style="background-color: #ffffff">Wyoming's active PDMP system.</span> <br />
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&nbsp;<br />
<br />
== Find Your State's PDMP ==<br />
<div class="_">Use this [http://mytopcare.org/resources/using-the-state-prescription-monitoring-program-pmp-effectively/find-your-states-pmp/ link] to find your state's Prescription Drug Monitoring Program.</div> <div class="_"><br />
= Funding Opportunities =<br />
<br />
=== Current Funding Methods ===<br />
<br />
*Federal grants <br />
*Private/Non-federal grants <br />
*General revenue funds <br />
*Controlled substance registration fees <br />
*Professional licensing fees <br />
*Regulatory board funds <br />
<br />
=== Potential Funding Methods ===<br />
<br />
*PDMP licensing fees <br />
*Health insurance licensing fees <br />
*Private donations <br />
*Medicaid fraud settlements <br />
*Assessed fines <br />
*Asset Forfeiture <br />
*Drug manufacturers' assessment <br />
*Prescription fees <br />
*Private third party payers or health insurers <br />
*PDMP authorized users<ref> [13]Technical Assistance Guide, No.04-13, Prescription Drug Monitoring Program Training and Technical Assistance Center, Brandeis University, July 3, 2013. Retrieved from chrome-extension://cdonnmffkdaoajfknoeeecmchibpmkmg/assets/pdf/web/viewer.html?file=http%3A%2F%2Fwww.pdmpassist.org%2Fpdf%2FPDMP_Funding_Options_TAG.pdf</ref> <br />
*see the PDMP TTAC Funding Options for Prescription Drug Monitoring Programs in [[TR_-_Expand_&_Enhance_Prescription_Drug_Monitoring_Programs|Tools and Resources for]] full descriptions.<br/> <br/> <u>The Comprehensive Opioid Abuse Program Training and Technical Assistance (TTA) Program</u> is a grant from the U.S. Bureau of Justice given to state, local, and tribal governments to provide resources to intervene with persons with substance use disorders.<sup class="reference"><ref>[14]Bureau of Justice Assistance—Comprehensive Opioid Abuse Program (COAP). (n.d.). Retrieved November 24, 2019, from https://www.bja.gov/ProgramDetails.aspx?Program_ID=72#horizontalTab1</ref></sup> The goals of the Comprehensive Opioid Abuse TTA Program are twofold. First, the program aims to support site-based and state initiatives designed to reduce opioid misuse and the number of overdose fatalities. Second, the program supports PDMPs and their stakeholders in expanding the implementation, enhancement, and proactive use of prescription drug monitoring programs to support clinical decision-making and prevent the misuse and diversion of controlled substances. Proposals due April 25, 2017.<sup class="reference"><ref>[15]Comprehensive Opioid Abuse Site-based Program FY 2017 Competitive Grant Announcement, U.S. Department Of Justice, Office of Justice Programs, Bureau of Justice Assistance, Retrieved from chrome-extension://cdonnmffkdaoajfknoeeecmchibpmkmg/assets/pdf/web/viewer.html?file=https%3A%2F%2Fwww.bja.gov%2FFunding%2FCARA17.pdf</ref></sup><br/> <br/> The Comprehensive Opioid Abuse Site-based Program - Harold Rogers Prescription Drug Monitoring Program Implementation and Enhancement Projects<br/> Funding opportunity which provides state, local, and tribal governments resources to intervene with persons with substance use disorders.The Harold Rogers Prescription Drug Monitoring Program (PDMP) is being incorporated into the FY 2017 Comprehensive Opioid Abuse Site-based Program. The purpose of this program is to improve collaboration and strategic decision-making of regulatory and law enforcement agencies and public health officials to address prescription drug and opioid misuse, save lives, and reduce crime. This is made possible through the collection and analysis of controlled substance prescription data and other scheduled chemical products through a centralized database administered by an authorized state agency. This program will be applied by April 25, 2017.<sup class="reference"><ref>[16]Comprehensive Opioid Abuse Site-based Program FY 2017 Competitive Grant Announcement, U.S. Department Of Justice, Office of Justice Programs, Bureau of Justice Assistance, Retrieved from chrome-extension://cdonnmffkdaoajfknoeeecmchibpmkmg/assets/pdf/web/viewer.html?file=https%3A%2F%2Fwww.bja.gov%2FFunding%2FCARA17.pdf</ref></sup> <br />
</div> <div class="_">&nbsp;</div> <br />
= Tools & Resources =<br />
<br />
[[TR_-_Expand_&_Enhance_Prescription_Drug_Monitoring_Programs|TR - Expand & Enhance Prescription Drug Monitoring Programs]]<br/> <br/> The Pew Charitable Trust created a report on [http://www.pewtrusts.org/en/research-and-analysis/reports/2016/12/prescription-drug-monitoring-programs Evidence-Based Practices to Optimize Use of PDMPs]<br />
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[[Category:SAFE-Prescriptions and Medical Response]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Expand_%26_Enhance_Prescription_Drug_Monitoring_Program&diff=20384Expand & Enhance Prescription Drug Monitoring Program2021-02-08T16:14:43Z<p>Rwashington: Rwashington moved page Expand & Enhance Prescription Drug Monitoring Program to Expand & Enhance Prescription Drug Monitoring Program (PDMP)</p>
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<div>#REDIRECT [[Expand & Enhance Prescription Drug Monitoring Program (PDMP)]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Expand_%26_Improve_Support_for_Youth_Outreach,_Leadership,_Prevention,_and_Education&diff=20380Expand & Improve Support for Youth Outreach, Leadership, Prevention, and Education2021-02-08T15:54:12Z<p>Rwashington: Rwashington moved page Train Youth in How to Resist Peer Pressure to Try Drugs to Expand & Improve Support for Youth Outreach, Leadership, Prevention, and Education</p>
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= Background =<br />
<br />
A positive relationship between peer drug use and drug use among adolescents is well-established in scientific literature.<sup class="reference"><ref>[1]Santor, D. A., Messervey, D., & Kusumakar, V. (2000). Measuring Peer Pressure, Popularity, and Conformity in Adolescent Boys and Girls: Predicting School Performance, Sexual Attitudes, and Substance Abuse. Journal of Youth and Adolescence, 29(2), 163–182. https://doi.org/10.1023/A:1005152515264<br />
</ref></sup><sup class="reference"><ref>[2]Dielman, T. E., et al. </ref></sup><sup class="reference"><ref>[3]Brooks-Russell, A., Conway, K. P., Liu, D., Xie, Y., Vullo, G. C., Li, K., … Simons-Morton, B. (2015). Dynamic Patterns of Adolescent Substance Use: Results From a Nationally Representative Sample of High School Students. Journal of Studies on Alcohol and Drugs, 76(6), 962–970. https://doi.org/10.15288/jsad.2015.76.962<br />
</ref></sup><sup class="reference"><ref>[4]Tucker, J. S., Ewing, B. A., Miles, J. N. V., Shih, R. A., Pedersen, E. R., & D’Amico, E. J. (2015). Predictors and consequences of prescription drug misuse during middle school. Drug and Alcohol Dependence, 156, 254–260. https://doi.org/10.1016/j.drugalcdep.2015.09.018<br />
</ref></sup><sup class="reference"><ref>[5]McDonough, M. H., Jose, P. E., & Stuart, J. (2016). Bi-directional Effects of Peer Relationships and Adolescent Substance Use: A Longitudinal Study. Journal of Youth and Adolescence, 45(8), 1652–1663. https://doi.org/10.1007/s10964-015-0355-4<br />
</ref></sup> Recently, a study of teen and adult drivers showed that the reward-processing areas of the brains of teens are more active when their behavior is observed, suggesting that the "presence of peers is sufficient in itself to make risks feel more worthwhile to teens," including using drugs.<ref>[6]Chein, J., Albert, D., O’Brien, L., Uckert, K., & Steinberg, L. (2011). Peers increase adolescent risk taking by enhancing activity in the brain’s reward circuitry. Developmental Science, 14(2), F1-10. https://doi.org/10.1111/j.1467-7687.2010.01035.x<br />
</ref><br />
<br />
One of the best tools to utilize in any prevention effort is early prevention education. Individuals who start using substances as youth have been shown to be much more likely to abuse them later in life. Students have been shown to be most likely to begin substance use during the adolescent years. According to the National Institute on Drug Abuse: “ Collection of data from the National Survey of Drug Use and Health (NSDUH) on age at first use of illegal drugs across the U.S. begins at age 12 years, with data from 2014 indicating that 3.4 percent of 12- to 13-year-old children have used an illegal drug in the past month (including inappropriate use of prescription drugs), 2.1 percent are current alcohol users, and 1.1 percent are current tobacco users (CBHSQ, 2015). In 2015, NIDA’s annual Monitoring the Future (MTF) survey of adolescent drug use and attitudes showed that, by the time they are seniors, 64 percent of high school students have tried alcohol, almost half have taken an illegal drug, 31 percent have smoked a cigarette, and 18 percent have used a prescription drug for a nonmedical purpose.” <ref>National Institute on Drug Abuse. “Chapter 1: Why Is Early Childhood Important to Substance Abuse Prevention?” NIDA, www.drugabuse.gov/publications/principles-substance-abuse-prevention-early-childhood/chapter-1-why-early-childhood-important-to-substance-abuse-prevention#adolescent-drug-use.<br />
</ref>&nbsp;This is why it is so important to place an emphasis on proper prevention education in today’s youth. If they are properly implemented programs can help to provide real barriers to the first use and possible future abuse of substances.<br />
<br />
&nbsp;<br />
<br />
= Tools and Resources =<br />
<br />
== School Based Prevention ==<br />
<br />
=== '''Social Resistance Skills''' ===<br />
<br />
In this type of training, students are taught how to recognize situations in which they are likely to face peer pressure and are given strategies to deal with these situations including formulating counter arguments.<sup class="reference"><ref>[7]Griffin, K. W., & Botvin, G. J. (2010). Evidence-Based Interventions for Preventing Substance Use Disorders in Adolescents. Child and Adolescent Psychiatric Clinics of North America, 19(3), 505–526. https://doi.org/10.1016/j.chc.2010.03.005<br />
</ref></sup> This approach alone does not counteract peer pressure, but can be effective when used in conjunction with normative education.<sup class="reference"><ref>[8]Hansen, W. B., & Graham, J. W. (1991). Preventing alcohol, marijuana, and cigarette use among adolescents: Peer pressure resistance training versus establishing conservative norms. Preventive Medicine, 20(3), 414–430. https://doi.org/10.1016/0091-7435(91)90039-7<br />
</ref></sup><sup class="reference"><ref>[9]Clayton, R. R., Cattarello, A. M., & Johnstone, B. M. (1996). The Effectiveness of Drug Abuse Resistance Education (Project DARE): 5-Year Follow-Up Results. Preventive Medicine, 25(3), 307–318. https://doi.org/10.1006/pmed.1996.0061<br />
</ref></sup><br/> &nbsp;<br />
<br />
=== '''Normative Education''' ===<br />
<br />
This approach attempts to counteract inaccurate perceptions of drug and alcohol abuse. According to Griffen and Botvin (2010) "Many adolescents overestimate the prevalence of smoking, drinking, and the use of certain drugs, which can make substance use seem to be normative behavior. Educating youth about actual rates of use, which are almost always lower than the perceived rates of use, can reduce perceptions regarding the social acceptability of drug use."<sup class="reference"><ref>[10]Griffin, K. W., & Botvin, G. J. (2010). Evidence-Based Interventions for Preventing Substance Use Disorders in Adolescents. Child and Adolescent Psychiatric Clinics of North America, 19(3), 505–526. https://doi.org/10.1016/j.chc.2010.03.005<br />
</ref></sup> Studies have shown that normative education alone and in conjunction with social resistance training can be effective in reducing alcohol, cigarette, and marijuana use among adolescents.<sup class="reference"><ref>[11]Hansen, W. B., & Graham, J. W. (1991). Preventing alcohol, marijuana, and cigarette use among adolescents: Peer pressure resistance training versus establishing conservative norms. Preventive Medicine, 20(3), 414–430. https://doi.org/10.1016/0091-7435(91)90039-7<br />
</ref></sup><br />
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=== <br/> '''Competence Enhancement/Life Skills Training (LST)''' ===<br />
<br />
This approach focuses on the social learning processes that play a role in the development of drug use in adolescents. Students are taught some combination of the following life skills.<br />
<br />
*&nbsp; general social skills and general assertive skills<sup class="reference"><ref>[12]Griffin, K. W., & Botvin, G. J. (2010). Evidence-Based Interventions for Preventing Substance Use Disorders in Adolescents. Child and Adolescent Psychiatric Clinics of North America, 19(3), 505–526. https://doi.org/10.1016/j.chc.2010.03.005</ref></sup> <br />
*&nbsp; adapting coping strategies for relieving stress and anxiety through use of cognitive coping skills or behavioral relaxation techniques&nbsp; <br />
*&nbsp; general cognitive skills for resisting interpersonal media influences <br />
*&nbsp; skills for increasing self-control and self-esteem <br />
<br />
LST is effective in reducing use of alcohol, tobacco, marijuana, and other psychoactive drugs and is estimated to save $38 for every dollar invested.<sup class="reference"><ref>[13]Botvin, G. J., & Griffin, K. W. (2014). Life skills training: Preventing substance misuse by enhancing individual and social competence. New Directions for Youth Development, 2014(141), 57–65. https://doi.org/10.1002/yd.20086<br />
</ref></sup><br />
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[[TR_-_Train_Youth_in_How_to_Resist_Peer_Pressure_to_Try_Drugs|TR - Train Youth in How to Resist Peer Pressure to Try Drugs]]<br />
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= Promising Practices and Progams =<br />
<br />
== [http://abovetheinfluence.com/ Above the Influence] ==<br />
<br />
A national awareness campaign aimed at preventing youth from misuse of substances.<br />
<br />
== Parental Involvement ==<br />
<br />
High levels of parental disapproval of drug use may mitigate the negative influence of drug-using peers.<sup class="reference"><ref>[14]Chan, G. C. K., Kelly, A. B., Carroll, A., & Williams, J. W. (2017). Peer drug use and adolescent polysubstance use: Do parenting and school factors moderate this association? Addictive Behaviors, 64, 78–81. https://doi.org/10.1016/j.addbeh.2016.08.004<br />
</ref></sup><br />
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See Also: [[Empower_&_Strengthen_Parents|Empower & Strengthen Parents]]<br />
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[[Category:SAFE-Full Spectrum Prevention]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Train_Youth_in_How_to_Resist_Peer_Pressure_to_Try_Drugs&diff=20381Train Youth in How to Resist Peer Pressure to Try Drugs2021-02-08T15:54:12Z<p>Rwashington: Rwashington moved page Train Youth in How to Resist Peer Pressure to Try Drugs to Expand & Improve Support for Youth Outreach, Leadership, Prevention, and Education</p>
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<div>#REDIRECT [[Expand & Improve Support for Youth Outreach, Leadership, Prevention, and Education]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Empower_Parents&diff=20366Empower Parents2021-02-08T13:56:52Z<p>Rwashington: Rwashington moved page Empower & Strengthen Parents to Empower Parents</p>
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Return to [https://www.safeproject.us/noshame-mental-health-addiction/ Safe Solutions]<br />
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Return to &nbsp;[[ZOOM_MAP_-_Improve_Protective_Factors_to_Reduce_SUDs|Zoom Map - Improve Protective Factors to Reduce SUDs]]<br />
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Parents are one of the main influencers on whether or not their kids misuse drugs.&nbsp; But, parenting is not easy.&nbsp; Communities can take advantage of a wide variety of tools and programs to help parents be more effective in buiding the developmental assets that reduce the likelihood that kids use drugs.&nbsp; While good&nbsp;parenting (however that is defined) is certainly no guarantee that kids won't use drugs, and the use of drugs by kids does not mean that the parenting was bad, it still makes sense to try to help parents be more effective in helping their kids to grow in a good, supportive environment and for the parents to have as good of influence as they can on their kids' choices regarding use of drugs or alcohol.&nbsp;<br />
<div class="mw-parser-output"><br />
= Background =<br />
<br />
== Parents have a large role in prevention and recovery ==<br />
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Parental influence is one of the most powerful tools for any community prevention efforts. A youths parents have the ability to instill powerful values and create positive safety nets to help lessen the risk factors that youth face everyday throughout their lives. A study from the Journal of Adolescent Health “Through early childhood education, increasing early parental involvement and expectations can alter life-course outcomes by providing children with foundation for positive behaviors"&nbsp;<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808405/</ref>&nbsp;&nbsp; This holds true for any youth who is going through the recovery process as well, parental involvement is a key factor in that process. An article by Recovery First a American Addiction Center treatment facility states that “ Parents play an instrumental role in the drug addiction treatment or alcohol rehab of their dependent child. In fact, most rehab center report that it is often the mother or father who initiates treatment for their minor.”&nbsp;<ref>https://www.recoveryfirst.org/blog/the-role-of-parents-in-addiction-recovery/</ref> &nbsp;Parents also have the opportunity to provide valuable support to any youth going through treatment.&nbsp; Parents can play a very crucial role and potentially life saving role in the recovery process.&nbsp;<br />
<br />
== Parents have a big influence on youth behavior ==<br />
<br />
Youth who perceive that their parents would strongly disapprove of their use of marijuana are far less likely to have used it in the last month than youth who don’t receive such messages from their parents (4.3 percent versus 31 percent). <sup class="reference"><ref>[1]Results from the 2012 National Survey on Drug Use .pdf. (n.d.). Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUHresults2012/NSDUHresults2012.pdf<br />
</ref></sup><br />
<br />
When school prevention programs are supported by families, peers, and the community all sending the consistent message that drug use is not tolerated, it can have a powerful effect on young people.<ref> [2]Hazelden Publishing Releases Opioid Toolkit. (n.d.). Retrieved December 3, 2019, from https://www.hazeldenbettyford.org/about-us/news-media/press-release/2014-hazelden-publishing-release-heroin-prescription-toolkit<br />
</ref><br/> &nbsp;<br />
<br />
== Parents Influence Use of Opioid Pain Medication ==<br />
<br />
In many cases, doctors, dentists and oral surgeons are still prescribing opioids to teens more often than would be ideal. Many parents may not realize the risks. Helping educate parents may result in some parents working with medical care providers to reduces the prescription of opioid pain medication and pursue other options. This resource is targeting [http://masstapp.edc.org/rx-student-athlete parents of student athletes].<br />
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</div> <br />
= Tools and Resources =<br />
<br />
== SAMHSA National Hotline ==<br />
<br />
[https://www.samhsa.gov/find-help/national-helpline The SAMHSA national hotline]&nbsp; is a confidential, free, 24 hour a day 365 day a year, information service, in English and Spanish, for individuals and family members facing men and/or substance use disorders. They also provide many links with helpful information to help families and individuals answer important questions about drug abuse and recovery.<br />
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== Parent Resources: ==<br />
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=== [https://teens.drugabuse.gov/parents https://teens.drugabuse.gov/parents] ===<br />
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This resource has many links on how to prevent teen drug use starting from home.<br />
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=== [https://drugfree.org/article/get-one-on-one-help/ Drugfree.org] ===<br />
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This is a hotline that allows parents to speak to other trained parents about substance abuse issues.<br />
<br />
&nbsp;<br />
</div> <br />
= Promising Programs =<br />
<br />
== Safe Homes Network and App ==<br />
<br />
Originated near Scottsdale, Arizona, Safe Homes Network is an application that allows parents to know where their kids are when they go to a party. When the child goes to a party the parent can check on the app. to see whether or not the house is registered in the directory. If so, parents can contact that head of house and make sure they know whether or not a party is occurring. The system is set up to act like a barrier for alcohol and drug consumption to happen under people's roofs.<br />
<br />
&nbsp; To become a Safe Homes member, you must:<br/> &nbsp; 1. Parents sign a pledge not to allow underage drinking or drug use in their home.<br/> &nbsp; 2. Parents' contact information is entered into the Safe Homes Network database.<br/> &nbsp; 3. Parents download the Safe Homes Network App to their phone or tablet and check it when their child is invited to a party or gathering where they don't know the parents.<br />
<br />
&nbsp; Since the Fountain Hills, AZ coalition started the Safe Homes Network, there has been a 44 percent decrease in the past 30-day use of alcohol, a 37 percent decrease in marijuana use and a 51 percent decrease in prescription drug abuse.<br />
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&nbsp;[[More_information_on_Safe_Homes_Network|More information on Safe Homes Network]]<br/> &nbsp;<br />
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== Gobi ==<br />
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Parent involvement is critical in preventing teen substance use. As a parent, it can be extremely difficult to talk about drug use with your kids in an engaging and effective way. Whether you suspect there's already a problem or you want to help make sure there is never a problem, Gobi can help.<br />
<br />
[https://www.gobi.support/ Gobi] is the only online prevention program designed by professionals and young adults for teens and their families. Gobi is based on the proven principles of professional drug and alcohol prevention. It’s designed specifically for teens, and it speaks their language—using a tool they already have in hand. Every day for 21&nbsp;days teens get an email assignment on their smartphone and it takes only 5 minutes per day. Several times a week they get a supportive text message that is meant to be irreverent, humorous, cynical, and just offensive enough to keep them laughing (and engaged).<br />
<br />
Parents are involved and get their own series of emails on adolescent development and communication skills. Teens will be asked three&nbsp;times to schedule a time to talk with their parents. Topics and guidelines will be included to make the conversation as successful as possible, and parents will also receive program support.<br />
<br />
Teens Using Gobi Report: (Get source)<br />
<br />
*Improved relationship with their parents <br />
*A decrease in their use of drugs and alcohol <br />
*Better ability to manage stress <br />
*Increased awareness of their choices <br />
<br />
[https://www.gobi.support/get-started Signing up for Gobi] is free to use by both parents and youth.<br/> [[More_information_on_adopting_the_Gobi_program|More information on adopting the Gobi program]]<br />
<br />
&nbsp;<br />
</div> <br />
== Drug Prevention Resources ==<br />
<br />
[https://drugfreegeneration.org/ Drug Prevention Resources] has an abundance of tools and resources to help parents to reduce the likelihood of their kids using drugs.<br/> &nbsp;<br />
<br />
== Fathers' Uplift ==<br />
<br />
[http://fathersuplift.org/fathers/ Fathers' Uplift] empowers fathers to overcome barriers and become positively engaged in their children's lives.<sup class="reference"><ref>[5]Front Page | Fathers Uplift. (n.d.). Retrieved December 3, 2019, from http://fathersuplift.org/fathers/<br />
</ref></sup><br />
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= Parent Education =<br />
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== DEA Books ==<br />
<br />
The DEA produced two books, "Growing Up Drug Free: A Parent's Guide to Prevention" and "Prescription for Disaster: How Teens Abuse Medicine." Copies of each resource can be found in [[TR_-_Empower_&_Strengthen_Parents|Tools & Resources]].<br />
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== Family Life's Art of Parenting ==<br />
<br />
FamilyLife’s [https://www.familylife.com/parenting Art of Parenting] FREE online course gives parents a simple vision and creative ways to make faith the core of their parenting.<br />
</div> <br />
= Tools & Resources =<br />
<br />
[[TR_-_Empower_&_Strengthen_Parents|TR - Empower & Strengthen Parents]]<br />
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<br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span><br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span><br />
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[[Category:SAFE-Full Spectrum Prevention]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Empower_%26_Strengthen_Parents&diff=20367Empower & Strengthen Parents2021-02-08T13:56:52Z<p>Rwashington: Rwashington moved page Empower & Strengthen Parents to Empower Parents</p>
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<div>#REDIRECT [[Empower Parents]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Expand_School-Based_Prevention_Programs&diff=20359Expand School-Based Prevention Programs2021-02-05T21:45:46Z<p>Rwashington: Rwashington moved page Expand School Prevention Programs to Expand School-Based Prevention Programs</p>
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Schools are in a unique position to reach the vast majority of youth in a community, and there are excellent low-cost and free resources that can be used by schools to enhance prevention. Schools bear a significant burden when students misuse drugs and develop addictions, so they should be motivated to be partners in prevention.<br />
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= Background =<br />
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== The Need for Prevention Programs Targeting Youth ==<br />
<br />
This [http://www.wbur.org/commonhealth/2017/08/29/the-opioid-epidemic-needs-a-strategy-for-teens article by two doctors provides a strong case] for specific strategies to address teen opioid abuse. It links to good sources of information and resources.<br/> <br/> The National Survey on Drug Use and Health (NSDUH), conducted in 2015 in the United States on 68,073 people 12 years of age and older, revealed that the prevalence of past year pain reliever NMU was 3.9% among 12–17 year olds (Hughes et al., 2016). The 2015 Monitoring The Future (MTF) survey among high school students revealed that older adolescents (12th graders) had the highest annual prevalence of OxyContin® and Vicodin® use (3.7% and 4.4% respectively), with the lowest annual prevalence seen in 8th graders (0.8% and 0.9%, respectively) (Johnston, O'Malley, Miech, Bachman, & Schulenberg, 2016). Learn more in [https://www.sciencedirect.com/science/article/pii/S0306460317301351 this article].<br/> <br/> This [https://www.hhs.gov/ash/oah/adolescent-development/substance-use/drugs/opioids/index.html HHS page] also has good information on opioid and adolescents. (Add key points to this wiki page).<br/> <br/> Using "[[Reduce_the_Use_of_Gateway_Drugs|Gateway Drugs]]" and smoking increases risk factors.<br />
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== Opioid Education Programs ==<br />
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Recommendations for selecting a school program<sup class="reference"><ref>[1]The Opioid Epidemic and Youth: Prevention Considerations. (n.d.). Retrieved December 3, 2019, from Prevention Plus Wellness, LLC website: https://preventionpluswellness.com/blogs/news/the-opioid-epidemic-and-youth-prevention-considerations<br />
</ref></sup><br />
<br />
*Start by looking at programs that have evidence that they work. The list on [https://www.blueprintsprograms.org/about Blueprints for Healthy Youth Development] is a place to start. Do a keyword search of this registry using the term “opioid prevention” to find programs. <br />
*Look for programs that have a good Return on Investment (effective, but not too expensive). See below on this page. <br />
*Adopt programs that not only prevent substance use but also promote protective fitness and healthy habits among teens. Programs that integrate substance use prevention with positive behavior promotion are more likely to be accepted and used by youth, families and funders than those limited to just communicating substance use risks and harm. This was key to the success of the Youth in Iceland Program and is backed by many studies. <br />
*Promote prevention in multiple settings to reach a broader youth audience, and ensure overlapping prevention messages. Critical settings for providing prevention programs include schools and colleges, healthcare, youth and family organizations, juvenile justice, sports and recreation programs, and homes. <br />
*Innovate to make evidence-based programs more relevant in these fast-changing times. Research takes time and the opioid crisis is moving fast. You should consider how to innovate and enhance programs that may have targeted other drugs to make them more relevant for today's opioid crisis. <br />
<br />
<br/> '''School Prevention Programs have a Positive Impact'''<br/> In 2012, a special report of the National Survey on Drug Use and Health reported that 75% of youth ages twelve to seventeen reported having seen or heard drug or alcohol prevention messages at school. Of those who received such exposure, 8.9% reported using an illicit drug in the past month, versus 12.3% among students who reported no exposure to such messages.<br/> &nbsp;<br />
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= Classroom Resources =<br />
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=== Operation Prevention ===<br />
<br />
[https://www.operationprevention.com/ Operation Prevention], a joint partnership between Discovery Education and the DEA, developed '''free''' resources that "that are aligned to national health and science standards and integrate seamlessly into classroom instruction." Toolkits and lesson plans have been designed for middle school students and another for high school students. A parent toolkit designed alongside the material to provide further discussion of the topic at home is included as well. See [[Empower_&_Strengthen_Parents|Empower & Strengthen Parents]] for more strategies to include parents. See [[TR_-_Expand_School_Prevention_Programs|Tools & Resources for]] copies of toolkits.<br/> &nbsp;<br />
<br />
=== Not Prescribed ===<br />
<br />
[https://notprescribed.org/ Not Prescribed] is a&nbsp;classroom-based lesson empowering teens with the science and the stories to understand the risks of misusing prescription drugs and the skills to rise above. It is provided at not cost to non-profit organizations and schools.&nbsp; &nbsp;<br />
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&nbsp;<br />
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=== Everfi's Prescription Drug Safety Course ===<br />
<br />
[https://everfi.com/about/mission/ EVERFI] provides schools with a free, state-of-the-art on-line learning course on prescription drug safety&nbsp;&nbsp;[https://everfi.com/offerings/listing/prescription-drug-abuse-prevention/ https://everfi.com/offerings/listing/prescription-drug-abuse-prevention/]<br />
<br />
Due to support from a wide range of public and private supporters in the [https://everfi.com/networks/prescription-drug-safety-network/ Presecription Drug Safety Network], EVERFI has the resources and experience to delivier a high-quality E-learning course to schools at no charge.&nbsp; EVERFI has a long history of provideing training on topics like personal financial management, and they have leveraged that experience to create a 30 to 40-minute course that can be offered in schools or in out-of-school programs.&nbsp; &nbsp;This [https://everfi.com/wp-content/uploads/2018/08/Prescription-Drug-Safety_-17-18-Impact-Report.pdf report] shares some of the impact that this course is having.&nbsp;<br />
<br />
= Analysis of Research-Based Programs and Return on Investment =<br />
<br />
This report looks at thirteen Youth Marijuana Prevention programs and shares valuable insights on the Return on Investment of these programs. Use of marijuana is a risk factor for starting misuse of opioids, and there are underlying factors where prevention efforts impacts the use of many different types of drugs.<br />
<br />
Wsipp_Preventing Youth Substance Use: A Review of Thirteen Programs Benefit-Cost-Results &nbsp; [http://www.wsipp.wa.gov/ReportFile/1563/Wsipp_Preventing-Youth-Substance-Use-A-Review-of-Thirteen-Programs_Benefit-Cost-Results.pdf Preventing Youth Substance Use]<br/> Positive Prevention Plus: A comprehensive school-based sexual health education and teen pregnancy prevention curriculum ([http://www.positivepreventionplus.com/ Positive Prevention Plus]<br />
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&nbsp;<br />
<br />
= Examples of Promising, Evidence-based Programs =<br />
<br />
These are programs the you can consider...<br/> [https://preventionpluswellness.com SPORT Prevention Plus Wellness]: A single-session screening and brief intervention that integrates substance use prevention with the promoting of physical activity and healthy behaviors for youth.<br />
<br />
&nbsp;[http://www.positivepreventionplus.com/ Positive Prevention Plus]: A comprehensive school-based sexual health education and teen pregnancy prevention curriculum.<br />
<br />
&nbsp;[https://olweus.sites.clemson.edu/ Olweus Bullying Prevention Program]: Includes schoolwide, classroom, individual, and community strategies.<br/> &nbsp;<br />
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&nbsp;<br />
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= Media Literacy =<br />
<br />
Media literacy is a promising approach to school-based substance abuse intervention."<ref>[2] Media Literacy as an Approach to Substance Abuse Prevention. (n.d.). Retrieved December 3, 2019, from http://irtinc.us/Products/MediaDetective/SubstanceAbusePrevention/MediaLiteracysRoleinPrevention.aspx<br />
</ref>Beneficial outcomes include:<br />
<br />
&nbsp;<br />
<br />
*Increased media skepticism<sup class="reference"><ref>[3]Kupersmidt, J.B., Barrett, T.M., Elmore, K.C., & Benson, J.W. (2007). Preliminary Findings from the Evaluation of the Elementary Media Literacy, Substance Abuse Prevention Project. Paper presented at the first Research Summit of the Alliance for a Media Literate America, St. Louis, MO. Retrieved from http://irtinc.us/Products/MediaReady/SubstanceAbusePrevention/MediaLiteracysRoleinPrevention.aspx</ref></sup> <br />
*Increased perceived efficiency in resisting pro-drug media messages<sup class="reference"><ref>[4]Austin, E. W., Pinkleton, B. E., Hust, S. J. T., & Cohen, M. (2005). Evaluation of an American Legacy Foundation/Washington State Department of Health media literacy pilot study. Health Communication, 18(1), 75 Retrieved from http://irtinc.us/Products/MediaReady/SubstanceAbusePrevention/MediaLiteracysRoleinPrevention.aspx</ref></sup> <br />
*Greater ability to make counter-arguments to beer advertisements<sup class="reference"><ref>[5]Slater, M.D., Rouner, D., Murphy, K., Beauvais, F., Van Leuven, J., & Domenech-Rodriguez, M.M. (1996). Adolescent counterarguing of tv beer advertisements: Evidence for the effectiveness of alcohol education and critical viewing discussions. Journal of Drug Education, 26(2), 143-158. Retrieved from http://irtinc.us/Products/MediaReady/SubstanceAbusePrevention/MediaLiteracysRoleinPrevention.aspx</ref></sup> <br />
*Increased belief that smoking and drinking are "wrong"<sup class="reference"><ref>[6]Kupersmidt, J., Feagans, L., Eisen, M., & Hicks, R. (May 2005). The North Carolina Media Literacy Education Program: An evaluation. Poster presented at the annual meeting of the Society for Intervention Research, Washington, D.C. Retrieved from http://irtinc.us/Products/MediaReady/SubstanceAbusePrevention/MediaLiteracysRoleinPrevention.aspx</ref></sup> <br />
*Reduced middle school boys' intentions to use alcohol or tobacco in the future<sup class="reference"><ref>[7]Kupersmidt, J., Feagans, L., Eisen, M., & Hicks, R. (May 2005). The North Carolina Media Literacy Education Program: An evaluation. Poster presented at the annual meeting of the Society for Intervention Research, Washington, D.C. Retrieved from http://irtinc.us/Products/MediaReady/SubstanceAbusePrevention/MediaLiteracysRoleinPrevention.aspx </ref></sup> <br />
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<br/> &nbsp;<br />
<br />
= Healthy Youth Development Programs in Schools reduce Opioid Misuse =<br />
<br />
Article on Evidence-based practices: <ref>[3]]Kupersmidt, J.B., Barrett, T.M., Elmore, K.C., & Benson, J.W. (2007). Preliminary Findings from the Evaluation of the Elementary Media Literacy, Substance Abuse Prevention Project. Paper presented at the first Research Summit of the Alliance for a Media Literate America, St. Louis, MO. Retrieved from http://irtinc.us/Products/MediaReady/SubstanceAbusePrevention/MediaLiteracysRoleinPrevention.aspx</ref><br/> <br/> &nbsp;<br />
<br />
&nbsp;<br />
<br />
= Successful Examples =<br />
<br />
== Putnam Middle School Social Norms Campaign ==<br />
<br />
In partnership with [http://putnampride.org/ Putnam Pride], this campaign focused on the common misconceptions that students have about their peers' substance use. Most kids believe that a majority of students use substances when, in reality, only a very small percentage does. Changing social norms of a school by educating students on the reality of substance use would lead to a changed perspective of drug use as deviant rather than something that "everyone is doing."<br />
<br />
&nbsp; Although this program focused on alcohol use, the same idea could be used for prescription opioid drugs as an education tool for students.<br />
<br />
&nbsp;<br />
<br />
== SAFIR -- Substance Abuse Free Indian River ==<br />
<br />
This Drug Free Coalition in Vero Beach, Florida, has been implementing several promising programs in schools and working with community partners.<br/> &nbsp; “We are very proud of our initiatives: SAFIR Rx, Talk, They Hear You, No One’s House and Friday Night Done Right, but we are particularly excited about Know the Law, which is conducted by law enforcement officers (LEOs) in the classroom,” said Robin Dapp, Executive Director. “It helps bring students and officers together.”<ref>[8] Coalitions in Action: Partnering for Prevention with Local Law Enforcement | CADCA. (n.d.). Retrieved December 3, 2019, from https://www.cadca.org/resources/coalitions-action-partnering-prevention-local-law-enforcement<br />
</ref>At the beginning of each school year, school resource officers provide the Know the Law classes to incoming high school freshmen. The program is designed to make our local youth and young adults aware of the laws and the consequences of breaking the law. The training covers the common offenses committed by youth on a regular basis.<br />
<br />
&nbsp; SAFIR has supported the delivery of a very comprehensive prevention strategy for our middle school youth. All middle schools in the community receive Botvin’s LifeSkills Training program, beginning in 6th grade through 8th grade. The curriculum is delivered by the Substance Awareness Center, and consists of a total of 30 lessons.<br />
<br />
&nbsp; A significant environmental strategy that has been embraced by local law enforcement is Civil Citation. See details on<br/> &nbsp;<br />
<br />
&nbsp;<br />
<br />
== Boy Scouts & Girl Scouts ==<br />
<br />
Each of these groups can participate in the DEA Red Ribbon Patch Program. This program empowers young people to create, embrace and strengthen their drug free belief. See [[TR_-_Expand_School_Prevention_Programs|Tools & Resources details on participation]].<br />
<br />
&nbsp;<br />
<br />
= Tools & Resources =<br />
<br />
[[TR_-_Expand_School_Prevention_Programs|TR - Expand School Prevention Programs]]<br />
<br />
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= Sources =<br />
<br />
----<br />
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[[Category:SAFE-Full Spectrum Prevention]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Expand_School_Prevention_Programs&diff=20360Expand School Prevention Programs2021-02-05T21:45:46Z<p>Rwashington: Rwashington moved page Expand School Prevention Programs to Expand School-Based Prevention Programs</p>
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<div>#REDIRECT [[Expand School-Based Prevention Programs]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Improve_Detection_and_Treatment_of_Mental_Health_Conditions&diff=20350Improve Detection and Treatment of Mental Health Conditions2021-02-05T20:02:11Z<p>Rwashington: Rwashington moved page Improve Detection & Treatment of Mental Health Conditions to Improve Detection and Treatment of Mental Health Conditions</p>
<hr />
<div>Initial use of opioids by youth is often done as self-medication for dealing with trauma, depression or anxiety. (Research and sources needed).&nbsp; In one national survey of young adults aged 18-24, more than 61 percent of respondents who had used opioids not prescribed to them had done so primarily to relieve anxiety and stress<sup class="reference"><ref>[1]Hazelden Betty Ford Foundation(2015), Youth Opioid Study: Attitudes and Usage, Retrieved from http://marychristiefoundation.org/core/uploads/2015/04/Youth-Opioid-Survey-Report.pdf<br />
</ref></sup>. Therefore, a comprehensive strategy should include efforts to improve the detection and treatment of mental health conditions. <br />
= Background =<br />
<br />
== Mental Health and Drug addiction ==<br />
<br />
Mental health and drug addiction are undeniably linked. According to the National Institute on Drug Abuse “Many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders, and vice versa. Multiple national population surveys have found that about half of those who experience a mental illness during their lives will also experience a substance use disorder and vice versa.”&nbsp; <ref>https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness</ref>&nbsp;Studies have shown that around 1 in 4 individuals that have a serious mental illness also have a substance abuse disorder.&nbsp;<ref>https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness</ref>&nbsp;Many people attempt to use drugs to self medicate their mental illness or escape their situation. Understanding mental health is essential to any prevention or recovery effort.<br />
<br />
== Youth are Struggling with Mental Health Issues ==<br />
<br />
A nationwide U.S. survey of over 1300 14- to 22-year-olds done in February and March of 2018 shows evidence of a growing mental health crisis affecting young people. The survey, sponsored by Hopelab and Well Being Trust (WBT), finds that many teens and young adults are experiencing moderate to severe symptoms of depression are turning to the internet for help. Common uses of the Internet include researching mental health issues online (90 percent), accessing other people’s health stories through blogs, podcasts, and videos (75 percent), using mobile apps related to well-being (38 percent), and connecting with health providers through digital tools such as texting and video chat (32 percent).<ref> [2]Page Not Found </ref><br />
<br />
== Depression ==<br />
<br />
*Because depression is under-diagnosed and untreated, depression and opioid abuse are strongly concurrent.<sup class="reference"><ref>[3]Does Depression Contribute to Opioid Abuse? - The Atlantic. (n.d.). Retrieved December 3, 2019, from https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/<br />
</ref></sup> <br />
*People with depression show abnormalities in the body’s release of its own opioid chemicals<sup class="reference"><ref>[4]Does Depression Contribute to Opioid Abuse? - The Atlantic. (n.d.). Retrieved December 3, 2019, from https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/<br />
</ref></sup> <br />
*Depression tends to exacerbate pain—it makes chronic pain last longer and hurts the recovery process after surgery<sup class="reference"><ref>Sullivan, M. D. (2016). Why does depression promote long-term opioid use? PAIN, 157(11), 2395. https://doi.org/10.1097/j.pain.0000000000000658</ref></sup> <br />
*Depression nearly doubles the risk that someone already using opioids will continue to use them long-term<sup class="reference"><ref>[6]Does Depression Contribute to Opioid Abuse? - The Atlantic. (n.d.). Retrieved December 3, 2019, from https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/<br />
</ref></sup> <br />
<br />
== Depression & Opioids ==<br />
<br />
*Depressed people are about twice as likely as non-depressed people to misuse their painkillers for non-pain symptoms<sup class="reference"><ref>[7]Does Depression Contribute to Opioid Abuse? - The Atlantic. (n.d.). Retrieved December 3, 2019, from https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/<br />
</ref></sup> <br />
*Depressed individuals were between two and three times more likely to ramp up their own doses of painkillers<ref> [8]Does Depression Contribute to Opioid Abuse? - The Atlantic. (n.d.). Retrieved December 3, 2019, from https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/<br />
</ref> <br />
*Adolescents with depression are also more likely to use prescription painkillers for non-medical reasons and to become addicted<sup class="reference"><ref>[9]Does Depression Contribute to Opioid Abuse? - The Atlantic. (n.d.). Retrieved December 3, 2019, from https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/<br />
</ref></sup> <br />
*Depressed people are likely to keep using opioids, even when their pain has subsided and when they are more functional <sup class="reference"><ref>[10]Does Depression Contribute to Opioid Abuse? - The Atlantic. (n.d.). Retrieved December 3, 2019, from https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/<br />
</ref></sup> <br />
<br />
== Stigma & Depression ==<br />
<br />
Stigmatization of depression can reduce the likelihood of people reaching out to get the mental care they need. Instead, depressed people may ask for prescriptions for physical ailments, and use their prescription drugs to treat their emotional pain. <sup class="reference"><ref>[11]Does Depression Contribute to Opioid Abuse? - The Atlantic. (n.d.). Retrieved December 3, 2019, from https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/<br />
</ref></sup><br />
<br />
== Rural Areas ==<br />
<br />
In particular, shortages of mental-health providers are prominent in rural areas where the opioid epidemic hit the hardest. Some have suggested that providing mental health care to those suffering from chronic pain may help detangle the relationship between pain and depression.<sup class="reference"><ref>[12]Does Depression Contribute to Opioid Abuse? - The Atlantic. (n.d.). Retrieved December 3, 2019, from https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/<br />
</ref></sup><br/> &nbsp;<br />
<br />
== Co-Occurring Disorders ==<br />
<br />
Co-occurring disorders, or dual diagnosis, refers to having a simultaneous mental health disorder and substance use disorder. It is common for people with addictions to also suffer from depression, anxiety, or more severe mental illnesses such as schizophrenia or bipolar disorder. Research shows that people who use alcohol or other drugs early in life are more likely to have mental or emotional problems. It’s also true that many people with mental illnesses “self-medicate” with alcohol or other drugs to numb emotional pain, relieve anxiety, or quiet their thoughts. In the past, the medical profession treated one disorder first, typically the substance use disorder, before addressing the other. It is now understood that treating both simultaneously leads to better outcomes. Any successful addiction treatment program will include a mental health assessment and treat co-occurring disorders at the same time.<br />
<br />
= Tools and Resources =<br />
<br />
== [https://www.nimh.nih.gov/health/find-help/index.shtml The National Institute of Mental Health] ==<br />
<br />
Provides resources on how to find immediate help, health care providers, how to decide if a provider is right for you, how to join a study, and resources to learn more about mental disorders.<br />
<br />
== [https://www.aacap.org/AACAP/Families_and_Youth/Resources/CAP_Finder.aspx The American Academy of Child and Adolescent Psychiatry] ==<br />
<br />
Provides a service that helps find child and adolescent psychiatrist throughout America.<br />
<br />
== SAMHSA Resources for Suicide and Substance Use Prevention in Youth ==<br />
<br />
2017 SAMHSA Webinar on [https://www.youtube.com/watch?v=AIQWbywRzWY Suicide and Substance Abuse among Young People] and includes best practices for prevention and intervention.<br />
<br />
SAMHSA has a [https://www.samhsa.gov/sites/default/files/programs_campaigns/nation_prevention_week/npw-2018-organizations-places-assistance.pdf new list of organizations and resources] updated May 2018 with many different types of resources and organizations.&nbsp;<br />
<br />
&nbsp;<br />
<br />
[[TR_-_Improve_Detection_&_Treatment_of_Mental_Health_Conditions|TR - Improve Detection & Treatment of Mental Health Conditions]]<br />
<br />
&nbsp;<br />
<br />
= Promising Programs =<br />
<br />
There are a growing number of promising programs for helping to identify and address mental health issues.<br />
<br />
== Virtual Reality Therapy ==<br />
<br />
[http://ict.usc.edu/profile/albert-skip-rizzo/ Dr. Skip Rizzo] has been working since the 1990s to use virtual reality to treat mental illness. <ref>[13] Crain.com. (n.d.). Retrieved December 3, 2019, from Crain website: https://www.crain.com/<br />
</ref>In an "early clinical trial of the software found that "after an average of seven sessions, 45 percent of those treated no longer screened positive for PTSD and 62 percent had reliably improved."<sup class="reference"><ref>[14]Crain.com. (n.d.). Retrieved December 3, 2019, from Crain website: https://www.crain.com/</ref></sup><br/> <br/> The [http://www.vrphobia.com/index.htm Virtual Reality Medical Center] uses simulation technologies for:<br />
<br />
#Treating patients with anxiety disorders <br />
#Training for both military and civilian populations <br />
#Enhancing various educational programs <br />
<br />
== Benefits of VR Therapy ==<br />
<br />
*Faster than traditional therapy and desensitization<sup class="reference"><ref>[15]About Us. (n.d.). Retrieved December 3, 2019, from Virtual Reality Medical Center website: https://vrphobia.com/about-us-old/<br />
</ref></sup> <br />
*Practice these skills in situations in which you previously experienced anxiety, allowing the skills to generalize more easily to real world settings<sup class="reference"><ref>[16]About Us. (n.d.). Retrieved December 3, 2019, from Virtual Reality Medical Center website: https://vrphobia.com/about-us-old/<br />
</ref></sup> <br />
*Can do some sessions in between office session at home, cuts down on the number of sessions people need<sup class="reference"><ref>[17]Crain.com. (n.d.). Retrieved December 3, 2019, from Crain website: https://www.crain.com/</ref></sup> <br />
<br />
&nbsp;<br />
<br />
== M3 Checklist (Screening Tool) ==<br />
<br />
[https://www.m3information.com/about-us/ M3 Information] developed a mental health screen that measures outcomes based on a 27-question diagnostic checklist and a related algorithm targeted for adults aged 18 and older. The M3 Checklist accurately measures outcomes based on question responses for major depression, bipolar disorder, anxiety disorder and posttraumatic stress disorder (PTSD).<br/> &nbsp;<br />
<br />
== Project Aware ==<br />
<br />
[https://www.samhsa.gov/nitt-ta/distance-learning-videos/project-aware Project AWARE] is a SAMHSA program that focuses on student mental health and wellness, While not specifically focused on opioid abuse prevention, much of the work that grantees are doing may also help prevent opioid misuse. Through Project AWARE, schools are implementing evidence-based, culturally appropriate prevention programs that support youth at the universal, selective, and indicated levels.<br/> &nbsp;<br />
<br />
== Communities that Care ==<br />
<br />
Programs such as [https://www.communitiesthatcare.net/ Communities That Care] promote a range of youth mental and behavioral health outcomes, included reduced risk for opioid misuse and addiction. (Find Source)<br />
<br />
&nbsp;<br />
<br />
== myStrength ==<br />
<br />
[http://www.mystrength.com myStrength] is a digital platform that integrates state-of-the-art technologies to support people in addressing mental and behavioral health issues. It can be integrated with a professional practice to allow them to see more patients more efficiently and better meet the needs of their patients between in-person visits. Learn more at this [https://www.mystrength.com/news/events/webinar-drive-utilization-revenue-and-outcomes-via-an-integrated-in-person-and-digital-therapeutic-model recorded Webinar].<br/> <br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span><br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span><br />
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<div>#REDIRECT [[Improve Detection and Treatment of Mental Health Conditions]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Improve_Access_to_Recovery_Coaches_for_Mothers&diff=20343Improve Access to Recovery Coaches for Mothers2021-01-19T18:34:29Z<p>Rwashington: Rwashington moved page Improve Access to Recovery Coaches for Mothers of Babies to Improve Access to Recovery Coaches for Mothers</p>
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=Improve Access to Recovery Coaches for Mothers of Babies=<br />
Return to [[Opioid Top-Level Strategy Map]]<br /> <br /> <div id="toc"><br />
=Table of Contents=<br />
<div style="margin-left: 1em">[[#Tools & Resources|Tools & Resources]]</div><div style="margin-left: 1em">[[#Scorecard Building|Scorecard Building]]</div><div style="margin-left: 1em">[[#Resources to Investigate|Resources to Investigate]]</div><div style="margin-left: 1em">[[#Sources|Sources]]</div></div>(Replace this text with the information you will place here.)<br /> <br /> <br /> <br /> <br /> <br /> <br />
=Tools & Resources=<br />
TR - ___<br /> <br />
=Scorecard Building=<br />
Potential Objective Details<br /> Potential Measures and Data Sources<br /> Potential Actions and Partners<br /> <br />
=Resources to Investigate=<br />
More RTI on __<br /> <br /> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span><br /> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span><br /> <br />
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</div></div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Improve_Access_to_Recovery_Coaches_for_Mothers_of_Babies&diff=20344Improve Access to Recovery Coaches for Mothers of Babies2021-01-19T18:34:29Z<p>Rwashington: Rwashington moved page Improve Access to Recovery Coaches for Mothers of Babies to Improve Access to Recovery Coaches for Mothers</p>
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<div>#REDIRECT [[Improve Access to Recovery Coaches for Mothers]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Expand_Perinatal_Treatment_and_Support_for_Women_with_SUDs&diff=20341Expand Perinatal Treatment and Support for Women with SUDs2021-01-19T18:27:02Z<p>Rwashington: Rwashington moved page Expand Perinatal Treatment for Women with SUDs to Expand Perinatal Treatment and Support for Women with SUDs</p>
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<div><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">__NOTOC__ <div class="mw-parser-output"><div class="mw-parser-output">Return to&nbsp; [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]&nbsp;or&nbsp;[[ZOOM_MAP_-_Expand_Steps_to_Minimize_Opioid_Use_During_Pregnancy_or_Pregnancy_during_Opioid_Use|ZOOM MAP - Expand Steps to Minimize Opioid Use During Pregnancy or Pregnancy during Opioid Use]] <div class="mw-parser-output"><div class="wiki" id="content_view" style="display: block">__TOC__ <br />
= Background =<br />
<br />
<span style="display: inline !important; float: none; background-color: rgb(255, 255, 255); color: rgb(34, 34, 34); font-family: sans-serif; font-size: 13.93px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;">Most doctors recommend that pregnant women undergo a long-term treatment plan called drug-assisted stabilization using methadone, also known as harm reduction therapy. This treatment remains sustainable for a woman after she has given birth, because it's covered under Medicaid, so new mothers can still access the treatment, even after their six-week Medicaid-provided postnatal care is done. The treatment also doesn't subject a woman's mind and body through the stress of full withdrawal, allowing her to focus on caring for herself and her baby</span><br />
<br />
= Promising Programs =<br />
<br />
== Perinatal Addiction Treatment Program ==<br />
<br />
<br/> '''[https://geiselmed.dartmouth.edu/psych/care/dhmc_services/perinatal/ Perinatal Addiction Treatment Program] - Dartmouth Hitchcock Medical Center'''<br/> ''Program Highlights''<br />
<br />
*Integrated Care Model: Includes maternity care, substance use treatment, behavioral health/psychiatry, pediatrics <br />
*Participant Drive Design <br />
*Private setting 10 minutes from hospital campus <br />
*Tablet-based [http://www.integration.samhsa.gov/clinical-practice/SBIRT SBIRT] screening <br />
*18 week parenting class <br />
<br />
''Outcome Successes''<br />
<br />
*Perinatal: Average gestational age is over 38 weeks; Average birthweight in the normal range <br />
*Decreased NAS treatment rate <br />
*Decreased neonatal LOS <br />
*Effective use of technology for screening <br />
*2/3 of participants remain in treatment postpartum <br />
<br />
&nbsp;<br />
<br />
== Centering Pregnancy ==<br />
<div class="_">While not specifically focusing on issues of addiction or substance misuse among pregnant women, the [https://www.centeringhealthcare.org/what-we-do/centering-pregnancy CenteringPregnancy] approach has the potential to cost-effectively improve prenatal and perinatal care among women who may be using or be addicted to opioids or other substances. It is a group approach to prenatal and perinatal care.&nbsp;</div> <div class="_">&nbsp;</div> <br />
= Tools & Resources =<br />
<br />
[[TR_-_Expand_Perinatal_Treatment_for_Women_with_SUDs|TR - Expand Perinatal Treatment for Women with SUDs]]<br />
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Return to [[Reduce_Stigma_for_Pregnant_Women_with_Opioid_Addictions|Reduce Stigma for Pregnant Women with Opioid Addictions]]<br />
<br />
= <span style="background-color: #ffffff">Potential Actions</span> =<br />
</div> </div></div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=PA_-_Reduce_Stigma_for_Pregnant_Women_with_Opioid_Addictions&diff=20339PA - Reduce Stigma for Pregnant Women with Opioid Addictions2021-01-04T19:58:50Z<p>Rwashington: Rwashington moved page PA - Reduce Stigma for Pregnant Women with Opioid Addictions to PA - Reduce Stigma for Pregnant Women with SUDs</p>
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<div>#REDIRECT [[PA - Reduce Stigma for Pregnant Women with SUDs]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Improve_Identification_of_Pregnant_Women_At_Risk&diff=20336Improve Identification of Pregnant Women At Risk2021-01-04T19:57:22Z<p>Rwashington: Rwashington moved page Improve Identification of a Women At Risk of having NAS Baby to Improve Identification of Pregnant Women At Risk</p>
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<div><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><br />
Return to &nbsp;[[ZOOM_MAP_-_Expand_Steps_to_Minimize_Opioid_Use_During_Pregnancy_or_Pregnancy_during_Opioid_Use|ZOOM MAP - Expand Steps to Minimize Opioid Use During Pregnancy or Pregnancy during Opioid Use]]<br />
<br />
&nbsp;&nbsp;<br />
<br />
= Tools & Resources =<br />
<br />
[[TR-Creating_Improve_Identification_of_a_Women_At_Risk_of_having_NAS_Baby|TR-Creating Improve Identification of a Women At Risk of having NAS Baby]]<br />
<br />
= Scorecard Building =<br />
<br />
[[PO_-_Improve_Identification_of_a_Women_At_Risk_of_having_NAS_Baby|Potential Objective Details]]<br/> [[PM_-_Improve_Identification_of_a_Women_At_Risk_of_having_NAS_Baby|Potential Measures and Data Sources]]<br/> [[PA_-_Improve_Identification_of_a_Women_At_Risk_of_having_NAS_Baby|Potential Actions and Partners]]<br />
<br />
= Resources to Investigate =<br />
<br />
[[RTI_-_Improve_Identification_of_a_Women_At_Risk_of_having_NAS_Baby|More RTI on Improve Identification of a Women At Risk of having NAS Baby]]<br/> <br/> '''PAGE MANAGER:''' [insert name here]<br/> '''SUBJECT MATTER EXPERT''': [fill out table below]<br />
<br />
{|<br />
|-<br />
| '''Reviewer'''<br />
| '''Date'''<br />
| '''Comments'''<br />
|-<br />
| &nbsp;<br />
| &nbsp;<br />
| &nbsp;<br />
|}<br />
<br />
= Sources =<br />
</div> </div> </div> <br />
[[Category:SAFE-Treatment and Recovery]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Improve_Identification_of_a_Women_At_Risk_of_having_NAS_Baby&diff=20337Improve Identification of a Women At Risk of having NAS Baby2021-01-04T19:57:22Z<p>Rwashington: Rwashington moved page Improve Identification of a Women At Risk of having NAS Baby to Improve Identification of Pregnant Women At Risk</p>
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<div>#REDIRECT [[Improve Identification of Pregnant Women At Risk]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Expand_Steps_to_Minimize_Substance_Use_During_Pregnancy_or_Pregnancy_During_Substance_Use&diff=20334Expand Steps to Minimize Substance Use During Pregnancy or Pregnancy During Substance Use2021-01-04T19:50:42Z<p>Rwashington: Rwashington moved page Expand Steps to Minimize Substance Use During Pregnancy or Pregnancy During Opioid Use to Expand Steps to Minimize Substance Use During Pregnancy or Pregnancy During Substance Use</p>
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<div><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">__NOTOC__ <div class="mw-parser-output"><div class="wiki" id="content_view" style="display: block"><br />
Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map&nbsp;or]] [[ZOOM_MAP_-_Expand_Steps_to_Minimize_Opioid_Use_During_Pregnancy_or_Pregnancy_during_Opioid_Use|Zoom Map (Expand Steps to Minimize Opioid Use During Pregnancy or Pregnancy During Opioid Use)]]&nbsp;or [[ZOOM_MAP_-_Improve_Treatment_&_Enable_Recovery_for_People_with_SUDs|Zoom Map (Improve Treatment & Enable Recovery for People with SUDs)]]&nbsp;View [[Minimize_Babies_born_with_Opioid_Dependence|Minimize Babies Born with Opioid Addictions]] &nbsp;or&nbsp;[[ZOOM_MAP_-_Expand_Harm_Reduction_Practices_Associated_with_Opioid_Misuse|ZOOM MAP - Expand Harm Reduction Practices Associated with Opioid Misuse]]__TOC__<br />
<br />
= <span style="color: #ed3900">PRENATAL STRATEGIES</span> =<br />
<br />
= Draft Driver Diagram =<br />
<div class="_">The Public Health Foundation worked with the Department of Public Health at the University of Tennessee Knoxville to create a Driver Diagram for improving perinatal care and reducing Neonatal Abstinence Syndrome (NAS). This format is different from a strategy map, but has useful ideas that could be integrated into this strategy map template.<br/> [http://www.phf.org/resourcestools/Documents/TN%20NAS%20driver%20diagram%20Revised%2012-15-15.pdf [1]]</div> <div class="_">&nbsp;</div> <br />
= Increase Access to Contraception =<br />
<br />
The National Preconception Health and Health Care Initiative provides educational resources to clinicians and their patients, and coordinates outreach and social media campaigns related to improving preconception health, including reducing substance use and treating substance use disorders before pregnancy.<br/> &nbsp;<br />
<br />
= Help Women Overcome Obstacles to Treatment, Family Planning and Prenatal Care =<br />
<div class="_">Women who are misusing opioids or who have OUD may have many obstacles to getting treatment, family planning or prenatal care. A strategy to minimize unintentional pregnancies for these women should include plans to help them overcome obstacles to receiving these services. The obstacles include:</div> <br />
*Transportation <br />
*Childcare <br />
*Employment conflicts <br />
*Unsupportive Living Environments <br />
*Unstable Living Environments <br />
*Homelessness <br />
*Partner with a Substance Use Disorder <br />
*Stigma and/or Guilt <br />
*Fear of losing the child <br />
*Fear of incarceration <br />
*Fear of being discovered about misusing substances (by family, employer, etc.) <br />
<br />
&nbsp;<br />
<br />
= Tools + Resources =<br />
<br />
[[TR_-_Expand_Steps_to_Minimize_Opioid_Use_During_Pregnancy|TR - Expand Steps to Minimize Opioid Use During Pregnancy]]<br />
<br />
<br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span><br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span><br />
<br />
{| class="wiki_table"<br />
|-<br />
| '''Reviewer'''<br />
| '''Date'''<br />
| '''Comments'''<br />
|-<br />
| &nbsp;<br />
| &nbsp;<br />
| &nbsp;<br />
|}<br />
<br />
= Sources =<br />
</div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <br />
[[Category:SAFE-Treatment and Recovery]] [[Category:SAFE-Prescriptions and Medical Response]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Expand_Steps_to_Minimize_Substance_Use_During_Pregnancy_or_Pregnancy_During_Opioid_Use&diff=20335Expand Steps to Minimize Substance Use During Pregnancy or Pregnancy During Opioid Use2021-01-04T19:50:42Z<p>Rwashington: Rwashington moved page Expand Steps to Minimize Substance Use During Pregnancy or Pregnancy During Opioid Use to Expand Steps to Minimize Substance Use During Pregnancy or Pregnancy During Substance Use</p>
<hr />
<div>#REDIRECT [[Expand Steps to Minimize Substance Use During Pregnancy or Pregnancy During Substance Use]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Expand_Steps_to_Minimize_Substance_Use_During_Pregnancy_or_Pregnancy_During_Substance_Use&diff=20332Expand Steps to Minimize Substance Use During Pregnancy or Pregnancy During Substance Use2021-01-04T19:45:18Z<p>Rwashington: Rwashington moved page Expand Steps to Minimize Opioid Use During Pregnancy or Pregnancy During Opioid Use to Expand Steps to Minimize Substance Use During Pregnancy or Pregnancy During Opioid Use</p>
<hr />
<div><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">__NOTOC__ <div class="mw-parser-output"><div class="wiki" id="content_view" style="display: block"><br />
Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map&nbsp;or]] [[ZOOM_MAP_-_Expand_Steps_to_Minimize_Opioid_Use_During_Pregnancy_or_Pregnancy_during_Opioid_Use|Zoom Map (Expand Steps to Minimize Opioid Use During Pregnancy or Pregnancy During Opioid Use)]]&nbsp;or [[ZOOM_MAP_-_Improve_Treatment_&_Enable_Recovery_for_People_with_SUDs|Zoom Map (Improve Treatment & Enable Recovery for People with SUDs)]]&nbsp;View [[Minimize_Babies_born_with_Opioid_Dependence|Minimize Babies Born with Opioid Addictions]] &nbsp;or&nbsp;[[ZOOM_MAP_-_Expand_Harm_Reduction_Practices_Associated_with_Opioid_Misuse|ZOOM MAP - Expand Harm Reduction Practices Associated with Opioid Misuse]]__TOC__<br />
<br />
= <span style="color: #ed3900">PRENATAL STRATEGIES</span> =<br />
<br />
= Draft Driver Diagram =<br />
<div class="_">The Public Health Foundation worked with the Department of Public Health at the University of Tennessee Knoxville to create a Driver Diagram for improving perinatal care and reducing Neonatal Abstinence Syndrome (NAS). This format is different from a strategy map, but has useful ideas that could be integrated into this strategy map template.<br/> [http://www.phf.org/resourcestools/Documents/TN%20NAS%20driver%20diagram%20Revised%2012-15-15.pdf [1]]</div> <div class="_">&nbsp;</div> <br />
= Increase Access to Contraception =<br />
<br />
The National Preconception Health and Health Care Initiative provides educational resources to clinicians and their patients, and coordinates outreach and social media campaigns related to improving preconception health, including reducing substance use and treating substance use disorders before pregnancy.<br/> &nbsp;<br />
<br />
= Help Women Overcome Obstacles to Treatment, Family Planning and Prenatal Care =<br />
<div class="_">Women who are misusing opioids or who have OUD may have many obstacles to getting treatment, family planning or prenatal care. A strategy to minimize unintentional pregnancies for these women should include plans to help them overcome obstacles to receiving these services. The obstacles include:</div> <br />
*Transportation <br />
*Childcare <br />
*Employment conflicts <br />
*Unsupportive Living Environments <br />
*Unstable Living Environments <br />
*Homelessness <br />
*Partner with a Substance Use Disorder <br />
*Stigma and/or Guilt <br />
*Fear of losing the child <br />
*Fear of incarceration <br />
*Fear of being discovered about misusing substances (by family, employer, etc.) <br />
<br />
&nbsp;<br />
<br />
= Tools + Resources =<br />
<br />
[[TR_-_Expand_Steps_to_Minimize_Opioid_Use_During_Pregnancy|TR - Expand Steps to Minimize Opioid Use During Pregnancy]]<br />
<br />
<br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span><br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span><br />
<br />
{| class="wiki_table"<br />
|-<br />
| '''Reviewer'''<br />
| '''Date'''<br />
| '''Comments'''<br />
|-<br />
| &nbsp;<br />
| &nbsp;<br />
| &nbsp;<br />
|}<br />
<br />
= Sources =<br />
</div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <br />
[[Category:SAFE-Treatment and Recovery]] [[Category:SAFE-Prescriptions and Medical Response]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Expand_Steps_to_Minimize_Opioid_Use_During_Pregnancy_or_Pregnancy_During_Opioid_Use&diff=20333Expand Steps to Minimize Opioid Use During Pregnancy or Pregnancy During Opioid Use2021-01-04T19:45:18Z<p>Rwashington: Rwashington moved page Expand Steps to Minimize Opioid Use During Pregnancy or Pregnancy During Opioid Use to Expand Steps to Minimize Substance Use During Pregnancy or Pregnancy During Opioid Use</p>
<hr />
<div>#REDIRECT [[Expand Steps to Minimize Substance Use During Pregnancy or Pregnancy During Opioid Use]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Improve_Screening_for_Infectious_Disease_among_Those_with_SUDs&diff=20330Improve Screening for Infectious Disease among Those with SUDs2021-01-04T19:43:53Z<p>Rwashington: Rwashington moved page Improve Screening for Infectious Disease among Opioid Users to Improve Screening for Infectious Disease among Those with SUDs</p>
<hr />
<div><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">__NOTOC__Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Expand_Harm_Reduction_Practices_Associated_with_Opioid_Misuse|Zoom Map (Expand Harm Reduction Practices Associated with Opioid Misuse)]] <div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="wiki" id="content_view" style="display: block">__TOC__ <br />
= Current Status =<br />
<br />
*Hep C virus (HCV) infections tripled between 2010 and 2015 <br />
*Substance abuse and infectious diseases shared common populations, risk factors, social determinants, and even contracting venues<sup class="reference">[1]</sup> <br />
*There was little collaboration between programs that provided services to these populations<sup class="reference">[2]</sup> <br />
*Methadone clinics would be optimal venues for service integration because these clinics serve a population that is 60% injection drug users; have medical staff performing brief health assessments for all new clients; and already have some infectious disease screenings in place, including routine tuberculosis testing and intermittent opt-in HIV testing<sup class="reference">[3]</sup> <br />
*One study showed that 68% of opioid treatment programs nationwide had staff capacity for HCV testing, but only 33% actually offered on-site HCV testing<sup class="reference">[4]</sup> <br />
*<span style="background-color: #ffffff; color: #333333; font-family: roboto,'helvetica neue',helvetica,arial,sans-serif; font-size: 16px">Awareness of HCV infection among this particular population may motivate them to reduce their consumption and hopefully high-risk behavior</span> <br />
<br />
= Promising Programs =<br />
<br />
== Texas Department of State Health Services ==<br />
<br />
[https://www.cdc.gov/nchhstp/programintegration/successstories-tx/inf-disease-screening.html [1]]<br/> &nbsp;<br />
<br />
== Philly Website ==<br />
<br />
[http://www.phillyhepatitis.org/support-care/ phillyhepatits.org] is an example of a resource for people seeking to identify if they have hepatitis, next steps they can take, and where they can find care or assistance.<br/> &nbsp;<br />
<br />
== TLC Awareness Campaign ==<br />
<br />
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342624/ "Test, Listen, Cure" (TLC) Hepatitis C Community Awareness Campaign] provides information about how HCV infection is transmitted, risk factors for the disease, the importance of screening and treatment, and the availability of improved treatment for the disease.<br />
<br />
= Tools & Resources =<br />
<br />
[[TR_-_Improve_Screening_for_Infectious_Disease_among_Opioid_Users|TR - Improve Screening for Infectious Disease among Opioid Users]]<br />
<br />
= <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span> =<br />
<br />
<span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span><br />
<br />
{| class="wiki_table"<br />
|-<br />
| '''Reviewer'''<br />
| '''Date'''<br />
| '''Comments'''<br />
|-<br />
| &nbsp;<br />
| &nbsp;<br />
| &nbsp;<br />
|}<br />
<br />
= Sources =<br />
<br />
----<br />
<br />
#[https://www.cdc.gov/nchhstp/programintegration/successstories-tx/inf-disease-screening.html [2]] <br />
#[https://www.cdc.gov/nchhstp/programintegration/successstories-tx/inf-disease-screening.html [3]] <br />
#[https://www.cdc.gov/nchhstp/programintegration/successstories-tx/inf-disease-screening.html [4]] <br />
##<br />
##*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670662/ [5]] <br />
</div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <br />
[[Category:SAFE-Prescriptions and Medical Response]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Improve_Screening_for_Infectious_Disease_among_Opioid_Users&diff=20331Improve Screening for Infectious Disease among Opioid Users2021-01-04T19:43:53Z<p>Rwashington: Rwashington moved page Improve Screening for Infectious Disease among Opioid Users to Improve Screening for Infectious Disease among Those with SUDs</p>
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<div>#REDIRECT [[Improve Screening for Infectious Disease among Those with SUDs]]</div>Rwashingtonhttp://ifi-wikis.com/IFI-OpioidCrisis/index.php?title=Adopt_Harm_Reduction_Practices_in_Jails_and_Prisons&diff=20328Adopt Harm Reduction Practices in Jails and Prisons2021-01-04T19:42:07Z<p>Rwashington: Rwashington moved page Adopt Harm Reduction Practices in Prisons to Adopt Harm Reduction Practices in Jails and Prisons</p>
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<div><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="wiki" id="content_view" style="display: block"><br />
Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Mapor]] [[ZOOM_MAP_-_Expand_Harm_Reduction_Practices_Associated_with_Opioid_Misuse|Zoom Map (Expand Harm Reduction Practices Associated with Opioid Misuse)]]<br />
<br />
= Background =<br />
<br />
== Hepatitis C ==<br />
<br />
Hepatitis C is more than three times more prevalent among people who inject drugs than HIV. In most countries, more than half the people who inject drugs live with Hepatitis C. The level of Hepatitis C infection amongst US prisoners is substantially higher than the general population: between 12 and 35 percent of prison inmates are infected with hepatitis C, compared to between 1 and 2 percent of the general population.<sup>[1]</sup> Global HIV prevalence is up to 50 times higher among the prison population than in the general public, while one in four detainees worldwide is living with Hepatitis C."<sup class="reference">[2]</sup><br />
<br />
== Preventing the Spread of Hepatitis C by Treating Infected Prisoners ==<br />
<br />
WHO, the United Nations Office on Drugs and Crime and UNAIDS recommended in 2007 that "prison authorities in countries experiencing or threatened by an epidemic of HIV infections among people who inject drugs should introduce and scale up Needle and Syringe Programs (NSPs) urgently."<sup class="reference">[3]</sup><br />
<br />
An analysis of studies of European Prison NSPs "Ten Year of Experience with Needle and Syringe Exchange Programs in European Prisons" concluded that prison NSPs are not only feasible but effective, especially when embedded within a comprehensive prison-based harm reduction and health-promotion strategy."<sup class="reference">[4]</sup><br />
<br />
There is increasing evidence that experience of imprisonment is a strong predictor of HIV and Hep C transmission for the individual prisoners. Nor is this an issue confined to prison. A majority of prisoners serve short-term sentences, during which they are unable to access long term drug treatment, and return to the wider community having been at significantly higher risk of Blood Borne Virus transmission and subsequently more likely to pass on Blood Borne Viruses. For this reason prisons have been called HIV and Hep C incubators.<sup class="reference">[5]</sup><br />
<br />
== Syringe Economy ==<br />
<br />
Syringes in prisons without Needle Syringe programs are sold on illicit markets and very expensive, given high demand and scarcity. In prisons where NSPs operate however, there has not been any illicit market reported where needles and syringes are accessible.<sup class="reference">[6]</sup><br />
<br />
= Prison Needle Syringe Program Studies =<br />
<br />
These findings come from a Harm Reduction International study on HIV, Hep C, TB and Harm Reduction in Prisons<sup class="reference">[7]</sup> . This 2016 study found that:<br />
<br />
*Prison NSPs are feasible and affordable across a wide range of prison settings <br />
*Prison NSP are effective in decreasing syringe sharing among people who inject drugs in prison, thereby decreasing the risk of blood borne virus transmission between prisoners and from prisoners to prison staff <br />
*Prison NSP are not associated with increased attacks on prison staff or other prisoners <br />
*Prison NSP do not lead to increased initiation of drug consumption or injection <br />
*Prison NSP contribute to workplace safety <br />
*Prison NSP can reduce the incidence of acscesses <br />
*Prison NSP facilitate referral to available drug-dependence treatment programs <br />
*Prison NSP can be delivered successfully via a range of methods in response to staff and inmate needs <br />
*Prison NSP are effective in a wide range of prison systems <br />
*Prison NSP can successfully coexist with other drug prevention and drug dependence treatment programs <br />
<br />
<br/> Important factors in the success of prison NSPs include:<br />
<br />
*Easy and confidential access to the service <br />
*Providing the right type of syringes <br />
*Building trust with the prisoners accessing the program <br />
<br />
<br/> Germany, Switzerland, and Spain had 19 programs in total by 2000. Evaluations of these pilot programs have shown that the aims of the programs have been achieved. These include:<br />
<br />
*Reduction in syringe sharing <br />
*Subsequent reduction in Blood borne Virus rates <br />
*No increase in drug use <br />
*No syringes used as weapons <br />
<br />
= Models of Prison NSPs =<br />
<br />
There are four main models of prison needle exchange programs<br />
<br />
#'''Hand-to-hand distribution by prison health staff, social workers, physicians, or nurses'''. This method is used in several Spanish and Swiss prisons. The used syringes are either exchanged at the cell door or in the medical unit. <br />
#'''Hand-to-hand distribution by trained peers''' (i.e., prisoners) to ensure confidential contact with prisoners who use drugs as well as access at almost all times. This system is mostly used in Moldovan prisons. <br />
#'''Hand-to-hand distribution by external personnel or NGOs''' who also provide other harm reduction services. <br />
#'''Automated dispensing machines''' e.g., Germany and Hindelbank women's prison, Switzerland (one-for-one exchange, starting with a dummy syringe as the first device). <br />
<br />
= Tools & Resources =<br />
<br />
[[TR_-_Adopt_Harm_Reduction_Practices_in_Prisons|TR - Adopt Harm Reduction Practices in Prisons]]<br />
<br />
<span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span><br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span><br />
<br />
{| class="wiki_table"<br />
|-<br />
| '''Reviewer'''<br />
| '''Date'''<br />
| '''Comments'''<br />
|-<br />
| &nbsp;<br />
| &nbsp;<br />
| &nbsp;<br />
|}<br />
<br />
= Sources =<br />
<br />
----<br />
<br />
#[https://www.globalcommissionondrugs.org/hepatitis/gcdp_hepatitis_english.pdf [1]] <br />
#[https://www.hri.global/files/2016/02/10/HRI_PrisonProjectReport_FINAL.pdf [2]] <br />
#[http://www.aivl.org.au/wp-content/uploads/NSP-in-Prisons-An-International-Review.pdf [3]] <br />
#[http://www.aivl.org.au/wp-content/uploads/NSP-in-Prisons-An-International-Review.pdf [4]] <br />
#[https://www.hri.global/files/2016/02/10/HRI_PrisonProjectReport_FINAL.pdf [5]] <br />
#[https://www.hri.global/files/2016/02/10/HRI_PrisonProjectReport_FINAL.pdf [6]] <br />
#[https://www.hri.global/files/2016/02/10/HRI_PrisonProjectReport_FINAL.pdf [7]] <br />
</div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <br />
[[Category:SAFE-Law Enforcement and Criminal Justice]]</div>Rwashington