Presentation on theme: "Reed Hruby Heroin Prevention Project"— Presentation transcript:
1Reed Hruby Heroin Prevention Project My intro and background, transition to center….next slide
2Robert crown center history 1958- Opened our doors as HinsdaleHealth MuseumCurrently have offices in Hinsdale, North Lawndale, AuroraServe more than 80,000 students annuallyMission: Keep kids happy, healthy, safeMajor topic areas: puberty and sex education, drug use prevention, obesity preventionNew audiences
3Today’s objectivesIncrease knowledge of heroin use trends in the Chicago suburbsShare key findings from Robert Crown sponsored primary research conducted by Illinois Consortium on Drug PolicyProvide suggestions for actions to reverse trend
4Reed Hruby Heroin Prevention Project Background of our drug program renovationsHruby proposalPartnership with Reed Hruby Memorial Foundation, Robert Crown Center, IL Consortium on Drug PolicyTimelineAccomplishments so farResearch included literature review, interviews, focus groups, life-mapping
5National indicators of Growing Heroin Use Initiations to heroin have increased 80% since 2002, from around 100,000 in 2002 to over 180,000 in 2009.34,000 youths initiate to heroin in a given year (ages 12-17).On any given day 3,753 youth (12 to 17year olds) use heroin.
6Treatment and hospital discharges demonstrate growth among young users Across the United States, treatment admissions for heroin from to 2006 increased 56 percent among teens and 58 percent among young adults.The majority of youth aged 12 to 17 entering public treatment for heroin across the nation was White (76%), followed by Latinos (16 %), and African Americans (2%).In Illinois, nearly 70% of youth under age 18 admitted to public treatment were White and 85% of those aged 15 to 19 discharged from the hospital were White.Lots of words…but, suburban, caucasian problem
7Where does it come from?Majority comes from Mexico (high purity, low price)Teens purchase it in open-air markets on Chicago’s West Side (Austin blvd. off the Eisenhower)Cheap, 10 dollars per bagHighly pure…kids don’t have to inject it to get high
8Suburban heroin not confined to Chicago area Atlanta, St. Louis, Cincinnati, New York City, Kansas City, Wichita, Boston, Philadelphia, Milwaukee, Denver, Los Angeles, Salt Lake City, Charlotte, Baltimore, Seattle, San Jose, Detroit, and Chicago have all reported increasing and alarming use among younger people in the suburbs.
9What is heroin?Heroin is in a class of drugs known as depressants. Alcohol and Xanax are examples of other types of depressants.Depressants are drugs that temporarily slow down your central nervous system.Heroin is an opioid. All opioids are depressants. Other opioids include things like prescription pain medications (Vicodin or OxyContin).
11Understanding heroin use, addiction, and dependency Only nicotine ranks higher in dependency profile.Of those who are offered heroin, about 20% will try itOf those who try it, 25% will proceed to dependency.Physical dependency, withdrawal symptoms develop rapidlyTolerance develops rapidly (leading to increased use)Causes more harm to users than other “hard drugs”(mean age of death is 30, 50 percent of heroin users die before age 50)Physical dependency withdrawal, insomnia, nausea vomiting, anxiety, runny nose, etc.Rapid tolerance means that $10 a day habit can quickly escalate into a much larger habit.
12How does heroin cause addiction? Heroin molecules rapidly cross the blood-brain barrierHeroin causes neurons in the brain to release a flood of dopamineDopamine makes the user feel goodThe user’s brain creates links between feeling good and heroin useRepeated use reinforces these linksWhen drug is gone, chemical imbalance in brain causes physical withdrawal symptomsBecause of rapid cross of blood brain barrier, heroin rush is unlike feeling from any other drug…this is a brain disease…with heroin users who are addicted, the organ (brain) is not working correctly
14Heroin Respondents: Characteristics All from the suburbs including Cook, DuPage and Will Counties.Half were male, half female.Youngest was 22, oldest was 31.Wide range of socio-economic backgrounds, peer group participation and experiences.Here were the respondents….so what did we learn?....
15Co-occurring disorders and self medication The majority of the sample self reported co-occurring disorders or symptoms:DepressionAnxiety DisordersADHDBipolar Disorder (this was the least common)The majority of the interviewees indicated that heroin use was a form of self-medication for depression or other problems:I was in my own world, in my own area, doing my own thing….And it [heroin] would make me not be sad.SELF-REPORTING NOT ALWAYS OVERT, SOMETIMES INFERRED BY RESEARCHERS FROM PARTICIPANT STATEMENTS
16Sensation seekingMore than two-thirds of the sample exhibited sensation seeking behaviors, which include risk-taking (e.g. skydiving); disinhibition; boredom susceptibility; and adventurousness: I found going to the west side exciting. It was a thrill. The chance was that you could get caught, but the reward was that you got your dope. I am a thrill-seeker. I bungee-jumped when I was 12. I used to steal small things just to do it. My parents would describe me that way – as a thrill seeker.Now, I’ve been skydiving…but I have never tried heroin…it just means that this is a risk factor that parents should be aware of
17Low drug knowledge among participants We had a D.A.R.E. program, but they spoke to us mostly about violence and gangs. And that was all in elementary school. And in high school it was just sex education. No drug education then. I didn’t know it [heroin] was a downer like it was. I thought it was like marijuana. I thought that the people that got addicted – that it was all in their head. I just saw heroin as another drug. I thought maybe it wasn’t true that it was so bad. I thought maybe people did more than they could handle.Feeling of little drug education exposure in early teens when drug use opportunities first presented…they think it is just like marijuana…talk about the issue in drug education with lumping drugs together versus talking about relative harms of different drugs
18No understanding of dependency Being around people that were doing it, if you don’t see anything bad happening, then it seems OK. But that was in the beginning. I expected it all to be like in the beginning when I was not getting sick. All those things that were supposed to happen were not happening then, so I thought it was fine. And I kept using. If I knew about withdrawal, I would not have done it. If I knew, I would never have used. If they could show people this, what it is like— I think people might not use.Lack of knowledge about withdrawal…addiction potential of heroin…
19Peer group Two patterns emerged Individual leaves peer group or seeks out people using drugs.Heroin comes to the group and spreads.When I turned 20, a lot of my close friends from that group were starting to do heroin. And then my other friends in the group started using. And then I was around all them and thought it was OK to try.After dependence, peer group changed to include other heroin users.
20Initiation: Mode of Administration All interviewees sniffed or snorted heroin:When I was at [college] then I heard about it. And this person snorted it. And he said “you don’t get addicted this way” since you are snorting it and not injecting it.I didn’t think it would be bad sniffing it. I thought, oh, when you sniff it, then it’s ok.If you are at a party and someone opens a pack and dips a key into the powder and then puts it under your nose and says sniff, that’s not so scary. That’s how we did it.Fear is gone from kids due to sniffing…this is really important, how do kids get initiated?Starts with sniffing…perceived as lower risk (also mention low disapproval of pain pill use)
21Pill Use → HeroinAbout one third of interviewees were misusing or dependent on opioid pills before transitioning to heroin.I didn’t use heroin first – I broke my foot and I was out of pain in like 2 weeks, but he [the doctor] kept me on Vicodin for 8 months. I kept calling for refills and he kept giving them to me. I didn’t know it was addicting. I figured it was safe because it was from a doctor and he kept giving it to me.Pill use softened perception of heroin useI remember thinking that I was scared to try it because it was heroin, but then I remember thinking that it was the same as Oxys, so it was OK.In 2008, over 900, year olds initiated to prescription pain pills.Prescription pain pills were the 2nd most common illicit drug initiation behind cannabis - over 17 percent of first time initiates to any illicit substance used pain relievers.About 1.9 million Americans were dependent on the non-medical use of pain pills during the last year.
22Discovering Dependency Dependency was generally pointed out by another person I really thought I had the flu. I said “lately I’ve been feeling weird like I am sick” and my friend V flat out told me “that’s withdrawal.” I don’t remember what I felt. I know it wasn’t good. I was surprised. I didn’t know what addicted meant. I didn’t understand why people would get sick or how or why they would have to use all day.This person was addicted and thought their withdrawal symptoms were the flu!
24Focus group methods To participate: Had to have used at least one illicit substance in high school AND had to attend a suburban high school.Recruited through a variety of means including:Posted in Triblocal, CraigslistPosted on Facebook college and high school networksPosted fliers throughout the suburbs at public locationsHanded out fliers over the summer at public beaches, malls and other areas where young people congregate.Participants names were not recorded, used disposable phone and gmail address to ensure confidentiality.
25Drug EducationParticipants believed drug education was not comprehensiveFocused primarily on tobacco, alcohol and marijuanaDid not provide information or discussion on heroin or other “hard drugs”Programs “lumped drugs together,” making it difficult to understand the effects of specific drugs on the personPrograms did not clearly explain addiction, dependency or withdrawalPrograms did not help students understand the path from experimenting to addiction“Just don’t do it” is not a reasonParticipants wanted authentic presenters, and authentic messages. They wanted to hear about the path to addiction which includes the honeymoon period…why do people do drugs? Because at first it makes them feel good.These are all concerns ABOUT DRUG EDUCATION: how the education was not comprehensive.These are problems that the participants noted about their drug education and wanted changed.Participants also echoed Interviewee sentiments that they received little education or guidance at the age when exposure to drug use first occurred, i.e. late middle-/early high school
26Participant knowledge High disapproval of heroin, low disapproval of opioid pillsDid not understand the link between the two (heroin and pills)Did not understand differences between “dependency” and "addiction”Understood that there was a link between mental health and drug use, but not how the two were linkedThis is the RESULT of their drug education: many, many knowledge gaps.
27Addressing Knowledge gaps Participants believed parents did not have the knowledge or communication skills to talk to them about drugsDid not know where to go to find a source of accurate, quality information about drugsFocus of their programs did not include all drugsWe are working to provide resources for parents/teens through this project…check out our website for more information
28Major trendsHeroin use is a growing problem in Chicago suburbsBecause it is highly addictive, this trend won’t fix itself!What can we do?
29Parents Talk to your kids!!! Monitor for behavior changes (dropping out of activities, change of friends, grades drop, etc.)Link between mental health disorders and heroin useLook for signs (watery eyes, runny nose, appears sleepy and distant, frequent excuses, valuables missing, high mileage on car)Push school board to support drug prevention
30schools Research-proven effective education at every grade level Authentic messages from authentic messengersParent resourcesStaff development trainingSchool wide system for early intervention
31Medical communityEducate patients about potential danger of pain medicationClosely monitor pain medication, and prescribe the minimum amount necessary
32Today’s objectivesIncrease knowledge of heroin use trends in the Chicago suburbsShare key findings from Robert Crown sponsored primary research conducted by Illinois Consortium on Drug PolicyProvide suggestions for actions to reverse trend