Presentation is loading. Please wait.

Presentation is loading. Please wait.

Primary Care Drug Diversion: Psych co-morbidities in teenage patients with addictions and opioid dependence.

Similar presentations


Presentation on theme: "Primary Care Drug Diversion: Psych co-morbidities in teenage patients with addictions and opioid dependence."— Presentation transcript:

1 Primary Care Drug Diversion: Psych co-morbidities in teenage patients with addictions and opioid dependence

2 Primary Care Drug Diversion: Emergency Department CME Meeting Minimizing Opiates in the Medicine Cabinet

3 William Morrone DO, ASAM, ACOFP, DAAPM Medical Director, Hospice of Michigan CT 101 Consulting Liaison Addictionologist @ Wolverine Human Services Assistant Director of Family Medicine @ Synergy Medical Education Alliance MSU - CHM

4

5

6 Ethical speakers are required to give: CREDENTIALS A NEEDS STATEMENT FINANCIAL DISCLOSURES CONFLICTS OF INTEREST PURPOSE OF CURRICULUM A RISK DISCLOSURE CITATION GOALS

7 Who is speaking? ACOFP board certified primary care physician Family Medicine educator (Synergy Medical) Joint appointment to Dept. of Psychiatry Credentials in Pain and Addiction Credentials in Forensics/Deputy Med Examiner Armed Forces Institute of Pathology Masters Tox/Pharm U. Missouri at KC/Pharm Active pain consultant & Hospice Director Activist, advocate & addictionologist

8 Needs statement 8

9 $$ Disclosures $$ Lawyers DMC MHPCO MOA MAOFP MAFP (MSMS) MSU-SCS AOAAM/AOA HealthPlus Memorial Healthcare MidMichigan Medical Center

10

11 11 This curriculum includes the core information for the evaluation of patient risk for opioids. Treatment decisions should be made based upon the individual patient, the level of risk and available resources to reduce diversion. The standard of care constantly evolves and this lecture will review the current status. Physicians who use opioids are responsible for their own decisions. Dr. Morrone does not assume any patient care responsibilities. Purpose of this curriculum and disclaimer

12 Upon completion of this course participants will be able to: 1) Describe the prevalence of the illicit use of prescription drugs by Midland County youth. 2) Discuss the causes of the increase in illicit use of prescription drugs by Midland County youth. 3) List strategies to reduce and prevent youth from obtaining illicit prescription drugs.

13 Target of Change Issues Teenagers at schools were drugs are used, sold and kept are more likely to use. Illegality of drugs deters use. CASA 2005 drug survey, ( C enter on A ddiction and S ubstance A buse at Columbia University) “High stress, frequent boredom and too much spending money are a catastrophic combination for many American teens,” said CASA Chairman and President and former U.S. Secretary of Health, Education and Welfare Joseph A. Califano, Jr.

14 Reasons behind drug diversion: # 1 undiagnosed psychiatric co-morbidity # 2 peer non-medical use of prescription # 3 drug access has too few barriers # 4 reluctance to monitor UDS, MAPS etc… # 5 unknown resources to help recovery # 6 inherit drug diverting teen from other PCP # 7 Parents are involved in diversion & misuse # 8 Parents are not involved in teen’s life # 9 teen insulated from criminal consequences

15

16

17 I have been to the dark side.

18 MMMC 2005-07 drug abuse admissions 15-19 y/o 13% 20-24 y/o 16% 25-34 y/o 16 % 35-44 y/o 22 % 35-54 y/o 19% 55 y/o +14%

19 Rule CHANGES in our model MAPS use to identify patients/parents at risk. Target parents taking Norco, Valium and Soma. UDS the teens at risk. Operation Medicine Cabinet programs (OMC). Psychiatric screen teens for stress and ASPD. Naloxone in home and high risk environments. Public school programs involving parents. Look for intoxication and withdrawal in teens.

20

21

22 What is drug diversion?

23

24 Ten Sixteen webpage www.1016.orgwww.1016.org People come to Ten Sixteen Recovery Network with life stories that don't match their dreams. Hope has been lost. The staff at Ten Sixteen is here to help change that story. It starts with trust. We listen. We don't make judgements. We build a partnership. We show the client this isn't how the story has to go after all. Life has possibilities. Through gut-wrenching honesty and hard work, they can free themselves from the past. They can find joy in a new way of living. Our goal is far more than abstinence. It is about changing the whole person. Living with honesty and integrity. Being responsible. Developing a new vision for the future. Creating a plan to make that real. Finding the spirit to keep going. Finally free. Finally Strong. They have found where they belong, equipped to change their story. Hope is restored.

25 Ten Sixteen Outpatient Alcohol45 % Marijuana26 % Opiates9 % Cocaine/crack 8 % Heroin1 % Rx1 %

26 Ten Sixteen inpatient drug use Alcohol47 % Marijuana6 % Cocaine/crack 12 % Rx34 %

27

28

29 DIGFAST on the radar? D istractible I ndiscretion G randiosity F light of ideas A ctivity increase S leep problems T alkative

30

31

32

33

34

35

36

37

38

39

40

41

42

43 Get your own web copy. www.dbsalliance.org/pdfs/MDQ.pdf

44

45

46

47

48

49

50

51

52

53

54

55

56

57 Narcotic CRIME trends Midland 2000 -- 37.51 % Midland 2004 -- 50.83 % INCREASE of 36 % Third District -- 37.86 % Third District -- 45.36 % INCREASE of 20 %

58

59

60

61

62 Options and Examples TEN Sixteen Network Dr. Rene Thomas-Clark pediatric psychiatrist Recovery Pathways, LLC licensed treatment Dr. Doug Foster, addiction psychiatrist (AAAP) Wolverine voluntary Vassar boot camp White Pine psychiatric inpatient residential Vista Maria psychiatric inpatient residential BRMC psychiatric inpatient mental health Dr. Dale D’Mello inpatient St. Lawrence MSU

63 Recovery Pathways Kim Debelak Executive Director Contract Counseling, Education, Mental Health & Substance Abuse Resources

64 Recovery Pathways, LLC 717 East Midland Street, Bay City, MI 48706 (989) 928.3566 business office (989) 891.9199 fax Kim Debelak, Executive Director RecoveryPathways@gmail.com

65 Recovery Pathways uses CLIA waived UDS.

66 Recovery Pathways, LLC offers focused growth oriented services for communication, stress, depression, anger management, PTSD assault, anxiety, bipolar-mood, parent/child/family issues, addictions, identity issues, parent education, conduct disorder adjustment issues and frank substance abuse.

67

68

69

70 Special problems to teenagers Teenagers see themselves as indestructible. Without juvenile justice they’re not motivated. Faulty thinking and poor judgment remain. Parents insulate and protect bad behaviors. Peer pressure and friends don’t change enough. Medicalization and CBT are expensive and slow. Primary care doesn’t have the time.

71 You should be drug testing everyone. When teens are in trouble at school. When teens are lying and they get violent. When teens have friends change. When teens don’t come home. Annual physical or sports physical. When teens are hiding cigarettes and alcohol. “You can’t prevent it, if you don’t monitor it.” PUBH-6145: Epidemiology, Walden University MPH

72 Upon completion of this lecture participants will be able to: 1) Describe the prevalence of the illicit use of prescription drugs by Midland County youth. 2) Discuss the causes of the increase in illicit use of prescription drugs by Midland County youth. 3) List strategies to reduce and prevent youth from obtaining illicit prescription drugs.

73 Summary of Change Issues Teenagers at schools were drugs are used, sold and kept are more likely to use. Illegality of drugs deters use. CASA 2005 drug survey, ( C enter on A ddiction and S ubstance A buse at Columbia University) “High stress, frequent boredom and too much spending money are a catastrophic combination for many American teens,” said CASA Chairman and President and former U.S. Secretary of Health, Education and Welfare Joseph A. Califano, Jr.

74


Download ppt "Primary Care Drug Diversion: Psych co-morbidities in teenage patients with addictions and opioid dependence."

Similar presentations


Ads by Google