1. Meth Matters Critical Issue Collaborative Responses

2. Retail Impact DEA has developed training materials regarding self- certification training for regulated sellers of non- prescription drug products containing – ephedrine, pseudoephedrine, and phenylpropanolamine – required by the Combat Methamphetamine Epidemic Act of 2005 (Title VII of Public Law 109- 177).

3. In 2009, Gov. Bobby Jindal signed a bill into law geared to stopping local meth production. The law requires that pseudoephedrine drugs (a key ingredient in meth) are only sold by licensed pharmacies and that when pharmacies sell them, they must enter sale information into a new Central Computer Monitoring System. Law enforcement officials will be able to access the database and monitor pseudoephedrine sales.

4. Training Required to Sell Drug Products Containing Ephedrine, Pseudoephedrine, and Phenylpropanolamine by Mobile Retail Vendors U.S. Department of Justice Drug Enforcement Administration Office of Diversion Control

5. U.S. Department of Justice Drug Enforcement Administration Office of Diversion Control Why do I have to take this training? Because a new federal law, the Combat Methamphetamine Epidemic Act of 2005, says you cannot sell Scheduled Listed Chemical Products containing ephedrine, pseudoephedrine, or phenylpropanolamine until you have completed this training. This training will help you to understand the laws and what you must know before you can sell these drug products. 2

6. What am I going to learn from this training? This training will teach you: that you must keep a logbook of sales; that the name on the identification your customer shows you matches the name your customer wrote in the logbook; that these Scheduled Listed Chemical Products must be kept either behind the counter or in a locked cabinet; that you can sell only a limited amount (3.6 grams) of these drug products to each customer per day; that your customer can only buy a limited amount, (9 grams) of these drug products in a 30-dayperiod.

7. What are methamphetamine and amphetamine? Methamphetamine and amphetamine are highly addictive drugs that are dangerous to use and make. Other common names for methamphetamine are“meth,” “crystal,” “crank,” and “ice.” Ephedrine and pseudoephedrine can be used illegally to make methamphetamine. Phenylpropanolamine can be used illegally to make amphetamine.

8. What is the purpose of the new law? The new law establishes requirements for selling Scheduled Listed Chemical Products containingephedrine, pseudoephedrine, andphenylpropanolamine because these ingredients canbe used illegally to make methamphetamine oramphetamine. In all states every seller of these drug products must follow the new law. Some states have tougher laws than the current federal law. If your state has tougher laws, those lawsmust be followed in addition to the federal law.

9. What information must be in the logbook? You must keep a logbook which contains a written or electronic list of sales of drug products containingephedrine, pseudoephedrine, andphenylpropanolamine. You must write or enter in the logbook the name ofthe drug product and the quantity sold. Your customer must write or enter in the logbooktheir name and address, and the date and time of thesale. Your customer must also sign the logbook(signature).

10. Who can see the logbook information? You must keep the logbook secure. You may share information in the logbook: To comply with the law; and For a product recall. Logbook information may only be shown to local, state and federal law enforcement. Information in the logbook may be copied, inspected only, or turned over entirely. Ask your supervisor for further information about sharing information.

11. How much of these drug products can I sell to each customer per day? You cannot sell more than 3.6 grams per day to each customer of Scheduled Listed Chemical Products containing ephedrine, pseudoephedrine or phenylpropanolamine. Refer to the charts on the next two slides for the amount of tablets or liquids that equals 3.6 grams. No matter how many sales you make to a customer, you cannot legally sell more than 3.6 grams per day of these drug products to the same person.

12. Number of tablets in 3.6 grams Office of Diversion Control Ingredients Number of tablets = 3.6 grams 25 mg Ephedrine HCl 75 Tablets 25 mg Ephedrine Sulfate 186 Tablets 30 mg Pseudoephedrine HCl 146 Tablets 60 mg Pseudoephedrine HCl 73 Tablets 120 mg Pseudoephedrine HCl 36 Tablets 30 mg Pseudoephedrine Sulfate 155 Tablets 60 mg Pseudoephedrine Sulfate 77 Tablets 120 mg Pseudoephedrine Sulfate 38 Tablets 240 mg Pseudoephedrine Sulfate 19 Tablets Phenylpropanolamine (PPA) - FDA issued a voluntary recall as being unsafe for human consumption. Veterinary use is by prescription only.

13. Liquids -Number of milliliters in 3.6 grams Ingredients Number of milliliters (ml) = 3.6 grams 6.25 mg Ephedrine HCl/ 5 ml Liquid 3515 ml 15 mg Pseudoephedrine HCl / 1.6 ml Liquid 468 ml 7.5 mg Pseudoephedrine HCl / 5 ml Liquid 2929 ml 15 mg Pseudoephedrine HCl / 5 ml Liquid 1464 ml 15 mg Pseudoephedrine HCl / 2.5 ml Liquid 732 ml 30 mg Pseudoephedrine HCl / 5 ml Liquid 732 ml 30 mg Pseudoephedrine HCl / 2.5 ml Liquid 366 ml 60 mg Pseudoephedrine HCl / 5 ml Liquid 366 ml Phenylpropanolamine FDA issued a voluntary recall as being unsafe for human consumption. Veterinary use is by prescription only.

14. Environmental Impact Field Safety Concerns

15. Methamphetamine Availability January 2007 – Price Per Gram $147.12 – 57% Purity December 2008 – Price Per Gram $168.61 – 61.8% Purity Highest Cost Per Gram during date range - $295 LABS IN LOUISIANA 2008 – 4 2009 – 1 2010 – 24 2011 - 1

16. Outcomes  Improper storage, use, and disposal of chemicals  Chemical Fires and Explosions  Toxic Chemical Production  5 to 7 pounds of waste per pound of methamphetamine  Waste discarded in fields, streams, forests, and sewer systems  Extensive environmental damage Clean up Cost 2003 - $17,000.00 2010 - $3,000.00 - $4,000.00

17. So What About Today-Shake and Bake Other than Gassing, made in soda bottle Takes about 1 ½ hr. 2 Boxes of Tablets may yield 4 grams (92% Yield) $30 investment that fits in a backpack produces $600 yield Generates lots of heat Only 10-15# of Pressure 20% of Pop Bottle labs found from Fire

18. Potential for Exposure Contamination is often easily detected, due to distinctive smell and obvious stains on surfaces Stains can persist for years and “bleed through” paint, creating vapor Vapor can be removed by venting the house; inadequate ventilation can cause buildup to toxic levels Residue reacts with spray starch Stained items/surfaces may be discarded

19. Decontamination Safety 2:1 Spic and Span Water

20. CRIMINAL FACTORS IN MANUFACTURINGMETHAMPHETAMINE

21. SECONDARY CRIMES CHECK FRAUD CREDIT CARD FRAUD COUNTERFEIT MONEY IDENTITY THEFT FORGERY

22. Community Impact Drug Endangered Children

23. 23 SHE MATTERS AND SO DOES HER SAFETY!

24. 24 Department of Justice: Originally stemming from the methamphetamine crisis, this movement was initiated within the last decade to respond to the growing phenomenon of finding children in meth labs’ homes and other areas where they were living or playing.

25. 25 A drug endangered child is a young person under the age of 18 who lives in or is exposed to an environment where drugs, including pharmaceuticals, are present for any number of reasons, including trafficking and manufacturing of these drugs. As a result of that exposure, these children experience or are at high risk of experiencing physical, sexual or emotional abuse, harm or neglect

26. The FACTS US Department of Health and Human Services (1999) – Substance abuse was a factor in two-thirds of all foster care placements In 2009, 980 children were reported to the El Paso Intelligence Center (EPIC) as present at or affected by methamphetamine laboratories 8 were injured and 2 were killed in labs How are you handling Your cases that involve Children in the home?

27. Exposure Dangers Chemical Contamination Fires and explosions Abuse and Neglect Hazardous lifestyle Social Problems Physical Hazards (Unsafe and Unsanitary)

28. Meth Use During Pregnancy Baby – Low birthweight, birth defects – Drug withdrawal – Developmental disabilities

29. Child Maltreatment The caretaker who is responsible for, or permits the abuse or neglect of a child: Physical Abuse/Neglect Sexual Abuse Emotional Abuse/Neglect Physical Neglect Educational Neglect Failure to thrive

30. SOCIAL CONSEQUENCES Delinquency School discipline problems School absenteeism Criminal behavior Isolation Poor peer relations Unemployment Poverty Addiction

31. Multidisciplinary Team Approach Issues to address Staff Training Agency Roles and Responsibilities Confidentiality/HIPPA Issues Safety Procedures for children, families, and responding personnel Interviewing procedures Medical procedures Community Resource Development

32. Multidisciplinary Team Composition Medical and Mental Health Services Child Protective Services Law Enforcement Public Safety (Fire Department) Prosecution

33. Community Impact Elder Care and Safety

34. Elder Abuse defined…. National Research Council mistreatment as “(a) intentional actions that cause harm or create a serious risk of harm to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder, or (b) failure by a caregiver to satisfy the elder’s basic needs or to protect the elder from harm.”

35. Warning Signs Do you have a participant living with another adult over the age of 50? What is the physical/mental state of the adult over the age of 50? What are the living conditions in the home? PAY ATTENTION TO THE SIGNS INTERVENE WHEN APPROPRIATE

36. Physical Signs Injury that has not been cared for properly Injury that is inconsistent with the explanation for its cause; Pain when touched; Cuts, puncture wounds, burns, bruises, welts; Dehydration or malnutrition without illness-related cause; Poor skin color; Sunken eyes or cheeks; Inappropriate administration of medication; Soiled clothing or bed; Lack of necessities such as food, water, or utilities; Lack of personal effects, pleasant living environment, personal items; or Forced isolation.

37. Behavioral Signs Vulnerable Adult Fear; Anxiety, agitation; Anger; Isolation, withdrawal; Depression; Non-responsiveness, resignation, ambivalence; Contradictory statements, implausible stories; Hesitation to talk openly; or Confusion or disorientation. Caregiver Prevents vulnerable adult from speaking to or seeing visitors; Anger, indifference, aggressive behavior toward vulnerable adult; History of substance abuse, mental illness, criminal behavior or family violence; Lack of affection toward vulnerable adult; Flirtation or coyness as possible indicator of inappropriate sexual relationship; Conflicting accounts of incidents; Speaks of vulnerable adult as a burden; or Believes vulnerable adult could do more self care than actually capable of.

38. Perpetrators of Elder Abuse A majority of perpetrators of physical abuse were partners or spouses Half of perpetrators were using drugs or alcohol at the time of the mistreatment Three in ten perpetrators had a history of mental illness Over a third of perpetrators were unemployed Four in ten perpetrators were socially isolated National Institute of Justice Phone Survey (2008)

39. Inspector Vanessa Price Oklahoma City Police Department Office of Weed and Seed Programs vanessa.price@okc.gov