2. The purpose of this overview is to update the facts pertaining to the possibility of upward trends related to heroin trafficking and/or abuse in the Commonwealth of Virginia. FOR OFFICIAL USE ONLY

3. **Reported to VA Department of Health over the Five year span from 2010-2012 as compared to 2103

4. FOR OFFICIAL USE ONLY

6. During 2013, VSP DES participated in 38 federal, state and local multi-jurisdictional task forces, encompassing 106 jurisdictions. These multi-jurisdictional task forces participated in 6,154 investigations that accounted for $14,465,247 in illicit drug seizures, $905,320 in seized U.S. currency, and 3,398 persons arrested on 4,365 charges. These task forces also seized 83 vehicles and 405 weapons. FOR OFFICIAL USE ONLY Multi-Jurisdictional Drug Task Forces

7. FOR OFFICIAL USE ONLY

8. A highly addictive drug Derived from morphine (opium poppy) A “downer” or depressant, schedule I Different appearances – white or off-white – Black and sticky – Dirty brown powder FOR OFFICIAL USE ONLY

9. In 2010, 38,329 unintentional drug overdose deaths occurred in the United States, increase for 11 th consecutive year; – one person dies every 14 minutes 1 – 22,134 were prescription drug overdose deaths, of which Opioid pain relievers were involved in 16,651 deaths (75.2 %) 1 Enough prescription pain relievers were prescribed in 2010 to medicate every American adult every four hours for a month 1 Opioid pain relievers were involved in more overdose deaths than cocaine and heroin combined 1 Prescriptions for painkillers in the United States have nearly tripled in the past two decades and fatal overdoses reached epidemic levels, exceeding those from Heroin and Cocaine combined, according to the Centers for Disease Control and Prevention (CDC). 1 SOURCE: CDC, 2010 Drug Overdose Deaths In The United States; October 2012 CDC, Pharmaceutical Overdose Deaths, United States, 2010; February 20, 2013 (Update) FOR OFFICIAL USE ONLY

11. Prescribers and pharmacists made 1.3 million requests to Virginia’s PMP in 2013, up from 860,000 in 2012.

12. FOR OFFICIAL USE ONLY The number of prescriptions being dispensed is trending downward while the percentage of PMP requests to prescriptions dispensed is increasing.

13. FOR OFFICIAL USE ONLY Doctor Shopping Statistics 2010 - 2013

14. Hydrocodone (Vicodin®, Lortab,® Lorcet®) Oxycodone (Percocet®, Percodan®, Roxicodone®) OxyContin® OPANA Heroin FOR OFFICIAL USE ONLY

15. Addicts turn to Heroin because it is cheaper, easier to obtain and offers users a more intense high - Local users will make multiple trips a day to source cities where Heroin is cheaper and readily available through open air drug markets. Heroin users typically inject.10 -.25 gram of Heroin at a time. We have interviewed users that have a 2.5 gram a day habit. ($1,000 a day habit) The current street value of Heroin in our area is $100 for ¼ gram, $400 for 1.0 gram. (A sugar packet contains 2 - 4 grams of sugar.) FOR OFFICIAL USE ONLY

16. What is Law Enforcement Doing About the Drug and Heroin Problem? EDUCATION Presentations to Civic Groups, Medical Professionals, Behavioral Health and Developmental Services, Elected Officials, Law Enforcement Partners, Prosecutors, Schools etc. FOR OFFICIAL USE ONLY

17. What is Law Enforcement Doing About the Drug and Heroin Problem? ENFORCEMENT Working Closely with LE Agencies and Legislators, Intelligence Analysis, O.C.D.E.T.F Investigations with Federal Agencies FOR OFFICIAL USE ONLY

18. COMBINING RESOURCES FOR OFFICIAL USE ONLY

19. Shannah Duggan, age 19, 2005 “Pregnant.” John Kacena, age 20, 2012. “Well-Loved.” Jena Dolstad, age 14, 2012. “Willing to Try Something New.” Faces of Heroin Overdose Deaths Today Photographs from the Internet FOR OFFICIAL USE ONLY

20. Captain Gary T Settle Bureau of Criminal Investigation Virginia State Police Gary.Settle@vps.virginia.gov540-829-7400 FOR OFFICIAL USE ONLY