1. 21st Century Prevention Amid the Opioid Crisis
Gonzalo Cadima, Director - UWBCCBH&DP
Jim Hall, Epidemiologist – NSU ARSH

2. Mission: “End the Epidemic”
Block the Pipeline to Addiction
Early Alcohol and Other Drug Use by Youth

3. Changes in Patterns of Substance Abuse
More Poly-Substance Abuse
Both Intentional
And Unintended
More Pharmaceuticals
More Addictive
More Deadly
New Psychoactive Substances - Synthetic Drugs
Contaminated Street Drugs

4. Fentanyl Analogue Contaminated Street Drugs
Heroin
Counterfeit Pills
Cocaine
Methamphetamine
Mollys
Any Powder or Liquid Drug

5. Presidential Commission Report March 2018
files/images/Final_Report_Draft_ pdf

6. Prevention under-utilized,
………..but cost-effective

7. Reflecting New Knowledge of the 21st Century
Focused on the Brain and Neurology
How People Communicate and How People Learn
The “Parkland Generation” – Social Media

8. National Public Education Campaign
As with HIV/AIDS in 1980’s
Substance Use Disorders (Addiction)
Not a moral failing
But a chronic Brain Disease
Evidence-Based Treatment available

9. Impacted Sectors of Society
Individuals,
Families and Friends,
Communities

10. Impacted Sectors of Society - Individuals
Neonatal Abstinence Syndrome

11. Source: Florida Agency for Health Care Administration
Number of Neonatal Abstinence Syndrome Cases State of Florida:
21st Century Prevention
Broward
N/A
Source: Florida Agency for Health Care Administration
Jim Hall

12. OPIOID EPIDEMIC COLLATERAL DAMAGE TO CHILDREN
More than 4,000 babies born with Neonatal Abstinence Syndrome in Florida during 2016, an increase of over 1,000 percent from a decade ago.
Substance abuse played a role in 67 percent of the cases where children were removed from their homes within 30 days of birth last year.
There's been a 38 percent increase in the number of children under the age of 5 who have been removed from homes because of substance abuse in the past four years.
In the first half of 2017, more than 60 percent of all removals were due to drug abuse --- nearly double the percentage just four years ago.
The influx of children has resulted in a shortage of foster-care beds in Florida.
Source: The News Service of Florida, January 2018

13. Impacted Sectors of Society - Individuals
Neonatal Abstinence Syndrome
Adverse Childhood Experiences
Early intervention for children with risk factors
Trauma Informed Prevention

14. Impacted Sectors of Society - Individuals (Continued)
Foster Care
Developmental Disorders
Vast Majority are aged 16 to 34:
Peak period of pregnancy, parenting,
and adverse consequences
Special issues for “Baby Boomers”

15. Impacted Sectors of Society – Families and Friends
Prevention with Parent-Based Components
Overdose Reversal with Naloxone

16. Impacted Sectors of Society – Communities
Strategic Prevention Framework

17. Assess
Build
Evaluate
Act
Plan

18. Impacted Sectors of Society – Communities
Strategic Prevention Framework
United Way of Broward Commission on Behavioral Health and Drug Prevention
Community Response Team
Opioid Action Plan

19. Responding to Broward County’s Opiate Epidemic
Opiate Action Plan

20.
Click on:
Initiatives

21. Community Non-Profits
Branch of Community Organization Resources Available Activities Contact
Branches of Community
Law Enforcement
First Responders
Medical
Community Non-Profits
Addiction Treatment
Judicial
Faith-Based
Education
County Government
Media
Business Sector
Youth/Parents
Federal Agencies

22. Community Non-Profits
Branch of Community Organization Resources Available Activities Contact
Branches of Community
Law Enforcement
First Responders
Medical
Community Non-Profits
Addiction Treatment
Judicial
Faith-Based
Education
County Government
Media
Business Sector
Youth/Parents
Federal Agencies

23. Broward County Strategies to Address the Opiate Epidemic
Non-medical Rx use Prevention:
1. Promote compliancy of the CDC prescribing guidelines.
2. Increased disposal sites for Rx medication.
3. Education on safe Rx and OTC products use and secure storage of medications.
4. Increased use of the Prescription Drug Monitoring Program.
5. Information Dissemination: community engagement, education and outreach.
6. Media Engagement 
Harm Prevention:
1. Education on safe needle usage
2. Education on the danger of new poisonous opiate analogs and trends
3. Promotion of Syringe Exchange Programs

24. Overdose Prevention:
1. Increase access to naloxone through pharmacies and law enforcement.
2. Cross-sector trainings and trainings for families and significant others on naloxone usage
3. Education and public awareness about the Good Samaritan Law
4. Collaborate with hospitals to provide referrals/discharge plan for individuals who have overdosed
5. Create a PSA and distribute through YouTube and Comcast
Treatment:
1. Medication-Assisted Treatment with emphasis on wrap-around services
Policy:
1. Increased funding and expansion for treatment facilities
2. Increased utilization of the Marchman Act
3. Implementation of the Designer Drug Enforcement Act

25. Impacted Sectors of Society – Communities
Strategic Prevention Framework
United Way of Broward Commission on Behavioral Health and Drug Prevention
Community Response Team
Opioid Action Plan
Health Care System
Education Environment
Workplace
Traffic Safety
Criminal Justice System

26. Effective Prevention Components
Consistent messages,
Culturally-appropriate
Repeated at Home
Reinforced: Schools, Workplaces, & Community
Organizations
Delivered by influential adults and peers

27. Evidenced-Based Programs
preventing-prescription-drug-misuse-strategies.pdf

28. Evidenced-Based Strategies
Education
Tracking and Monitoring
Proper Medication Disposal
Harm Reduction
Multiple Component Programs

29. Evidenced-Based Strategies
Education: Increase awareness for public and health care professionals.
Teach how to properly dispense, store, & dispose of controlled substances.
Tracking and Monitoring: Detect “doctor shopping” and Identify aberrant prescribers.
Proper Medication Disposal: To limit access and availability as well as raise awareness of
prescription drug misuse.
Harm Reduction: Mitigate risks linked to misuse of medications. Reduce Deaths & Disabilities.
Multi-Component Programs: Combine strategies to address multiple Risk Factors (e.g., lack
of awareness, perceptions of harm, access and availability.)

30. Prevention Resources

31. SBIRT
Screening, Brief Intervention, Referral to Treatment

32. CRAFFT Car, Relax, Alone, Forget, Family or Friends, Trouble

33. CRAFFT Car, Relax, Alone, Forget, Family or Friends, Trouble

34. Take-Back Your Meds

35. Pharmacology 101 – Appropriate Use of medications

36. Mass Media Addressing:
Hazards of substance use,
Danger of opioids,
Contaminated street drugs, and
Stigma

37. Media Issues: Branding Media Literacy
Effective for parents, not for youth
Integrate national campaign with local evidence- based programs

38. Social Media and Web-based prevention
#ReachMe

39. Mandatory Medical Education for Prescribers and Pharmacists