1. Scioto County Heath Commissioner Ohio Drug Task Force

2. SEOW

6.  10 treatment admissions for abuse  32 emergency department visits for misuse or abuse  130 people who abuse or are dependent  825 people who take prescription painkillers for non medical use CDC

7.  Enough prescription painkillers were prescribed in 2010 to medicate every American Adult around-the-clock for one month.  2 million people reported using prescription painkillers nonmedically for the first time in 2010- nearly 5,500 people a day CDC

8.  9.7 million doses of prescription painkillers were dispensed in Scioto County last year  123 doses for each of the 79,000 men, women and children in the county  Between 1999 and 2008, there was a 360% increase in accidental over-dose deaths in Scioto County; 92% of these deaths are due to prescription medication  Oxycodone toxicity deaths in Scioto County have quadrupled in the past 3 years.  85% of substance abuse treatment requests at the Scioto County Counseling Center are now for opiate addiction, marking a 300% increase in just the past 3 years. State Medical Board of Ohio

9. Time Period 10/1/2008 through 3/31/2009 Oxycodone dispensers (In Grams)

10. CDC

12. Other Source 7.1% Got from drug dealer or stranger 4.4% Took from friend or relative without asking 4.8% Bought from friend or relative 11.4% Prescribed by one doctor 17.3% Obtained free from friend or relative 55%

16. Bloom 3 Theft 1 Defrauding creditors 1 Identity theft Brush Creek 1 Identity theft Clay 1 Burglary 1 Theft Green 1 Theft Harrison 1 Criminal damaging 1 Burglary 1 Breaking and entering 1 Criminal simulation 1Disorderly conduct 1 Domestic Violence

17. Jefferson 1 Breaking and entering 1 Theft 1 Cruelty to animals Morgan 1 Telecommunications Harassment 1 Domestic violence Porter 1 Criminal Trespass 1 Theft 1 Telecommunications fraud 1 Forgery 2 Domestic violence 1 Violate protection order Rarden 1 Theft Rush 1 Breaking and entering

18.  466 OVI arrested in Scioto County alone in 2011  Compared to 325 in Lawrence County  220 in Jackson County  118 in Pike County  64 in Adams County.  “Part way through the year, at one point, we [Scioto County] were in the top 5 counties in the state for OVI arrests,” – Lt Karla Taulbee OSHP  Drugs are also included in these OVI arrest statistics  There were 13,799 OVI-related crashes on Ohio roadways, killing 401 and injuring 8,517 Portsmouth Daily Times March 9, 2012

19.  Chicago doctor who operated pill mills in Portsmouth and Chillicothe Ohio  Sentenced for illegally prescribing and dispensing pain pills outside the scope of a legitimate medical practice that resulted in deaths of 4 people from 2003-2005  Convicted May 10, 2011 on 4 counts of illegal drug distribution that resulted in death  Life sentence for each count  Also sentenced on 13 other counts that resulted in prison sentences from 10-20 years

20.  UPDATE: Many Speak Out as Pill Mill Doctor Sentenced to Four Life Terms UPDATE: Many Speak Out as Pill Mill Doctor Sentenced to Four Life Terms

23. The New York Times NPR Men’s Health John Terrett is a Washington DC based correspondent for al Jazeera English. …...…...

25.  36 states have operational Prescription Drug Monitoring Programs.  House Bill 93  Scioto County  Shut down 12 “pill mills”  Prevention not Permission Syringe Exchange  SOLACE  High Intensity Drug Trafficking Area (HIDTA)

26.  Goal of safer, healthier and drug-free communities  More than 5,000 community anti-drug coalitions in the US and abroad  Nonprofit status in the US  Collaboration among groups or sectors of a community with common goals  All Scioto County schools signed MOU with health department to participate in drug free community alliance grant application

27.  Preliminary projections from Ohio Department of Alcohol and Drug Addiction Services (ODADAS) nearly 1.5 million fewer opiates were dispensed in Scioto County in 2011  In 2010 there were 9,713,494 opiates dispensed in Scioto County  In 2011 a 20% decrease- 8,234,516 the biggest change in the state

28. Jan-June 2011 SEOW

29.  According to Scioto County Coroner, Dr. Darren Adams  In 2010 there were 24 deaths directly related to drugs and 19 deaths that were drug-related  In 2011 there were 20 deaths directly related to drugs and 11 deaths that were drug-related

30.  In operation since July 13,2011  Serving clients who have relationships with  Scioto County Court of Common Pleas  Portsmouth Municipal Court  Scioto County Jail  Clients must have no less than 15 separate legal charges prior to admission  Mean potential jail or prison day total for each client is 250

31.  25 out of 28 clients completed the program thus far  70% of clients who complete residential alcohol and drug treatment do not re-enter the court systems  Some main recipients of community service  Salvation Army  American Red Cross  Main Street Portsmouth  God’s Pantry (Church food pantry)

32.  Experience work-like activities in preparation for actual employment  Individualized vocational services are provided after brief stabilization period  Clients are educated and assisted in job readiness  Interviewing  Resume building  Cold calling  Professionalism  Jobs that are “black money” or “under the table” are not permitted

33.  Based on 70% of not re-offending in the future  6 month estimate savings $401,625-$580,125  12 month estimate savings $803,250-$1,160,250  18 month estimate savings $1,204,875- $1,740,375  Depending on jail per diem being $45-$65/day

34.  Conducting prescription drug abuse education and awareness pilot projects in high-risk areas  Two projects funded: Montgomery and Scioto Counties  Funding period: 2010-2013 (4 years) Coalition building Media campaign  Results seen already  1.5 million fewer pills prescribed in Scioto County in 2011, as compared to 2010 Webpage: http://www.healthyohioprogram.org/poison

35.  Ohio’s first Naloxone Distribution Program  Naloxone distribution programs (NDPs) provide overdose training and take-home doses of Naloxone, to be administered nasally or by muscular injection, to those who are deemed high-risk for an overdose  Since 1996, more than 53,000 individuals have been trained by NDPs resulting in more than 10,000 overdose reversals using Naloxone

36.  Developing a white paper for best practices  Opioid prescribing in the Emergency Departments

37. Why Emergency Departments?  The ED is the largest ambulatory source for opioid analgesics with 39% of all opioids prescribed, administered, or continued in the U.S. coming from EDs. This may be an even higher percentage in Ohio  Nationally, opioid prescribing for pain-related ED visits increased from 23% in 1993 to 37% in 2005  ED treatment of pain is frequently indicated without the benefit of an established doctor-patient relationship and often in an environment of limited resources  Closure of “pill mills” may result in increased drug seeking behavior (e.g. doctor shopping) at ED  In Ohio, 16% of 2008 fatal overdose victims had a history of doctor shopping