1. Sheboygan County Service Providers Heroin and Prescription Pill Abuse

2. A National Problem The United States is the Number One consumer of illegal drugs and prescription narcotics

3. Region, State and County Problem In 2011, SAMHSA reported a 8.3% increase of heroin substance dependence or abuse for persons aged 12 or older in the Midwest….. Wisconsin Teens (12-17) who have tried heroin up 300% since 1999 City of Sheboygan has seen a 1500% increase in heroin arrests since 2009

4. Local Impact and Extent Sheboygan County survey conducted October 2013 of 1,354 county residents – 27% of respondents personally knew someone who had been a victim of a heroin-related crime (i.e. theft, burglary) – 27% knew someone who has sought treatment for heroin addiction – Almost 9% knew someone who had used heroin in the past 30 days

5. How did this happen? Rx Drugs: opiates for treating chronic pain Rx drugs and heroin are opiates that produce similar effects 2010 OxyContin Reformulation Heroin as an affordable, accessible substitute Almost all young heroin users abuse Rx painkillers first

6. Heroin Does Not Discriminate Prescription Drug Abuse is Gateway to Heroin Affects people of all ages, races and socio- economic groups

7. Heroin use leads to death State of Wisconsin: 29 deaths (2000-2007) 199 deaths in 2012 City of Sheboygan: 200% increase in heroin overdoses since 2009

8. What is Heroin?

9. Heroin Highly addictive drug that produces an intense, euphoric high More than 75% of those who try heroin once will use again! Sedative, like other opiates (oxycodone, morphine, etc.) Street names: boy, white, brown sugar, etc. Locally, 15%-20% pure, mixed with Dormin, caffeine, sugar and unknown deadly combinations

10. How do users obtain heroin Dealer moves to area and begins to sell to known users while looking for new clients or Users pool their money, travel to a source city, purchase, use, return home and distribute to friends Risks: Robbed, Killed, Arrested, Overdose

11. How is heroin used?

12. Heroin ingestion methods Smoking Snorting – typically progresses to shooting with heroin rig Shooting – use of this method due to strong addiction and avoiding “being sick”

13. What does heroin do to you? First Use: Intense, euphoric “rush” Flushed skin, “heavy” arms and legs, dry mouth, slowed/heart rate Nod in and out of consciousness aka “on the nod” Addiction drives user for next fix to “feel normal” and to keep “the sick off” Vicious cycle begins….

14. Short Term Consequences Slowed breathing and heart rate Clouded thinking Drowsiness/sedation Nausea/vomiting Hypothermia/Cold Sweats Coma or death due to overdose from lack of oxygen to brain SOUNDS APPEALING, Huh!

15. Long Term Consequences Collapsed veins from injections Infected blood vessels and other vital organs AIDS/contagious infections from needle sharing Respiratory problems and immune system breakdown Coma or death due to overdose from lack of oxygen to the brain

16. Warning Signs of Use Changes in friends/attitude/behavior Secretive meetings/frequent calls Sickness/loss of appetite Nodding off/oversleeping Blackouts/Loss of memory Long sleeves in warm weather Money disappearing

17. How can I help? You already are…. Education leads to Prevention This presentation is one of many steps in preparing oneself in case you encounter this situation with a loved one, friend, co-worker, etc. Foster open communication about the negative affects of addiction to prescription drugs and heroin.

18. Why we must talk about this in our community… Every day…. Families are torn apart due to watching a loved one steal, lie and slowly kill themselves through addiction Businesses and property owners are victims of crime driven by the addiction

19. Why we must talk about this in our schools Every Day….. Students are hurt by alcohol and drug abuse.. Recognized diminished achievement in our schools Greater risks on the road Heartache of lives cut tragically short

20. What should I do if I am dealing with this situation? Remember heroin is a progressive condition Early, proactive involvement is key Recognize and confront the issue Be persistent in seeking assistance The sooner the addict seeks treatment and professional help, the better Quick admission into treatment for best chance at recovery

21. Information and Services Nationally – SAMHSA 1-800-662-HELP (4357) or findtreatment.samhsa.gov Locally – Mental Health America (not 24/7) (920) 458-3951 or www.mhasheboygan.orgwww.mhasheboygan.org Sheboygan County Mental Health Crisis Line (920) 459-3151 (24/7) In case of medical emergency, dial 911

22. What is happening in our community? Area Foundations are recognizing the need to provide assistance Educational Talks are being conducted Area Service Providers are examining best practices and collaborating on how to implement within our community

23. Service Providers are meeting with school boards, administrations, teachers and students

24. Increased Awareness of Drug Drop Off Points for Prescription Narcotics Store all needed medications in a secure, safe place Know what medications you have within your household Bring unwanted medicines to a secure drop- off box at one of the following locations: Police Departments: Sheboygan Falls, Sheboygan, Kohler, Plymouth, Elkhart Lake

25. Public Awareness Placement throughout Sheboygan County

26. Any Questions?