Heroin Track

To view PPTicon-web  PowerPoint presentations click here.

To learn more about individual breakout sessions click on the title name (updated 3-25-16):

Tuesday
Origins of the Heroin Crisis
Preventing Heroin Initiation and Deaths
Community Responses to Heroin: North Carolina and Northern Kentucky
 
Wednesday
From Rx Opioids to Heroin
HIDTA Heroin Response Strategy
Community Responses to Heroin: Huntington, WV, and Camden County, NJ

Overview
There was a five-fold increase in the total number of U.S. overdose deaths related to heroin from 2001 to 2013, based on Centers for Disease Control and Prevention (CDC) data reported by the National Institute on Drug Abuse (NIDA). Nearly 80 percent of recent heroin initiates reported using Rx opioids prior to heroin, according to NIDA. While implications of this devastating heroin trend will be covered in all tracks of the National Rx Drug Abuse & Heroin Summit, the Heroin Track will delve deeper into this scourge. Presentations will explore the forces driving the heroin crisis, with an eye toward identifying effective solutions. Attendees will learn from the outcomes of national, state and local responses that have been implemented on the policy, public health and law enforcement fronts.
Origins of the Heroin Crisis
Tuesday, March 29, 2016 | 11:15 am to 12:30 pm
CE certified AMA | ANCC | ACPE | ADA | APA | NASW | NAADAC | NCHES | NBCC | GA POST | GA Bar
Presenters Andrew Kolodny, MD
Chief Medical Officer, Phoenix House Foundation, Inc., and Executive Director, Physicians for Responsible Opioid Prescribing
 
Phil Walls, RPh
Chief Clinical Officer, myMatrixx
Moderator Jackie L. Steele, Jr., JD
Commonwealth Attorney, Kentucky 27th Judicial Circuit, and Vice Chairman, Operation UNITE Board of Directors
Session Description Heroin use has been increasing steadily over the past decade. By 2014, roughly 600 people initiated heroin use each day on average, according to the 2014 National Survey on Drug Use and Health. Over the past three years, overdose deaths involving heroin, often mixed with illicitly synthesized fentanyl, have skyrocketed. This session will consider how we arrived at this heroin crisis and where we should go from here.

The session will begin with a brief history of heroin use in America and its evolving impact on Rx drug abuse. After its sale was restricted in 1914 due to addiction dangers, heroin’s popularity and illicit use continued through the Vietnam War era and now has made a 21st Century resurgence. Americans addicted to Rx painkillers have found heroin to be a cheaper, more readily available alternative. The presenter will identify key roles for pharmacists and other health professionals in identifying at-risk patients to help them regain control of their health and their lives.

The second presentation will consider the Rx opioid origins of the current heroin crisis. The presenter will explain the relationship between rising rates of opioid addiction caused by use of opioid analgesics, and the rise in heroin use and overdose deaths. Media reports and some policymakers attribute rising heroin use to a so-called “crackdown on painkillers,” but evidence suggests that the relationship between rising heroin use and opioid painkillers is more complex. Public health interventions and policy responses to the heroin crisis will be discussed.

Learning Objectives 1. Describe the history of heroin use in America, with emphasis on its relationship to the Rx drug abuse epidemic.
2. Identify key roles for pharmacists and other health professionals in identifying patients at-risk of heroin abuse.
3. Explain the relationship between the rising rates of opioid addiction, heroin use and overdose deaths.
4. Specify health interventions and policy responses to the heroin crisis.
5. Provide accurate and appropriate counsel as part of the treatment team.
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Preventing Heroin Initiation and Deaths
Tuesday, March 29, 2016 | 4:15 pm to 5:30 pm
CE certified AMA | ANCC | ACPE | ADA | APA | NASW | NAADAC | NCHES | NBCC | AAFP | GA POST | GA Bar
Presenters Bennett Allen, MA
Research Associate, New York City Department of Health and Mental Hygiene
 
Alex Harocopos, MS
Senior Research Associate, New York City Department of Health and Mental Hygiene
 
Aaron Willis, AM, LSW, PhD Candidate
Indiana University School of Social Work
Moderator Grant T. Baldwin, PhD, MPH
Director, Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, and Member, Rx & Heroin Summit National Advisory Board
Session Description As rates of opioid and heroin misuse and associated harms continue to rise, the relationship between the drugs is being studied. This session will present research that attendees can use to inform prevention and intervention efforts in their communities.

The first presentation will investigate heroin initiation following non-medical opioid analgesic (OA) use in New York City, based on a study by NYC RxStat — a multi-agency, public health/public safety collaborative. Through in-depth interviews with individuals who initiated heroin within the past five years following OA misuse — all who were high school graduates with stable housing — several key points of transition were found: dual- to single-entity OAs, oral to intranasal OA administration and the development of physical opioid dependence. Participants described mechanisms of heroin-related stigma dissolution across social networks. The relatively short time to heroin initiation documented serves as an added challenge to the development of prevention interventions.

The next presentation will address heroin’s impact in opiate-related overdose deaths. Using toxicology reports and deputy coroner field reports by the Marion County Coroner’s Office in Indianapolis, similarities and differences were examined between 438 deaths with heroin in the blood and 734 deaths with no heroin in the blood from 2007 through 2014. The presenter will consider characteristics such as a history of previous overdoses, substance misuse, mental health concerns, recent incarceration and intravenous needle use, as well as explore predictive factors of an overdose death from the use of particular opiates. The goal is to assist in identifying additional areas for preventive and intervention strategies targeting Rx painkiller and heroin misuse and overdose fatalities.

Learning Objectives 1. Describe efforts to prevent Rx drug and heroin misuse and overdose fatalities.
2. Identify key transition points from opioid analgesic misuse to heroin initiation.
3. Examine the impact of heroin use in opiate-related overdose deaths.
4. Provide accurate and appropriate counsel as part of the treatment team.
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Community Responses to Heroin: North Carolina and Northern Kentucky
Tuesday, March 29, 2016 | 5:45 pm to 7:00 pm
CE certified AMA | ANCC | ACPE | APA | NASW | NADAAC | NCHES | NBCC | AAFP | GA POST | GA Bar
Presenters Kim Moser
Director, Northern Kentucky Office of Drug Control
 
Scott Proescholdbell, MPH
Epidemiologist, Injury and Violence Prevention Branch, North Carolina Department of Health and Human Services
 
Nidhi Sachdeva, MPH
Injury Prevention Consultant, Division of Public Health, North Carolina Department of Health and Human Services
Moderator Kelly J. Clark, MD, MBA, FASAM, DFAPA
President-elect, American Society of Addiction Medicine, and Member, Rx & Heroin Summit National Advisory Board
Session Description Attendees will learn lessons from Northern Kentucky’s community response to its devastating Rx opioid and related heroin epidemics. Working with courts, police, hospitals and county administrators, a new Office of Drug Control Policy was formed at a regional level, and it has reached “across the river” into Ohio. The director of this program will talk through the issues, resistance, unlikely allies, successes and less-than successes achieved as this hard-hit community tackles the epidemic head-on.

In North Carolina, medication and drug overdose deaths have increased by more than 300 percent since 1999 and heroin deaths by more than 500 percent since 2010. In the summer of 2015, a cluster of heroin mixed with clenbuterol were reported. In response, the North Carolina Division of Public Health’s Injury and Violence Prevention Branch (IVPB) increased its role. Presenters will describe the new IVPB protocol for being more responsive to events that involve drug overdose. IVPB will coordinate with preparedness and response to initiate appropriate actions, then work directly with key partners to communicate risk and prevention messages to health authorities and the public.

Learning Objectives 1. Describe the problem of heroin mixed with clenbuterol.
2. Explain the protocol developed by the North Carolina Injury and Prevention Branch to respond to events that involve overdose.
3. Outline regional partnerships and programs implemented in Northern Kentucky to respond to the Rx opioid and heroin epidemic.
4. Provide accurate and appropriate counsel as part of the treatment team.
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From Rx Opioids to Heroin
Wednesday, March 30, 2016 | 12:30 pm to 1:45 pm
CE certified AMA | ANCC | ACPE | APA | NASW | NADAAC | NCHES | NBCC | AAFP | GA POST | GA Bar
Presenters Deborah Dowell, MD, MPH
Senior Medical Advisor, Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention
 
Kun Zhang, PhD
Health Scientist, Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention
 
Jon E. Zibbell, PhD
Health Scientist, Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention
Moderator Grant T. Baldwin, PhD, MPH
Director, Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, and Member, Rx & Heroin Summit National Advisory Board
Session Description The number of first-time heroin users grew from 90,000 people to 156,000 between 2006 and 2012, according to the Centers for Disease Control and Prevention (CDC). In this session, CDC researchers will explore the link between this trend and the nation’s Rx drug abuse epidemic.

The first presentation will focus on the transition from Rx opioid misuse to heroin. The presenters will discuss the dramatic increase in the number of persons using and dying from heroin and the relationship this surge has with the country’s on-going Rx opioid epidemic. The presenters will demonstrate why these epidemics should be understood as two distinct but interrelated trends and why they require a comprehensive response that moves beyond interdiction-only approaches to include efforts that address the major health consequences associated with opioid addiction (e.g. overdose and infectious disease). Topics will include the social, physiological and pharmacological factors associated with the transition from Rx opioid misuse to heroin and the elevated risk associated with the continued presence of illicitly manufactured fentanyl in the heroin supply. The presenters will offer evidence-based interventions, both behavioral and medical, as practical strategies to increase health outcomes among this population.

Next, researchers will present a recent study that examined the relationship between state-level Rx opioid policies and heroin overdose deaths (HOD) between 2006 and 2013. The findings they discuss will include:
• HOD rates increased throughout the study period in states that did and in states that did not implement Rx opioid policies, from 0.73 to 2.70 deaths per 100,000 population.
• Implementation of pain clinic laws and of pain clinic laws combined with mandated provider review of Prescription Drug Monitoring Program (PDMP) data were not associated with changes in HOD.
• Mandated PDMP review combined with pain clinic laws appears to reduce amounts of opioids prescribed and opioid-related overdose deaths.

Learning Objectives 1. Identify social, physiological and pharmacological factors associated with the transition from Rx opioid misuse to heroin.
2. Outline evidence-based interventions as practical strategies to increase health outcomes among the opioid dependent population.
3. Analyze the relationship between state-level Rx opioid policies and Rx opioid and heroin overdose deaths.
4. Provide accurate and appropriate counsel as part of the treatment team.
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HIDTA Heroin Response Strategy
Wednesday, March 30, 2016 | 2:00 pm to 3:15 pm
CE certified AMA | ANCC | ACPE | APA | AAFP | GA POST | GA Bar
Presenters Jeremiah A. Daley, MBA
Executive Director, Philadelphia/Camden High Intensity Drug Trafficking Area
 
Vito S. Guarino, MA
Public Safety Coordinator, Heroin Response Strategy, Philadelphia/Camden High Intensity Drug Trafficking Area
 
Peter Luongo, PhD
Public Health Coordinator, Heroin Response Strategy, and Executive Director, Institute for Research, Education and Training in Addictions
 
Chauncey Parker
Director, New York/New Jersey HIDTA, and Member, Rx & Heroin Summit National Advisory Board
 
Marcia Lee Taylor, MPP
President and CEO, Partnership for Drug-Free Kids
Moderator Regina M. LaBelle, JD
Chief of Staff, White House Office of National Drug Control Policy, and Member, Rx & Heroin Summit National Advisory Board
Session Description The High Intensity Drug Trafficking Areas (HIDTA) program assists federal, state, local and tribal law enforcement agencies operating in areas determined to be critical drug-trafficking regions of the United States — an area covering 60 percent of the U.S. population. In this session, attendees from all U.S. communities will take home lessons from the HIDTA Heroin Response Strategy (HRS) — an innovative platform, designed to enhance public health-public safety collaboration across five HIDTA regions, with the goal of reducing drug overdose deaths.

The presenters will explain the structure and key components of HRS, as well as steps taken to ensure successful implementation. The HRS leverages a network of Drug Policy Analysts and Drug Intelligence Officers in 15 states, spanning Appalachia, the Mid-Atlantic and the Northeast. Drug Policy Analysts gather, analyze, and distribute health and safety drug-related data; develop and support data-driven policy and programming initiatives; and facilitate interagency public health-public safety collaboration. Drug Intelligence Officers are experienced law enforcement officers who establish points of contact and facilitate seamless information sharing across jurisdictional boundaries. This innovative law enforcement model is designed to yield smarter responses to increasingly expansive and sophisticated drug trafficking and distribution threats.

Learning Objectives 1. Describe the HIDTA Heroin Response Strategy.
2. Explain how to enhance public health-public safety collaboration to reduce drug overdose deaths.
3. Identify effective heroin response strategies that can be replicated in non-HIDTA communities.
4. Provide accurate and appropriate counsel as part of the treatment team.
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Community Responses to Heroin: Huntington, WV, and Camden County, NJ
Wednesday, March 30, 2016 | 3:30 pm to 4:45 pm
CE certified AMA | ANCC | ACPE | APA | NASW | NAADAC | NCHES | NBCC | AAFP | GA POST | GA Bar
Presenters Harry Earle, MA
Chief of Police, Gloucester Township (NJ) Police Department
 
William J. Lynch, Jr., RPh
Clinical Staff Pharmacist, Kennedy Health System, and Member, Camden County Addiction Awareness Task Force
 
Jan Rader, RN
Deputy Chief, Huntington Fire Department
Moderator Jackie L. Steele, Jr., JD
Commonwealth Attorney, Kentucky 27th Judicial Circuit, and Vice Chairman, Operation UNITE Board of Directors
Session Description The City of Huntington, WV, and the surrounding areas are experiencing one of the highest rates of heroin addiction in the country. In the first six months of 2015, there were 474 overdoses in Huntington, with 34 of them being fatal. Along with the rise in heroin use, there is also a public health epidemic. Hepatitis B, Hepatitis C and HIV infections have increased in the region and state, and approximately 275 babies were born with neonatal abstinence syndrome (NAS) in Huntington hospitals in 2014. This presentation will explore the problem in depth along with current and future programs that will lead those suffering from addiction through a portal to recovery.

Next, presenters will describe the battle against the heroin epidemic in Camden County, NJ, which had the state’s highest overdose death rate in 2014 with 93 deaths. The county is dealing with some heroin potency that has been found to be as high as 92 percent. Presenters will outline the programs crafted to respond on all fronts. For example, by equipping first responder police officers with nasal naloxone, 111 lives were saved in the last six months of 2014. They will explain how medical and law enforcement communities pulled together to combat the scourge of fentanyl-laced heroin, which hit the community hard in 2015 with 22 deaths in June alone.

Learning Objectives 1. Examine two communities’ responses to their heroin crises, emphasizing collaboration among stakeholders.
2. Describe the programs being implemented by Huntington, WV, as part of its holistic approach to heroin addiction.
3. Outline the programs developed in Camden County, NJ, to respond to its heroin epidemic.
4. Provide accurate and appropriate counsel as part of the treatment team.
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The content and scheduled time of these breakout sessions are subject to change.