2/12/2015 - Project Lazarus
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Project Lazarus is a nonprofit organization that provides training and assistance to communities to prevent drug overdoses and meet the needs of those with chronic pain. It believes drug overdoses are preventable if communities take responsibility for their own health. The document discusses drugs involved in overdoses in Jackson County such as opioids, benzodiazepines, and antidepressants. It outlines physical and behavioral signs of prescription drug abuse and provides information on how to properly take, store, dispose of, and never share prescription medications to help create a healthier community.
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2/12/2015 - Project Lazarus
- 2. PROJECT LAZARUS IS A GRANT- SUPPORTED PROGRAM THROUGH THE JACKSON COUNTY DEPARTMENT OF PUBLIC HEALTH Medication Safety
- 3. Who is Project Lazarus? •Nonprofit organization •Provides training and technical assistance •Using experience, data, and compassion we empower communities and individuals to prevent drug overdoses and meet the needs of those living with chronic pain •Believes that communities are ultimately responsible for their own health and that every drug overdose is preventable.
- 5. Overdose • Defined: • Prescription Drug Misuse • Accidental Poisoning • Who: • Patient misuse • Family/Friends sharing to self medicate • Recreational User • Substance Use Disorder/Treatment/Recovery
- 6. • Benzodiazepines • Xanax, Valium, Ativan • Opioids • Morphine, methadone, hydrocodone, oxycodone • Tranquilizers • Valium, Librium, Halicon • Antidepressants • Celexa, Lexapro, Prozac • Psychotropics and stimulants • Adderall, Ritalin, Depakote, Effexor • Diabetes medication • Aspirin Drugs involved in overdoses in Jackson County
- 7. Physical symptoms of Rx abuse
- 8. Behavioral signs of Rx abuse • Stealing, forging or selling prescriptions • Taking higher doses than prescribed • Excessive mood swings • Increase or decrease in sleep • Poor decision making • Appearing to be high, unusually energetic or revved up, or sedated • Continually "losing" prescriptions, so more prescriptions must be written • Seeking prescriptions from more than one doctor
- 9. •Overdose deaths are surpassing motor vehicle deaths •Preventable •A concern for every community member Why is it important?
- 11. DATA ATTRIBUTION AND DISCLAIMER: NC DHHS/DPHNC DETECT ED VISIT DATA WERE MADE AVAILABLEFOR THIS PRESENTATION BY THE NC DETECT DATA OVERSIGHT COMMITTEE. THE NC DETECT DATA OVERSIGHT COMMITTEE INCLUDES REPRESENTATIVESFROM THE NORTH CAROLINA DIVISION OF PUBLIC HEALTHIN THE DEPARTMENT OF HEALTHAND HUMAN SERVICES, THE CAROLINA CENTER FOR HEALTHINFORMATICS IN THE DEPARTMENT OF EMERGENCY MEDICINE AT THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL, ANDTHE NORTH CAROLINA HOSPITAL ASSOCIATION. THE NC DETECT DATA OVERSIGHT COMMITTEE AND NC DETECT DO NOT TAKE RESPONSIBILITYFOR SCIENTIFIC VALIDITYOR ACCURACY OF THE METHODOLOGY,STATISTICAL ANALYSIS, RESULTS, OR CONCLUSIONSPRESENTED. 11 Unintentional Poisoning Mortality Rates: North Carolina, 2001-2011 Citation: North Carolina State Center for Health Statistics. NC Health Data Query System. Retrieved April 24, 2013 from http://www.schs.state.nc.us/schs/data/query.html. Crude rates per 100,000 person-years
- 12. CDC Policy Impact: Prescription Painkiller Overdoses Source: CDC-www.cdc.gov/homeandrecreationalsafety/rxbrief/
- 13. ED visits for accidental poisonings*: Jackson and surrounding counties, 2008-2010 195 45 59 516 196 85 118 193 52 85 641 243 158 113 196 36 75 676 223 142 134 0 100 200 300 400 500 600 700 800 Swain Macon Jackson Haywood Graham Clay Cherokee 2010 2009 2008 Number of ED Visits
- 14. Number of prescriptions for controlled substances: Jackson and surrounding counties, 2008-2010 69,321 21,503 17,054 130,342 72,079 69,479 33,111 72,028 24645 20675 132569 74706 67742 31807 73,676 27,676 24,175 150,171 74,329 71,050 34,145 0 20,000 40,000 60,000 80,000 100,000 120,000 140,000 160,000 2008 2009 2010 Numberofprescriptions
- 15. Chronic pain patients •Chronic pain patients at risk for overdose or death, especially when taking opioid pain medication •Help is available for accidental overdoses •Naloxone kits recommended for these patients
- 17. Addiction help and rehabilitation •Smoky Mountain Center – provides help with substance abuse, mental health. Access line available 24 hours/7days for help 1-800-849-6127 •Meridian Health Services-- creates services environments and relationships which instill hope, facilitate choice, foster wellness, promote healing and support individuals on recovery. 828-631-3973 •Barium Springs– provides a safe home through group homes, therapeutic foster care, and other services through the Reclaiming Youth Program 828-586-8958 •Clean Slate Coalition– provides safe, accessible, affordable housing for women in transition. 828-586-3939
- 18. What can you do to help?
- 19. •Take Correctly •Store Securely •Dispose Properly •Never Share Remember to:
- 20. Take Correctly •Read warnings on the label. •Check the list of ingredients for things you may be allergic to. •Know the expiration date. •Don't skip doses -- know how much to take and how long to take it for. •Know which foods or beverages to avoid while taking any medicine. •Ask your health provider about side effects, and report any you experience. •Never share medicines. •Organize the medicines in your home. •Never take or give anyone medicine in the dark. •Keep a written record of medications each person is taking, including prescription drugs, over-the-counter medicines, and herbal and other dietary supplements.
- 21. Store Securely • Seniors can be abused/exploited for their medications. • Some are taking meds out of “your” cabinet for personal use or to sell. • Lock boxes available through Project Lazarus. • Make sure medications of any type are not in plain sight or reach of children.
- 22. Dispose Properly DO NOT Flush Down the Toilet If you do throw away in the garbage……….. Mix prescription drugs with an undesirable substance, such as used coffee grounds or kitty litter, and put them in impermeable, non-descript containers, such as empty cans or sealable bags. If you can’t get to a permanent drop site: Attend Pill Take Back Events
- 23. Dispose Properly Permanent Drop Box Locations Available in Jackson County Jackson County Sheriff’s Office 399 Grindstaff Road, Sylva (828) 586-8901 Available 8 a.m. through 5 p.m. Monday through Friday
- 24. Never Share Don’t be tempted to share your prescription drugs to cut costs for yourself or someone else. This is how improper doses are taken, potentially resulting in an overdose or death. There are programs available, such as SHIIP, to help seniors find low cost prescriptions. SHIIP = Seniors’ Health Insurance Information Program Works to counsel seniors with Medicare beneficiaries and caregivers about Medicare, Medicare supplements, Medicare Advantage, Medicare Part D, and long-term care insurance. Contact Diane Parker at 631-8037
- 25. Adverse Drug Reactions •Approximately 80 percent of adverse drug reaction hospitalizations due to incorrect dosing •Make sure each doctor knows what medications you take •Use one pharmacy •Before leaving the doctor’s office or pharmacy, be sure you understand dosing instructions
- 26. Areas of need in Jackson County •Increase knowledge of and access to Naloxone • Medicaid and other insurance providers cover Naloxone • Continue training law enforcement on need for Naloxone • Promote the Good Samaritan Law •Overdose prevention training •Open communication between patients, families, friends, and providers on prescription drugs •Establish more pain support groups •Seek out alternative ways to manage pain •Promote use of medication logs
- 27. Final Words Responsible medication management can lead to a healthier, safer community. ◦ Take medications correctly ◦ Store medications securely ◦ Dispose of expired, unused medications properly ◦ Never share
- 28. Questions?
- 29. This presentation brought to you by Project Lazarus, a grant-funded program of the Jackson County Department of Public Health. For more information or to participate in Project Lazarus, call the health department at 587-8288 or email jcprojectlazarus@gmail.com. Visit our website at www.jacksoncountyprojectlazarus.wordpress.com. Thank you for your time and attention.
Hinweis der Redaktion
- Introduce yourself. (If needed) Explain that Project Lazarus is a grant-supported project hosted by the Jackson County Department of Public Health. Funding came from Project Lazarus out of Monrovian Falls in Wilkes County, NC and from NC Department of Health and Human Services.
- Project Lazarus started in Wilkes County in 2008 to reduce the high number of prescription drug overdose deaths Has since gone statewide and has been recognized nationally as an evidence based practice Heavy focus on community empowerment and education Led locally by coalition chairperson Charles Easton and JCDPH Health Education Specialist Melissa McKnight
- A conceptualized wheel model is used with Project Lazarus. The Model is made up of 3 core components called The Hub and 7 spokes called The Wheel. The coalition decided to work on Public Awareness through education as an immediate goal. Four of the seven spokes are currently engaged– community education, harm reduction, hospital and ED policy review, and diversion control. The coalition will address the remaining spokes as we progress through these four. Through resources available from the JC Department of Public Health, the coalition is continually collecting data and is also keeping track of each meeting and community event as to evaluate the effectiveness of the effort.
- Results of an overdose can be: Death, paralysis, mental incapacitation, or a full recovery. Remember– overdose doesn’t always lead to death and also overdose doesn’t always lead to a full recovery.
- Data collected from NC DETECT, a reporting system for hospitals in NC The drugs, according to NC DETECT, used in overdoses Overdose: Benzo– impaired balance, ataxia, slurred speech, coma, respiratory depression Opioids– decreased level of consciousness, pinpoint pupils, slowed breathing, blue lips and nails, seizures, muscle spasms Tranqs– Slurred speech, clumsiness, mood swings, difficulty concentrating, nausea, difficulty sleeping, drowsy, lethargy Antidepressants– Tachycardia, drowsiness, dry mouth, nausea, vomiting, urinary retention, confusion, agitation, headach, hypotension, hallucinations, seizures Psychotropics/stimulants– Brisk reflexes, confusion, high or low bp, muscle twitching, brain bleeding, irregular heartbeat, muscle pain, rapid breathing, severe agitation Diabetes meds– Cold sweats, trembling hands, intense anxiety, confusion Aspirin– Upset stomach, nausea, vomiting, fatigue, fever, confusion, collapse, rapid heart beat, rapid breathing, ringing in the ears, hyperactivity, dizziness, seizures, coma
- Refer to chart but don’t read word for word We’ve all heard about symptoms of illicit drug abuse-- pot (dilated eyes, hunger, etc.); meth (erratic behavior, bumpy skin, picking at skin); heroin (needle tracks); cocaine (mirrors, scales, straws, rolled up bills, constant sniffing of nose) NOTE: Nothing in the above list would alert that a loved one was abusing Rx drugs. No clear “traditional” tell tale signs.
- Easier to recognize than physical signs of Rx abuse *If you think you may know someone who is abusing Rx, contact a professional through Meridian Behavior Health, Barium Springs, or the Smoky Mountain Center.
- 2011 National overdose deaths: 33,071 (with some unintentional, some suicidal, some homicidal, and some undetermined) 2012 Jackson County: 1 death Very fortunate but remember that we can only count those coded as overdoses Medical examiners may code death as heart attack or other but may have Rx overdose involved
- There is a misconception that medications acquired with a prescription are always safe to use. These types of drugs do not usually have the negative reputation as “street drugs” like marijuana or heroin. Why? A doctor prescribed them A pharmacist filled them They can be acquired legally (though often are not) They are “pure” Further, these drugs are often cheaper than street drugs due to health insurance like Medicare and Medicaid.
- As you can see, over time unintentional poisoning deaths in NC has dramatically increased, especially in WNC. Pay attention to the red/dark orange coloring as it seems to take over the state. (If someone asks) In 2011 in Jackson County, the unintentional poisoning mortality rate was 15.1-50 deaths per 100,000 person-years.
- Though a large problem, there are not many deaths in Jackson County due to prescription drugs. In 2009, there were 7 accidental poisoning deaths in Jackson County (poisoning deaths attributable to any type of drug, not just opioids). However, this graphic developed by the CDC shows that for every 1 death there are: 10 treatment admissions for abuse 32 ED visits, for misuse or abuse 130 people who are abuse or dependent 825 nonmedical (recreational) users In 2009 in Jackson County, that equates to: 7 deaths 70 treatment admissions for abuse 224 ED visits for misuse or abuse 910 people who abuse or are dependent 5775 nonmedical (recreational) users High numbers for a county of approx. 40,000 Remind folks that this is an estimate based on national data, not exact numbers
- From 2008-2010 in Jackson County 2008: 58 2009: 85 2010: 75 219 ED visits for accidental poisonings Approx 73/year
- Another alarming graph which shows the number of prescriptions for controlled substances in Jackson County. This is the number of prescriptions for controlled substances handed out to Jackson County residents. For 2008-2010, 221,114 prescriptions total 2008: 72,079 2009: 74,706 2010: 74,329 Approx 73,000/year Steadily rising Keep in mind that our county only has 40,000 residents so potentially that is 2 prescriptions per resident.
- Naloxone kits are also know as Narcan kits. Naloxone kits are life-saving kits available for those using opioid medications. Can get a kit through the NC Harm Reduction Coalition at no cost.
- Naloxone Myths Debunked Using naloxone on a drug user will give them the opportunity to use drugs more– NO. Studies report that naloxone does not encourage drug use and in fact has been show to decrease it. Naloxone creates an unpleasant effect (blocking effects of opiates) and causes withdrawals which no drug user wants. Drug users cant be trusted to respond appropriately with naloxone– NO. Since 1996, over 10,000 overdose reversals have taken place using naloxone with the vast majority being done by drug users. Naloxone will keep drug users from seeking treatment– NO. Death keeps drug users from seeking treatment. Naloxone makes people violent– Some truth. Naloxone causes confusion and the “fight or flight” mentality but rarely causes folks to become combative. Naloxone causes heart attacks– NO. Research indicates that complications such as seizures and arrhythmia are very rare.
- These are all great LOCAL services for those suffering from addiction. Reiterate that Project Lazarus is not equipped to help those suffer from addiction beyond giving out the above information. Project Lazarus is more about prevention, education, and awareness.
- The Project Lazarus motto. On all of our materials including t-shirts, flyers, etc.
- Go through list but focus on never sharing medication– you may think you are helping a family member, friend, etc but that medication was not intended for that person. You do not know their allergies, other medications they take that could interact, etc.
- Project Lazarus has lock boxes available for FREE and the Sheriff’s Office has kindly offered to install them.
- Flushing medication down the toilet is bad for the environment as medication enters the water system. Applies to old, expired medication as well.
- Diane Parker is located at the Department on Aging for those who need more information.
- Similar to “Take Correctly.” A bit of a restatement but still important.
- Project Lazarus is developing an action plan to guide our future work. We have been working on awareness raising activities and educational campaigns successfully but know that there is much to be done. Some of the above will be included in our action plan to ensure we move in the right direction. Get a copy of the Good Sam Law to add to presenter notebook Add explanation of each area for presenter to refer to