Techniques Used in Combating Prescription Drug Abuse

Becky Tussing, RN - Associate Director

KBIC DHHS

November 28, 2012

Bemidji Area I/T/U

Appleton, WI

Graph 1: Rate of prescriptions per 1,000

persons by county, Jan 07-Dec 08 (data from

Michigan Automated Prescription System,

MAPS, city-data.com and 2000 US Census)

4507

2468

1876

1223

0

1000

2000

3000

4000

5000

Baraga Houghton Marquette Ontonagon

0

0.05

0.1

0.15

0.2

0.25 Ja

n-1

1

Feb

-1

1

Mar-

11

Ap

r-1

1

May-1

1

Jun-1

1

Jul-

11

Aug

-1

1

Sep

-1

1

Oct-

11

Nov-1

1

Dec-1

1

Baraga County Unemployment Rate 2011

Baraga County

Michigan

U.S.

In 2007 and 2008, Baraga County had more than twice the prescriptions, per person, of the most dangerous prescription drugs (i.e. Oxycontin, Hydrocodone, etc.) than Marquette County, and nearly four times that of Ontonagon County.

The average amount of prescriptions in Baraga County is 4.5 per person, two more than Houghton County (2.5), and substantially higher than Marquette (1.9) and Ontonagon (1.2).

Graph 1: Rate of prescriptions per 1,000

persons by county, Jan 07-Dec 08 (data from

Michigan Automated Prescription System,

MAPS, city-data.com and 2000 US Census)

4507

2468

1876

1223

0

1000

2000

3000

4000

5000

Baraga Houghton Marquette Ontonagon

0 10 20 30 40 50 60 70

Assaults

Burglary

Child Abuse

Domestic Dispute

Domestic Violence

Drug Related

Harassment

Juvenile

Larceny

Sex Offense

Stalking

Number of Calls

2011 KBIC Tribal Police Calls

“To promote education through public awareness with the specific objective to

eliminate the use of “illegal drugs” for the betterment of the health, welfare, and safety of the Keweenaw Bay Indian Community and

our neighboring communities.”

Prescription Drug Abuse Contract

Direct Observation Random Drug Screens

PDSA Cycle for Controlled Substance Refill requests

MAPS/ Evaluation of prescribing history

Case Management Meetings

Medically assisted Treatment: Vivitrol

Referral network for outpatient substance abuse evaluation

Tribal Council approved Abusive Behavior Policy

Strong administrative support for Medical Staff

Drug Tip Line

KB Tribal Police- K-9 dog, Meth Officer

New Day Treatment Center

Outpatient Treatment/ATR

Transitional Housing

On-Staff Neuro Psychologist

Medically Assisted Treatment- Vivitrol

Wellness Court

Ojibwa Housing

Job Training

Makes it criminal to obtain or attempt to obtain a controlled substance ( or a prescription) for a controlled substance by fraud from a health care provider.

This statue also says that the medical records (or information released) for patients who do this are not protected by the physician-patient privilege, dentist-patient privilege, or any other health professional-patient privilege created or recognized by law.

Any person who shall do any act, or who shall fail to do any act, involving a substance defined as a controlled substance by the Michigan Controlled Substances Act, shall be guilty of a misdemeanor if such act or omission shall occur within the jurisdiction of this court.

A conviction upon a violation of the provisions of this section shall constitute a conviction of a Class B misdemeanor.

Simultaneously obtaining controlled substances from more than 1 physician.

Getting a controlled substance prescription for the same condition from more than 1 provider.

Getting a controlled substance in someone else’s name.

Using altered or falsified information to get a controlled substance.

Simultaneously filling the same controlled substance prescription at more than 1 pharmacy.

Health care providers may disclose protected health information when that information contains what the provider believes to be evidence of a crime committed on the health care facility’s premises. 45 CFR 164.512(f)(5).

Information regarding fraudulently obtaining or attempting to obtain controlled substances by fraud is evidence of a crime committed on the premises of the health care facility.

In 2009 and 2010, in an effort to address the substance abuse problem

in the Keweenaw Bay Indian Community, research into various grants

began.

Through a community-wide effort, in February 2011, the KBIC Healing

and Wellness Court was created.

FACT: Unless substance abusing/addicted offenders are regularly supervised and held accountable, 70% drop out of treatment prematurely.

FACT: Drug Courts are six times more likely to keep offenders in treatment long enough for them to get better.

FACT: Nationwide, 75% of Drug Court graduates remain arrest-free at least two years after leaving the program.

FACT: Rigorous studies examining long-term outcomes of individual Drug Courts have found that reductions in crime last at least 3 years and can endure for over 14 years.

FACT: The most rigorous and conservative scientific “meta-analyses” have all concluded that Drug Courts significantly reduce crime as much as 45 percent more than other programs.

It starts with the Team:

A diverse team of individuals include:

Court Advocate

Prosecutor

Police Commissioner

Probation Officer

Healing and Wellness Coordinator Police Officer

Psychologist-Educator

Judge

All team members have a “say” in the final decision that is made.

In conjunction with Medical and Mental health consultation such as: Vivitrol, Mental Health Counseling, Outpatient Treatment.

Clients work through four phases.

• Must attend at least two support network meetings (AA, NA, Smart Recovery)

• Follow all after care treatment plan as recommended by treatment provider

• Curfew

• Report to Drug Court Coordinator Twice a week. Drug test twice a week plus random testing

• Submit to court ordered mental health counseling recommendations

• Random home visits which include searches and drug tests

• Must attend Academy Psychology Positive Peer Culture Groups

• Thirty consecutive clean days required to move ahead to Phase Two

• Meet with Drug Court Coordinator once per week • • Drug test once a week plus random testing

• Random Home Visits

• Participate in Treatment Plan

• Employment Ready

• Community Service

• Participate in three support network meetings and Academy

Psychology Positive Peer Culture

• Sixty consecutive days clean to move to Phase Three

• Drug Court Coordinator office visits two times a month

• Random Home Visits

• Drug Tests two times a month in addition to random testing • • Educational/Vocational/GED

• Community Service

• Participate in at least 3 Support Network Meetings and Academy

Psychology Positive Peer Culture

• Develop Recovery Plan- Implement the Healthy Living Plan and submit a written narrative describing your lifestyle changes

• Sixty consecutive clean days required to move to Phase Four

• Attend Court Review Hearing once a month

• Participate in Treatment Plan

• Drug Court Coordinator office visits- (1) once a month

•

• Random Home Visits

• Drug Tests (1) once a month plus random testing

• No new criminal involvement

• Follow all previous Court Orders

• Employment Ready (resume, interviewing skills)

• Educational/Vocational/GED

GRADUATION!!!

This is what Wellness Court is about…

REFERENCES

Drug Courts Work. (n.d.). Retrieved October 19, 2012.

Tussing, B., & Pinnow, S. (2012). Regional Health Assessment (Rep.).

KBIC Drug Court

KBIC Drug Task Force

Mark Panasiewicz, Academy Psychology

btussing@kbic-nsn.gov