A rural Pennsylvania community gathers to talk about overdose

In the first two months of this year, 22 people died from opiate overdoses in Pennsylvania’s Westmoreland County, which neighbors Allegheny County, where IRETA is located.  This represents a startling increase: in 2002, there were 22 total overdose deaths in Westmoreland County and in 2012, 78 overdose deaths in all.

At this pace, by the end of 2013, 132 county residents will die from overdose.

Determined to change this frightening trend, hundreds of parents and students gathered in the auditorium of Hempfield Area High School last week for a drug summit on federal, state, and local solutions to the overdose crisis.  David Mineta, DeputyDirector of Demand Reduction at the Office of National Drug Control Policy (ONDCP) represented the White House.  Pennsylvania Attorney General Kathleen Kane joined him as a panel presenter, as did local law enforcement representatives, judges, and the drug preventionists.

The event was standing room only.  Many carried pictures of young people who had died and raised them above their heads whenever the crowd applauded.

Below is a compilation of resources referenced by conference panelists to help community members come together to begin addressing the local overdose epidemic.

Federal Resources

david-minetaDavid Mineta of the White House ONDCP emphasized the importance of spreading the message “that a drug free life can be happier, healthier, and more successful.”  He pointed to Above the Influence, an ONDCP campaign that helps teens develop multimedia educational materials for their peers.

He also discussed SAMHSA’s Drug Free Communities grants, which fund community coalitions to prevent drug abuse, and the DEA’s National Take-Back Initiative, which provides communities with safe, convenient, and responsible prescription drug disposal and educates the general public about the potential for abuse of these medications.  The next Take-Back Day is April 27.

Mineta, whose background is in social work, told the audience that overdose prevention is a critical piece of ONDCP’s mission.

State Resources

kathleen kanePennsylvania Attorney General Kathleen Kane focused on prescription medication abuse.  Resources from the Attorney General’s office include a diversion program for healthcare providers to report patients suspected of diverting medications, an ongoing investigation of overprescribers, and an Education and Outreach Unit available for school- and community-based presentations.  More detail is available on the Attorney General’s website.

She also referenced the importance of passing HB 317, a bill in the PA House that would create a statewide prescription drug monitoring system for practitioners that would record patients’ pharmaceutical prescriptions.  Currently, although Pennsylvania has a prescription drug monitoring system, only law enforcement agents can access it.

Local Resources

Local-level resources were proffered by a number of panelists, including law enforcement, prevention specialists, and advocates.  They included:

Sage’s Army: An advocacy group founded by Carmen Capozzi, in memory of his son Sage who died of a heroin overdose last year.   The group meets every second Thursday  in Irwin, PA and has an active Facebook group.

Life Skills program: An evidence-based prevention program that Pennsylvania school districts can apply to participate in.

Community Prevention Services of Westmoreland County: A county-level prevention service provider that offers school-based programs and oversees local implementation of the statewide Student Assistance Program, which assists school personnel identify and support students dealing with substance abuse issues.

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The FAQ portion of the evening allowed parents and community members to talk about their concerns and ideas.  They talked about the importance of better tracking of prescription medications, the need for specialized D&A counseling in schools, and ways that parents and adults influence young people’s substance use choices.

“If adults have a problem with drugs, reach out,” said a member of the community and Hempfield High graduate, pointing out that children model adult behavior.

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The panelists had limited time, so the resource list above is naturally not comprehensive.  Two other important parts of the solution bear mentioning: naloxone and SBIRT.

Naloxone, sold under the brand name Narcan, is an opiate antidote that will reverse the effects of overdose within minutes.  Advocates are pushing for wider distribution of
naloxone, with support from the scientific and clinical community, but it is currently not available in schools or other public places frequented by young people.  However, prescriptions are available through primary care providers.  Interested parents can talk to their PCP or their child’s pediatrician.

SBIRT, Screening, Brief Intervention and Referral to Treatment, is a public health approach to substance use.  It demystifies the question of “how to talk about drugs.”  An individual trained in SBIRT knows how to ask a few questions about alcohol and drug use, perform a brief motivational intervention (if necessary) and offer a referral to available specialized services (again, only if necessary).

There is strong evidence that implementing SBIRT universally in primary care would reduce the harms associated with substance misuse, including overdose.  It’s worth pushing for.  However, even SBIRT training for a school counselor, coach, or after school program staff member would be a step toward reducing overdose in a community.

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The idea that “it takes a village” was referenced many times at the Westmoreland County drug summit last week.  The sheer number of people packed into the auditorium, including those without children of their own, is testament to the wide support for community action to reduce overdose.

During his presentation, Mineta said to the audience, “Hands up if you knew someone who’s died of an overdose.”  About a third of the audience raised their hands.

Then he told the crowd, “Stand up if you want to support these people and do something about overdose in this community.”

Everyone rose quietly.  Pictures of young people were raised high.  It was a powerful moment.

Given the national numbers, we know that Westmoreland County residents are not alone in their struggle. Over 38,000 people die each year of drug overdose in the U.S, more than the number killed in car accidents. Communities all over the country are coming together, just like at Hempfield High school last week, to ask hard questions about overdose and how to work together to reduce it.

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Recommended Resources

When Numbers Get Serious on IRETA Blog (2013)

Overdose Prevention and Treatment Program Can Save Lives on Join Together (2013)

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IRETA has blogged about the local overdose epidemic before and will continue to cover this important public health issue  on our blog, e-newsletters, and through social media.