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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