Sustaining and expanding the capacity of current prevention programs in Clermont County is one of the most effective and cost-efficient ways to combat the opiate epidemic. Research shows that $1 spent on school-based substance use prevention programs can potentially save an estimated $18 in costs stemming from substance use.
Effective prevention efforts must be comprehensive, focus on all forms of drug misuse or abuse and address both individual and environmental influences associated with drug abuse. To prevent opiate abuse, we must create and promote a culture conducive to Clermont County residents making healthier choices of all kinds.
School-based prevention programs have been, and will continue to be, an important part of prevention efforts in Clermont County. However, reversing the epidemic requires prevention and outreach activities that touch Clermont County residents of all ages.
Our goal is to prevent the misuse of opiates and prevent new cases of addiction in Clermont County.
Educate the community about opiate abuse, including the symptoms of opiate abuse and the myths surrounding opiate use.
Up to 50 percent of medications are not taken as prescribed. According to the Coalition for a Drug Free Cincinnati, almost 18 percent of students in grades 7-12 said that using someone else’s prescription drugs was not harmful or only somewhat harmful. The Mayo Clinic identifies a lack of knowledge about prescription drugs as a risk factor for prescription drug abuse.
Create awareness of the existing prevention resources in the community.
There are several existing prevention programs in Clermont County, and the Opiate Task Force is already carrying out additional activities such as distributing fact sheets about opiate abuse and overdoses to the general public.
Educate prescribers about the dangers of opioid prescriptions.
Prevention activities are more effective when reinforced by policies, systems and standardized methods of tracking overdoses and other relevant information.
To help prescribers successfully intervene with patients who may be abusing opiates or who may be at risk for doing so, the Opiate Task Force promotes the use of SBIRT (Screening, Brief Intervention, and Referral to Treatment), an evidence-based approach to intervening at an earlier stage with people who are misusing substances or who are at risk for doing so. SBIRT can be offered in nearly any setting, but is typically seen in emergency rooms and primary care settings. It is designed to assist patients whose presenting issue may be something other than substance use or misuse. SBIRT is a prevention-based service that reduces the odds that someone will go on to develop a diagnosable substance use disorder.
Increase knowledge and availability of prescription drug boxes.
Since it can be tempting for children to try substances that are already in their homes or in others’ homes, it is important to reduce the availability of these substances that are no longer being used. Three police stations in Clermont County currently offer drop boxes where citizens may discard their unused prescription medications (Note: syringes and liquids cannot be put in the drop boxes). Clermont County requires six more drop boxes, and more must be done to publicize their availability.
Advocate for more school-based prevention program funding.
Although school-based prevention programming exists in Clermont County, more is needed to combat an epidemic of this magnitude.
Law enforcement agencies in Clermont County are committed to making a difference in the fight against opiate abuse and the eradication of heroin from the county by decreasing access and supply. Our approach includes the following action steps:
Support the work of street-level officers in Clermont County.
Street-level officers have the most direct exposure to people’s drug-related behavior, and they are often the first to experience drug-related trends in the county. Support for Clermont County’s street-level officers includes:
Support the work of organized law enforcement units.
The Clermont County Narcotics Unit is comprised of three law enforcement officers from the Clermont County Sherriff’s Office and one officer each from Pierce, Miami and Union Townships. Support for the work of the Narcotics Unit includes:
Educate the public.
The opiate epidemic affects every county resident. Clermont County’s law enforcement agencies and other organizations remain committed to educating the public about heroin and related issues. This includes:
The Clermont County Opiate Task Force’s recommendations for treatment and recovery are rooted in two assumptions: Addiction is a treatable disease and treatment is a sound investment. Based on data from the Substance Abuse and Mental Health Services Administration, approximately 12,106 residents of Clermont County are either dependent on or abuse alcohol and 4,915 are dependent on or abuse illicit drugs. The need greatly exceeds the availability of services in the county, especially for low-income residents.
Our goal for more residents to achieve long-term recovery as a result of addiction treatment, related services and sober support groups requires our community to:
Establish a residential detoxification program in Clermont County for indigent, uninsured and underinsured residents.
Clermont County has no residential detoxification program. The Opiate Task Force recommends establishing a 15-bed program for adult men and women. Residential detoxification provides:
Increase the availability of intensive outpatient treatment and medication-assisted treatment provided in conjunction with counseling.
The Clermont County Mental Health and Recovery Board contracts with Clermont Recovery Center to provide intensive and traditional outpatient treatment to county residents, regardless of insurance status or ability to pay. To better address the epidemic, intensive outpatient treatment needs to increase from 560 slots to 700 slots by 2016.
Establish 150 units of recovery housing in Clermont County.
There are no known sober-housing facilities or units in Clermont County. These facilities offer alcohol-and drug-free living arrangements for people in recovery from addiction in either group settings or individually leased apartments. Recovery housing can serve as a stepping stone between residential treatment and a full return to normal life. It also can serve as a permanent home if someone lacks family support or would otherwise have to live in a neighborhood not conducive to recovery.
The Opiate Task Force deems residential detoxification and sober housing as a pressing residential need. County residents need an accessible, safe place to undergo withdrawal from opiates and other substances regardless of the person’s insurance status or ability to pay. Although residential treatment benefits clients, most programs can only afford limited services during the acute phase of recovery. Sober housing will benefit clients over a longer period of time while increasing the stock of affordable rental housing in the county.
The Clermont County Mental Health and Recovery Board is currently in a collaborative partnership with several surrounding counties to provide and/or develop detox services and sober housing on a regional basis, using limited-time funds.
Strengthen treatment providers’ collaborations with mutual help groups such as Narcotics Anonymous (NA), Alcoholics Anonymous (AA) and SMART Recovery:
Treatment providers have a long history of collaborating with 12-Step fellowships such as Alcoholics Anonymous and Narcotics Anonymous to get their clients the long-term support they need to remain sober. Clients needing an alternative form of sober support now have options such as SMART Recovery® and Celebrate Recovery available in Clermont County. Mutual help groups and peer-support networks have played vital roles in helping many people remain sober and must remain available and easily accessible to all who need them.
Increase the availability of vocational services available for people in treatment.
By the time most opiate-addicted clients come to treatment, they already have a criminal record, which limits their employment options. Finding and keeping a job is more difficult if the client has few or no marketable skills and/or an unstable work history. To better address this need, the Opiate Task Force recommends expanding the county’s vocational assistance program, ASPIRE, from 80 slots to 200 slots by 2016.
Harm reduction refers to a set of practices and strategies designed to reduce the negative consequences associated with drug use. One of the main goals of harm reduction is to keep people alive long enough to eventually benefit from addiction treatment or medical care. Harm-reduction practices and strategies are guided by the following principles and beliefs:
The goal of harm reduction is to reduce the harmful effects of intravenous drug use and to decrease the public health risk to the community. The primary targets identified by the Clermont County Opiate Task Force include decreasing:
1.The transmission of hepatitis C, HIV and other infections through accidental needle sticks.
2.The number of new hepatitis C, HIV and other infections caused by intravenous drug use.
3.The number of unintentional overdoses due to opiate use.
In order to decrease opiate-related deaths and the rate of new hepatitis C infections in Clermont County, the following strategies must be sustained or implemented by 2016:
Increase community-based Naloxone distribution.
The Clermont Mental Health and Recovery Board recently received a two-year, $42,250 grant from Interact for Health to implement the Project D.A.W.N. (Deaths Avoided with Naloxone) initiative in the county. Through this program, Clermont Recovery Center (CRC) implemented, approximately 800 CRC clients at risk for an overdose, or their family members, will receive Naloxone kits to reduce overdose deaths. Funding also was provided to the Clermont County Sheriff’s Department to purchase Narcan kits. Deputies were trained and are now carrying the kits with them. Additional Naloxone kits must be distributed to first responders and others in the county to further reduce the incidence of overdose deaths.
Increase community support and education.
Provide educational opportunities to the community about various types of harm reduction strategies (Naloxone distribution, medication-assisted treatment, etc.).
Increase awareness and reduce infectious disease risks of HIV, hepatitis B and hepatitis C through education, testing, vaccination and referral for care.
Increase the availability of support services for children whose parents are addicted to opiates and for families affected by opiate addiction.