Heroin and Crime: How Can We Stop It?

Over the past couple of years, we've been charting the rise of heroin use on our tribal lands. Reservations near big cities have been the first to be affected, but even rural areas are suffering from this blight. Tribal police have seen an associated uptick in crime, too. As the White Earth Public Safety Director and Chief of Police, Randy Goodwin, said, "And along with the drug issue, guess what comes with it. Some of the gangs." One California tribe has seen gangland style killings over heroin deals. A big bust by St. Regis tribal officers resulted in three people being charged with multiple gun and drug felonies. The heroin problem for Minnesota tribes has been especially serious, as demonstrated by recent cases in Spirit Lake and Mille Lacs.

To learn more about why heroin is on the rise, what prescription drugs have to do with the problem, and the next steps for addressing the painkiller to heroin link, join us for a tuition-free webinar, Prescription Drugs to Heroin, Part II on June 26, at 10 am. The last session was full, so be sure to reserve your space now! This webinar will focus on developing community-based partnerships.  By assessing areas of strength and opportunity, members of our tribal communities can work together to protect our greatest resource- our children. Tools and resource links will be provided that can be used across programs to support mutual values.

A Hard Look at Stimulant Abuse

When looking at prescription drug abuse, we often focus on the 800-lb gorilla of prescription painkillers. But this beautiful, terrifying and moving article in Gawker, All My Friends Are Dead, gives us a first hand picture of what stimulant addiction can do to yourself and to those around you, and of how common it is for kids (especially boys) to become addicted to Adderall, Ritalin, and Dexedrine at an early age, even under the supervision of a medical professional.

Pill Mills Moving from Florida to Georgia

At the beginning of 2012, prescriptions written at "pain centers" or "pain management clinics" were responsible for at least 7 Floridians dying every day. Thanks to a combination of actions taken by legislators and law enforcement statewide, the number of overdose deaths is finally declining and indicators show that the Florida doctors are practicing medicine, particularly pain management, responsibly.

Meanwhile, in Georgia  the number of mills has surged more than tenfold since the crackdown in Florida and other southern states. The DEA is investigating anyone who moved from Florida to Georgia and opened a pain clinic, but new ones keep poppingup. The legislature might want to take note of Florida's success, and copy some of their tactics, including:

• Entering data in and querying the Prescription Drug Monitoring Program Database
• Passing laws against doctors selling oxycodone, opening "pain clinics"
• Passing laws against drug distributors and pharmacies that sell high volumes of controlled substances
• Committing sufficient resources to prosecute over-prescribing doctors and individuals involved in the prescription pill trade

The last part is critical. The legislature has passed a PDMP law, but the system is not yet up and running. Lawmakers are considering legislation to require stricter licensing for pain clinics, but it's not clear how this program would be managed. 

Killing the Pain Is Killing People

As prescription painkillers become harder to obtain, more expensive and less likely to get you high, opiate addicts in many areas are finding that it's cheaper to satisfy their jones with cheap Mexican heroin. Even though prescription drug-related deaths are have outstripped auto accidents in some areas, heroin is even more dangerous, cut as it is with a variety of chemicals, and of unpredictable potency.

While some areas, like Idaho and Montana, are still wrestling more with methamphetamine abuse (and have passed strict laws to control over-the-counter drugs like pseudoephedrine), more urban regions (like Minnesota, New York, Washington and Florida) are definitely seeing an increase in heroin related deaths and prescription overdoses.

Native Americans experience an overdose rate triple that of the general population, but even suburban parents of promising athletes have been seeing sports injuries tragically turn to opiate addiction, then death by overdose.

We've been sounding this alarm for a while now, but 2013 is the year that we're taking action. Sign up for our tribal drugs of abuse and drug endangered children training program to talk about how this deadly trend is impacting public health, public budgets and public safety in Indian Country. At our regional sessions and our May 1 webinar on the prescription drug to heroin link, we'll provide an overview of the problem and then get to work discussing solutions that will work with the resources we have in our communities. 

Prescription Overdoses Continue to Rise For 11th Year

Federal data compiled by the Center for Disease Control and Prevention show that prescription drug deaths rose for the 11th year in a row, to a shocking 38,329 deaths nationwide. The report, published in the Journal of the American Medical Association, shows that opioid painkillers like Vicodin and Oxycontin are the primary culprits, accounting for 75% of overdoses. Valium contributed to about 30% of the overdoses.

About 17% of these cases were clearly suicides, but the rest seem to have been accidental. The director of the chemical dependency program at NYC's Beth Israel Medical center told AP, "Right now there's a general belief that because these are pharmaceutical drugs, they're safer than street drugs like heroin. But at some point, people using these drugs are going to become more aware of the dangers."

In response to this growing problem, Indian Country Training is continuing its Tribal Prescription Drug Abuse Program, combined with Drug Endangered Children education, for another year. Intensive two-day regional sessions are scheduled for Albuquerque, Nashville, Spokane and Phoenix. For those who can't travel, or want some additional information, webinars are scheduled for May, July, September and November. Contact Indian Country Training for more information on these tuition-free events.

Drug Courts: Success Stories and Funding Opportunities

Throwing drug offenders in jail without addressing the problems that led to their arrest is a recipe for recidivism. In Indian Country, drug and alcohol offenders fill the courts, crowd the jails, and usually end up re-offending after their release. To end this destructive pattern, tribes across the nation have successfully implemented tribal healing to wellness courts. Tribal leaders of the Leech Lake Band of Ojibwe were initially reluctant to join a partnership with the state of Minnesota and the county courts, but with only two reoffending graduates after seven years, they are now vocal advocates of the wellness court, which also accepts DWI offenders. The tribe recently won an award for court innovation from the National Criminal Justice Association.

Participants in a tribal healing to wellness court work hard on their sobriety, involve family and community in their healing, and engage in traditional healing ceremonies, like sweats. Program staff do their part by  monitoring, meeting with and randomly drug and alcohol testing participants, and updating the tribal and county judges on each person's progress. This model works no matter where it's implemented; there is a very successful drug court serving Harris County, TX.

What's the drawback to tribal healing to wellness or drug courts? Without more judges, staff and service providers, courts can only handle a few people at a time. The Ojibwe and Cass County court supports a maximum of 25 offenders at a time and even the Houston court can only accommodate 50 offenders at a time. The Department of Justice BJA and OJJDP both have currently open grant solicitations to implement sustainable family drug court programs and adult drug court programs (link to PDF).

New Decongestant Harder to Use For Meth

Just as pharmaceutical companies have been adjusting the formula for prescription painkillers so it's harder to get an opiate high, Acura Pharmaceuticals Inc has released a kind of pseudoephedrine that is much harder to use as ingredient in methamphetamine. Nexafed contains an inert ingredient that is activated when someone tries to extract the pseudoephedrine, and which prevents crystallization by turning into a thick gel.

We applaud any effort that keeps dangerous drugs off the street and it seems like a promising trend that drug makers are taking ownership of the ways their products can be abused. However, as we've seen with oxycodone and heroin, or even with heroin and Krokodil, drug addicts will find something that meets their need. What does this mean for meth?  We'll be watching as this evolves and let you know.

Battling Heroin in Minnesota Requires Community Coalitions

Read the whole story at Indian Country Today Media Network. The news from Minnesota tribes may be grim, but Walter reminds us that solutions lie in education and community coalitions that battle this problem, starting with preventing and treating prescription opiate addiction.  Besides destroying the user's life and health, heroin use results in increased crime, HIV and hepatitis infections, and drug endangered children living in filthy and dangerous environments. Tribes are working with county, state and federal officials to turn this around, but all concerned community members, from caregivers to teachers and from health care workers to law enforcement officers and Tribal courts need to help with the effort to combat heroin.

Drugs of Abuse: Identification and Abatement in Tribal Housing

Learn to recognize the signs of methamphetamine use, prescription drug and over the counter drug abuse, synthetic drug use or heroin use. In addition to identification, participants will learn effective abatement strategies.

Click on the link to learn more about our upcoming training in Scottsdale, AZ. This two day, interactive program is free for Indian Tribe or Tribal Housing Authority employees. Any other participants can register for $50. Click here to register online.

Rx Drug Take Back Day A Huge Success

Americans turned in 488,395 pounds—244 tons—of prescription and over the counter drugs on Saturday to DEA agents nationwide. Removing these prescription medications from circulation cuts down on the potential for abuse and its catastrophic consequences.  All together, the Take Back events have collected over 1018 tons of prescription pills. We're making progress!

Do you have a Rx Drug Abuse Prevention success story?
Head over to our Facebook page and join the discussion!

Prescription Drug Take-Back Day Saturday, September 29

Coming To A Site Near You

The best way not to become a party to prescription drug abuse is to avoid having drugs in the house that are unused or expired. Prescription and over the counter drugs should never be flushed or put down the drain, to avoid contaminating the water supply. Instead, they must be disposed of in an environmentally safe manner.

To make disposing of unused drugs easier, the DEA will be accepting any pills or liquids you have lying around your house, between 10 am and 2 pm on Monday, September 29. To find the nearest collection site, go to the DEA website to search by your zip code. You can also call 1-800-882-9539 for more information about the program.