Heroin and Opioids Update: A Community Public Health and Safety Crisis - June 2017

1. Heroin & Opioids Update
A Community Public Health and Safety Crisis
Fairfax County, Virginia
Updated June 2017
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2. What’s going on?
An epidemic of addiction to heroin and other opioids
has gripped the nation. Overdose deaths are
skyrocketing.
• It’s happening throughout Virginia.
• It’s happening here.
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3. Crisis in Virginia  2016
• More than 1,100 Virginians died from an opioid overdose, including from
prescription opioids, heroin, and fentanyl.
• Virginia emergency departments reported more than 10,000 visits for opioid
and heroin overdose treatment.
• Emergency medical services workers reported more than 4,000 uses of
naloxone, an overdose-reversal drug.
• Carfentanil, used to tranquilize animals, is 100X more potent than fentanyl, and
has been identified in overdose deaths in Fairfax County.
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4. Crisis in Fairfax County  2016
• More than 100 drug-related deaths – more than
any other jurisdiction in the state.
• 80 of the deaths were related to opioid overdoses
(compared with 60 opioid-related deaths in 2015).
• EMS workers reported 369 uses of naloxone to
reverse opioid overdose. (Jan-Sept)
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5. What are opioids?
• Opioids act on the brain; produce euphoric effect.
• Often prescribed to relieve pain. Morphine, oxycodone, hydrocodone,
tramadol, methadone and fentanyl are all opioids.
• The illegal drug, heroin, is also an opioid.
• Highly addictive, even lethal, if used improperly.
• Carfentanil (an opioid tranquilizer used on large animals) has appeared in
illegal drug markets and is extremely dangerous for humans.
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6. Fentanyl encounters on the rise
• Fentanyl used for pain management for
Stage 4 cancer patients.
• Ten times more potent than heroin.
• Lethal dose of pure fentanyl is about the size of a few grains of
salt.
• From 2014 to 2015, fentanyl encounters more than doubled in
the U.S. (from 5,343 to 13,882).
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7. Carfentanil
• Now present in illegal U.S. drug markets.
• 10,000 times more potent than morphine;
100 times more potent than fentanyl.
• Depresses the central nervous system and ability to
breathe.
• Tiny particles (through nose, mouth, injection) can create
life-threatening effects within minutes of exposure.
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8. What is addiction?
• A chronic disease; can lead to death if not treated. Brain
chemistry is altered.
• Individual is unable to abstain from the drug; loses ability to
control behavior.
• Emotional responses become dysfunctional; judgment becomes
impaired.
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9. Behavioral warning signs
• Spends a lot of time alone.
• Loss of interest in favorite activities.
• Eats a lot more or a lot less than usual.
• Emotionally erratic: quickly changes
between feeling bad and good.
• Seems tired, sad or nervous, cranky – or
unusually energetic.
• Talks fast, says things that don't make
sense.
• Sleeps at strange hours.
• Misses important appointments.
• Neglects personal hygiene.
• Has problems at work or school.
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10. Risk factors for addiction
• Genetic – Person with family member who has addiction is at greater risk.
• Environmental – Parents not involved with children, peer use, social settings.
• Early use – More likely to develop addiction if use starts when young.
• Smoking or injecting – More addictive because drug passes directly into
bloodstream and brain without being filtered through liver and other organs.
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11. Physical signs of heroin use
• Pupils of eyes are small, pinpoints.
• Decreased respiration rate.
• Sleepy or non-responsive.
• No appetite.
• Intense flu-like symptoms: nausea, vomiting, sweating,
shaking of hands, feet, or head.
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12. • Change in attitude/personality
• Avoiding contact with family
• Change in friends, new hangouts
• Change in activities, hobbies,
sports
• Drop in grades or work
performance
Behavioral signs of heroin use
• Isolation and secretive behavior
• Moodiness, irritability,
nervousness, giddiness
• Stealing
• Wearing long-sleeved shirts out
of season
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13. Warning signs of drug use
• Missing medications
• Burnt or missing spoons or bottle caps
• Syringes
• Small bags with powder residue
• Missing shoe laces or belts
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14. If someone overdoses…what to do
• If you can’t get a response or you hear a deep snoring sound, don’t assume
the person is asleep; this can be a sign of an overdose.
• Call 911 immediately. Stay with the person.
• Not all fatal overdoses happen quickly; sometimes it can take hours.
Action taken during those critical hours can save a life.
• If Naloxone is available and you’ve been trained to use it, do so.
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15. What can I do?
• Learn the warning signs, be aware.
• Know where to get help.
• Clean out your medicine cabinet; dispose of unused, leftover
prescriptions safely.
• Learn how to dispense Naloxone, which reverses effects of
opioid/heroin overdoses. Find a class at
www.fairfaxcounty.gov/csb/revive/.
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16. Help is here, 24/7.
If emergency is immediately life-threatening, call 911.
CSB Emergency Services at Merrifield Center
(8221 Willow Oaks Corporate Drive in Fairfax) – Available 24/7.
You can come in to the Merrifield Center directly or call first. 703-573-5679 TTY 711
Fairfax Detoxification Center – Call 703-502-7000 TTY 703-322-9080
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17. Think you may need help?
• Take a free online, confidential screening, anytime 24/7:
http://screening.mentalhealthscreening.org/northern-virginia
• Come in person to the Merrifield Center during business hours and
talk with our entry and referral staff, Monday through Friday, 9 a.m.
to 5 p.m. Youth walk-in evaluations are offered during these times
and also until 7 p.m. on Tuesdays.
• Or call us at 703-383-8500 TTY 711.
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