Perspectives on opioid and heroin use in south central Pennsylvania Criminal Justice Trends and initiatives in opioid and heroin abuse: A panel discussion RESEARCH BRIEF

The contours of the convened to discuss the issue in 2017-18 Pennsylvania state depth, and to identify current budget (Madej, 2017). problem: Overdose initiatives to address the problem. Narcan is also now widely and death available to citizens over- The panel was comprised of: the-counter. Drug overdoses are the leading  Police officers cause of accidental death in the  Treatment providers The police officers on the U.S. having surpassed  Researchers panel credited equipping shootings and traffic accidents police and other first almost a decade ago (Centers Initiatives responders with Narcan as a for Disease Control and key factor in keeping the opioid overdose death rate Prevention [CDC], 2016). From A key initiative gaining increasing in Pennsylvania from 2014-2015, overdose deaths traction in managing opioid overdose climbing even higher than rose by 11 percent, to 52,404, in Pennsylvania and the greater sixth in the nation, and with roughly 63 percent of region, is the equipping of emergency lauded it as a sort of wonder those deaths involving an medical technicians, police, and other drug. opioid such as heroin, fentanyl, first responders with the opioid or other prescription opioids overdose reversal drug naloxone like Vicodin or Percoset (often (trade name: Narcan), which has been Misconception #1 prescribed legally for routine on the market since 1971. pain management). The Addiction propensity significant increases in drug In 2014, Pennsylvania passed Act overdose deaths were seen While productive discussion 139, which allows first responders ensued, key misconceptions primarily in the northeast, acting at the direction of a health care midwest, and mid-south emerged that were endorsed professional to prescribe Narcan and by several of the panelists. regions of the U.S. (CDC, 2016). to administer the drug to persons Pennsylvania had the sixth experiencing an opioid overdose. The highest overdose death rate law also provides immunity from among all states in 2015, at prosecution for citizens who report One misconception centered 26.3 deaths per 100,000 overdoses. on the belief that individuals persons (CDC, 2016). are equally vulnerable to addiction, which ignores As drug overdose death rates research on differences in continue to rise sharply (CDC, Narcan has also been made individual propensity. Only a 2017; Ruhm, 2017), especially available in newer, easier-to-use small portion of those who in Pennsylvania and the mid- become dependent on Atlantic region, a panel of local formulations (intranasal). As of prescribed opioids become stakeholders working in drug November 2017, first responders addicted, even fewer turn to treatment and policing was across Pennsylvania may apply for Narcan kits made available illicit opioids like heroin. with $5 million of the Criminal Justice Current research Misconception #2 This suggests that some individuals Cannabis as a “gateway” to This panel informs current field are more vulnerable to addiction opioid abuse research where interviews with than others, an important point not professionals employed in Itaddressed is well established by the panelists that persons. Another misconception that was policing, emergency medical who experience childhood adversity endorsed by several panelists in response, and drug addictions have a higher risk for addiction as policing and in treatment was the treatment in Lancaster County, adults (Fishbein & Ridenour, 2014). “gateway theory of drug Pennsylvania Rates of addiction are higher among addiction” or the belief that using examine persons whose childhoods are beset drugs like cannabis inevitably perceptions ofare Narcan being as a with mental and behavioral health leads to using other, more mobilizedconducted responseto to the opioid problems, poverty, lack of parental dangerous “hard” drugs, like overdose problem. involvement and social support, cocaine or heroin. The point raised geographic or social isolation, by the police was that one of the The study has several specific negative peer influences and poor principal drivers of the opioid aims: schools, compared with those who death crisis is the medicalization, 1) Assess whether Narcan is an use drugs but do not develop decriminalization, or outright effective first step biomedical addictions. This suggests that drug legalization of cannabis in various intervention in treating drug addiction is a social problem as U.S. states. Pennsylvania legalized addiction; much as it is a neurobiological one, cannabis for medical use in 2015, 2) Assess the role Narcan plays or due to the chemical properties of and cannabis possession has been in the treatment of opioid misuse specific kinds of dangerous drugs. decriminalized in Harrisburg, after the pre-hospital phase; Philadelphia, and other 3) Identify possible breaks in the In addition to individual variation in jurisdictions. chain of care; and propensity to addiction, there are 4) Propose changes to better additional concerns related to opioid It is important to note that mitigate against overdose and misuse and death that work to decades worth of studies find that relapse. obscure or misrepresent the nature cannabis use does not inevitably of the problem in all of its lead to more serious drug use, complexity, some of which have either in the long- or short-term. been previously identified by In fact, the U.S. government's own neuroscientist Carl Hart (2016). Institute of Medicine issued a Contact: These include: statement in 2008 that there is no Philip R. Kavanaugh, Ph.D. scientific evidence supporting the Phone: 717-948-6778  Opioid-sedative combination gateway theory of addiction. Its Email: [email protected] deaths; endorsement by those in policing  Acetaminophen toxicity; and underscores the importance of  Addiction. folklore and myth in drug debates, Sponsor: even among professionals School of Public Affairs in working across treatment and partnership with Penn State Justice and Safety Institute criminal justice. One of the key issues is persons using opioids in combination with popular legal recreational drugs like alcohol. This suggests that it is poly- drug use that is driving much of the 777 West Harrisburg Pike So,death. while it is certainly possible to Middletown, PA 17057 die from an overdose involving a Harrisburg.psu.edu single opioid drug, this accounts for Penn State is an equal opportunity, affirmative only about a quarter of opioid- action employer, and is committed to providing employment opportunities to all qualified related deaths each year. applicants without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. U.Ed. HBO 18-29

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