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S.T.O.P. Heroin: A comprehensive plan to address the heroin crisis in Wisconsin

The Problem

Heroin, an illegal and highly addictive drug, has contributed to a growing number of deaths in Wisconsin. Over approximately a decade, Wisconsin accidental opiate overdose deaths have nearly quadrupled. Last year, deaths from heroin rose 50% to 199. This is a huge increase from the average of 29 deaths each year between 2000 and 2007. Drug overdose is now the leading cause of accidental death, surpassing all motor vehicle crash deaths. The Wisconsin Crime Laboratory, which is responsible for scientific analysis of heroin samples submitted by law enforcement, has seen a dramatic increase from nearly all of Wisconsin’s 72 counties in recent years. Since 1995, the number of teens between the ages of 12 and 17 who have tried heroin has increased by more than 300%. In 2013, there was an estimated 1.25 million chronic users of heroin nationwide and only 20-25% of users were in treatment.

Heroin, which can be smoked, sniffed or injected directly into the bloodstream, is highly addictive; nearly 75% of first time heroin users will use again. The human body builds up a tolerance to heroin over time, requiring users to use more often and with a higher dosage in order to achieve the same effect. Heroin causes slower breathing, sometimes resulting in brain damage, convulsions, coma, and death. Not knowing the purity of the heroin increases the potential for overdosing. In addition to the emotional and physical effects of heroin, satisfying the addiction may cost an addict hundreds of dollars per day. In order to fund their habit addicts turn to theft, burglary, and robbery, often targeting family, friends, and neighbors. These addictions are also causing spikes in prostitution, human trafficking, ID theft, and organized retail crime (ORC).

At the same time Wisconsin has seen a rise in heroin and opiate related deaths, there has also been a dramatic increase in the administration, by peers and medical professionals, of Naloxone Hydrochloride, also known by the brand name Narcan. Narcan reverses the effects of an opiate overdose. Treatment clinics have also seen an increase in persons requesting treatment for heroin addiction.

Representative John Nygren, co-chair of the Wisconsin State Legislature’s Joint Finance Committee, authored legislation targeted at Wisconsin’s growing heroin and opiate problem that passed unanimously in both the State Assembly and Senate last month. The seven bills, known as Heroin Opiate Prevention and Education or H.O.P.E. Legislation, will help law enforcement on the front lines save lives and put an end to this public safety and public health crisis.

District Attorney Schimel proposed a plan, entitled S.T.O.P., which emphasizes the importance of partnering with local law enforcement, parents, teachers, and medical professionals to raise awareness about these deadly drugs. In addition, Schimel’s plan contains a training component for law enforcement and the establishment of drug treatment courts statewide.

Heroin being sold on the streets today is many times more powerful than the heroin law enforcement was dealing with as recently as the 1990s. Heroin once came to the U.S. exclusively from Southeast and Southwest Asia. It was difficult to get it here, so it had to be “cut”, or diluted, extensively to make it profitable. In the mid 1980s, the average purity of heroin in the U.S. was between 3 and 8%. In the course of the past decade, our source of heroin has shifted so that almost all of our heroin comes from Mexican and South American drug cartels. It is easier to get the deadly drug into our communities, so it is possible to make huge profits without having to dilute the drug so much. Now, heroin sold to users ranges from 20% to nearly 80% in purity. This more powerful drug causes addiction much more quickly, which creates the steady customer base the cartel business model envisions. Of course, the higher purity and lack of predictability of the purity levels have also resulted in many more overdose deaths, which to the drug cartels is a “cost of doing business.”

Schimel commended Attorney General JB Van Hollen for recognizing the problem and waging an aggressive educational campaign. Attorney General Van Hollen has addressed this problem head on with the Fall 2013 launch of “The Fly Effect” Heroin Prevention Campaign. Through the use of TV, radio, and online ads, as well as an interactive website targeted at young people, The Fly Effect educates and informs with facts about the deadly drug. The website also includes interviews with recovering addicts, users who are now in prison, and family members of those who have been addicted.

The Plan

In addition to continuing efforts to raise awareness, DA Schimel proposes the following measures as part of his plan for Wisconsin and the Department of Justice:

SUPPORT:

  • Create a new coalition of neighboring states, including Minnesota, Iowa, Illinois and Michigan to share data and training techniques.
    • Brad Schimel will convene the first upper-Midwest Attorneys General Association to discuss solutions and share resources to solve the problems posed by these dangerous drugs.
    • Partner with DEA
      • Partner with the DEA and law enforcement in neighboring states will help eliminate the pipelines that provide these dangerous drugs to hardworking Wisconsin families. The danger posed by heroin needs to be taken seriously by local law enforcement and members of the judicial system, who should ensure drug traffickers are prosecuted to the fullest extent of the law.
    • Expand resources and training available to local law enforcement and prosecutors.

TEACHING:

  • Drug treatment courts
    • Brad Schimel will advocate for organizing, training, and funding to expand the use of drug treatment courts statewide. According to the National Association of Drug Court Professionals, 75% of Drug Court graduates remain arrest-free at least two years after leaving the program. Additionally, for every $1.00 invested in Drug Court, taxpayers save as much as $3.36 in avoided criminal justice costs alone.
  • Implement technology upgrades to track and interface with local law enforcement
    • Integrating new technology will be another tool for criminal justice professionals to use in making quicker and more effective decisions. Although the information that will be contained in this new technology is currently available in many different places, it is not readily available to all criminal justice professionals. The advantage of using new technology is that it will bring together in one place criminal justice data from multiple systems to help create a clearer picture of an offender, and will be available to all criminal justice professionals.
    • This information can then be used to share with other states to combat the trafficking of heroin and other dangerous drugs harming our families.
  • Narcotics training
    • Brad Schimel will advocate for dramatic expansion of training available to law enforcement and prosecutors to handle narcotics investigations and prosecutions. Brad Schimel will make sure every law enforcement agency in the state has the training to effectively bring justice to those who provide the drugs that result in death.
    • Waukesha County, under Brad Schimel’s leadership, is leading the state in prosecuting Len Bias-type homicide cases and holding those who deliver the drugs that cause overdose deaths accountable. The successes experienced in Waukesha County demonstrate what is possible when law enforcement and prosecutors have the best training available and necessary resources to work together to combat this growing epidemic.
  • Brad Schimel will ensure the DOJ is a strong partner, ready to provide investigation and technical resources to assist local law enforcement and prosecutors to arrest and convict those who traffic dangerous narcotics, especially those who deliver drugs that result in overdoses.
  • The H.O.P.E. legislation provides for the use of Naloxone Hydrochloride (Narcan) by law enforcement officers to reverse the effects of heroin and opiate overdoses. Brad Schimel will make sure training for the safe administration of the life saving opioid antagonist, Narcan, is readily available to law enforcement officers statewide.

OPIATES:

  • Aggressive prosecution of heroin and opiate drug traffickers
  • Medical community awareness and legal ramifications
    • Aggressively investigate and incarcerate dirty doctors who profit off the misery of our communities by running pill mills.
    • Brad Schimel will ensure pharmacists follow the H.O.P.E. legislation requirement that a photo identification be provided by any person picking up prescription opiates from a pharmacy.
  • Prescription Drug Monitoring Program (PDMP)
    • Advocate for a state law change that would require dispensers, practitioners and their delegates to enter information about opioid prescriptions in real time. Current law provides up to 7 days for submission of data after dispensing a monitored prescription drug.
    • Advocate for state law that would require doctors, physicians assistants, and other prescribers of opioids to check the prescription drug website before issuing an opioid prescription to a patient. This will reduce the number of opportunities for heroin and opioid addicts to “doctor shop.”
  • Advocate for continuing medical education (CME) standards that require those who prescribe opioids to complete periodic training related to the dangers posed by opioid medications.
  • Brad Schimel will urge the medical community to have a different conversation with their patients who receive these medications, so patients understand the risks associated with taking these potentially dangerous drugs. A key piece to raising awareness on heroin and prescription opioids is getting the medical community on the team. Changing the conversation between doctors and patients will be crucial to educating the public on the dangers of abusing prescription drugs.

PREVENTION:

  • Brad Schimel will continue to enhance the “Fly Effect” advocacy programs
  • High school presentations
    • Brad Schimel will advocate for local and statewide law enforcement to get out in front of students, parents and the community in every school district in Wisconsin.
    • We need to make the community aware of the nature of this danger. An extensive review of heroin addiction shows the abuse often times starts with the recreational abuse of opioids, prescribed by doctors, and inevitably leads to heroin because it is cheaper and more available that prescription opioids . Still, many overdose deaths are from prescription opioid abuse, without the presence of heroin. Parents need to talk with their kids about these drugs and help them understand that the fact that a doctor prescribes them does not mean that they are not addictive and dangerous.
  • Safe Disposal of Unused Prescription Drugs
    • When parents ask where young people get opioids, the answer, more often than not, is from medicine cabinets of family members. We need to get these excess drugs out of medicine cabinets.
    • In April 2014, Wisconsin’s semi-annual drug take-back program resulted in the collected of more than 50,000 pounds of prescription medications, out of the bottles. However, these programs require resources that make the programs only feasible a few times per year.  The H.O.P.E. legislation makes it possible to have drug return boxes placed in locations throughout the community, such as police department lobbies.   Brad Schimel will work to make sure that every community has convenient and accessible drug return sites to reduce the potential for diversion of unused prescriptions drugs to drug abusers .
    • Brad Schimel would advocate for a requirement that pharmacies include a label that directs patients to a list of a nearby drug return locations.

As District Attorney, Brad Schimel has led the fight against heroin and prescription opiate abuse:

  • While serving as an Assistant DA in the Waukesha County Metro drug unit, Schimel saw the oncoming crisis early on and as District Attorney, Schimel worked with county law enforcement and EMS to make sure Waukesha County conducts effective investigations that hold people accountable for providing drugs that kill.
  • Schimel served on the State Good Samaritan Law Task Force, which developed the recommendations that became part of the H.O.P.E. legislation.
  • Schimel chaired the Waukesha County Drug Trends Committee, which created Waukesha County’s successful Drug Treatment Court.
  • Schimel participated in the development of Waukesha County’s first large scale community awareness event Schimel participated in the development of Waukesha County’s first large scale community awareness event and has continued to work to replicate those presentations in other school districts.
  • Schimel has given presentations to hundreds of medical providers to educate them on the crisis created by diversion of prescription narcotics.
  • Schimel has given presentations to thousands of students, parents, citizens and community leaders about the deadly effects of heroin and prescription opioids.

Sources: www.doj.wi.gov, www.theflyeffect.com, www.justice.gov/dea, www.nadcp.org

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