The

Opioid Crisis in Connecticut

Canton Community Center

March 9, 2017
5:30 PM
Miriam E. Delphin-Rittmon, Ph.D.,
Commissioner

Connecticut Department of Mental Health and Addiction Services

 DMHAS

Lead state agency for adult mental health and substance use
services
112,000+ served by DMHAS system of care in FY16
One State hospital and 7 State-operated Local Mental Health
Authorities; 3 with inpatient programs
160 non-profit agencies provide individuals with substance
use and mental health services
Prevention, Treatment and Recovery Support
Treatment and support for adults only (18+)
Prevention services across the lifespan

Connecticut Department of Mental Health and Addiction Services

 Nationally
Northeast has been hardest hit
Since 2007, nearly a 150%
increase in heroin abuse or
dependence
Heroin use has more than
doubled among young adults
ages 18-25 in the past decade
In many cases, prescription
painkiller misuse leads to heroin
use

Connecticut Department of Mental Health and Addiction Services

 In Connecticut
DMHAS Treatment
Admission for heroin has been
steadily increasing since 2011 after a
five-year decline
Heroin has replaced alcohol as the
primary drug reported at admission to
SA programs
In FY16, heroin and other opiates
accounted for more than half (52%) of
all substance abuse treatment
admissions

Connecticut Department of Mental Health and Addiction Services

 Overdose Deaths

Connecticut Department of Mental Health and Addiction Services

 Prescription Painkillers
US largest pharmaceutical market in the world
$320 billion in pharmaceutical sales in 2011
4 billion prescriptions written annually
Estimated 40% go unused
Prescription drugs often falsely considered
safe because theyre prescribed by doctors
Nearly half of young people who inject heroin
surveyed reported abusing prescription
opioids before starting heroin
Connecticut Department of Mental Health and Addiction Services
 Heroin and Other Synthetic Opiates
Heroin
Less expensive than prescription opiates
Increased availability
High purity
Synthetic opiates
Even less expensive than heroin
More potent
Fentanyl, carfentanil, furanyl fentanyl

Connecticut Department of Mental Health and Addiction Services

 Local Treatment for Opiates
(DMHAS and Private)
Town FY 12 FY 16 FY 12 FY 16
Admissions Admissions Unduplicated Unduplicated
Clients Clients
Avon 8 25 6 18
Barkhamsted 18 26 10 21
Burlington 17 53 12 30
Canton 24 11 15 6
Granby 20 24 12 14
New Hartford 16 52 8 25
Simsbury 40 51 21 29
State 21,150 27,789 11,560 14,474
The data shows new admissions each year where client is reporting opiates as the
primary drug (duplicated) and the number of unduplicated clients that were
involved in these admissions.

Connecticut Department of Mental Health and Addiction Services

 2016 Connecticut Legislation
PA 16-43, An Act Concerning Opioids/Access to Overdose Reversal Drugs

7-day limit on opioid prescriptions

Licensed health care professionals (LHCPs) allowed to
administer naloxone without fear of civil liability
Each municipality must ensure that their designated
first responder(s) are trained on and equipped with
naloxone
Pharmacies required to enter information about all
controlled substances dispensed into the CT
Prescription Monitoring and Reporting System

Connecticut Department of Mental Health and Addiction Services

 2017 Proposed Legislation
This year, the Governor is proposing the following
reforms:
Requiring Electronic Prescriptions
Facilitating in the Destruction of Unused Medication
Allowing Patients to Refuse Opioids through a
Directive
Expand the Requirement to Provide Information about
the Risk of Addiction to Adults
Encourage Data Sharing Among State Agencies

Connecticut Department of Mental Health and Addiction Services

 Alcohol and Drug Policy Council
(ADPC)
Tasked by Governor Malloy to coordinate state
substance abuse prevention and treatment
efforts and developed recommendations on
how to address the states opioid crisis
Subcommittees working to implement
recommendations
Prevention, screening and early intervention
Treatment and recovery supports
Recovery and health management

Connecticut Department of Mental Health and Addiction Services

 Connecticut Opioid Response (CORe)
Initiative
Governor Malloy engaged the Connecticut Opioid
Response (CORe) team to supplement and support the
work of the ADPC by creating a focused set of tactics
and methods for immediate deployment
Tactics include:
Increase MAT use among incarcerated
Increase access to buprenorphine
Increase accessibility to naloxone
Educational efforts with media, agencies, health care and
public health personnel
Diverting individuals from the legal system to the health
care and treatment system

Connecticut Department of Mental Health and Addiction Services

 DMHAS Prevention Activities
Statewide 800 number for people seeking treatment
(1-800-563-4086)
Public messaging (social media, PSAs, website)
Help promote drop boxes and drug take back days
Participation in a number of community task forces,
workgroups and advisory boards across the state to
coordinate efforts
Federal funding for communities to prevent
prescription drug abuse in teens and young adults

Connecticut Department of Mental Health and Addiction Services

 Additional SAMHSA Grants
Received 3 SAMHSA grants to address heroin and
opioid overdose and abuse
Prevention grants: reduce nonmedical use of
prescription drugs and prevent overdose ($8 million)
Medication Assisted Treatment (MAT) grant: fund
MAT and evidence-based recovery support services by
expanding and strengthening existing clinics and the
statewide MAT infrastructure. Funds will also be used
to hire recovery coaches and flexible funds for
individualized recovery supports ($5 million)
Connecticut Department of Mental Health and Addiction Services
 Additional SAMHSA Grants
Additional $5.5 million in SAMHSA funds
available to Connecticut through the 21st
Century Cures Act to combat the opioid crisis

Connecticut Department of Mental Health and Addiction Services

 Recovery Coaches in EDs
Launching early 2017
4 EDs in Eastern Connecticut (Manchester,
Lawrence and Memorial, Backus, Windham)
Recovery coaches will go to EDs and connect
patients who overdosed and link them to
services (peer staff have personal experience
that helps in a unique way with engagement
and linkage to treatment and recovery
supports)
Connecticut Department of Mental Health and Addiction Services
 Broad
Spectrum Inpatient Detox
SA Residential Treatment
of Services
SA Residential Long-Term
Serving
SA Outpatient and IOP
Individuals
DMHAS Recovery Houses
in Methadone Maintenance
Recovery Treatment
from SA

Connecticut Department of Mental Health and Addiction Services

 Medication Assisted Treatment
Medication Assisted Treatment (MAT),
along with counseling, is the treatment
of choice for people with dependence on
heroin or prescription opioids
Methadone clinics use multi-modal
approach including medication,
counseling and other supportive services

Connecticut Department of Mental Health and Addiction Services

 CT Methadone Clinics

Connecticut Department of Mental Health and Addiction Services

 Other MATs
Buprenorphine (Suboxone)
Available by prescription
Safer and has less regulation than methadone
Prescriber must receive special training and have
federal approval
Naltrexone (Vivitrol)
Monthly injection
Patient must be off opiates for 7 to 10 days to
start treatment

Connecticut Department of Mental Health and Addiction Services

 Recovery Community Centers
Drop-in community centers
Three locations: Bridgeport, Hartford,
Windham
Peer-to-peer recovery support services
Recovery meetings
Recovery training series
Family support
Recovery coaching
Recovery social events
Connecticut Department of Mental Health and Addiction Services
 Remembrance Quilt

Way for loved ones to

honor those they lost to
addiction
Raise awareness around
substance use disorders

Connecticut Department of Mental Health and Addiction Services

 Remembrance Quilt Dates
Scheduled Quilting Events:

Middletown - Saturday, March 11, 2017, 10:00 AM, Middlesex County Substance
Abuse Action Council (MCSAAC)

Bethel, Saturday, March 18, 2017, 2:00 PM,

Housatonic Valley Coalition Against Substance Abuse (HVCASA)

Norwich, Thursday, March 23, 2017, 5:00 PM, Rose City Senior Center

Wilton, Saturday, April 1, 2017, 10:00 AM, Mountainside

Wolcott, Saturday, April 8, 2017, 12:30 PM, Wolcott Activity and Learning Center
(WALC)

Information and locations: www.ct.gov/dmhas/notforgotten

Connecticut Department of Mental Health and Addiction Services