June 2016

1. Enfield Youth Services • Jean Haughey, Program Director • Kevin T. Kane, • Chief State’s Attorney • North Central Opioid Addiction Task Force • - Law Enforcement - • Presented by: • Francis J. Carino, Supervisory Assistant State’s Attorney • June 2016

2. A copy of this presentation will be available at www.francarino.com in the “Civilian Presentation/Training Modules” section.

3. The Connecticut Division of Criminal Justice, along with State and local police, is responsible for the enforcement of the laws enacted by the Legislature and the prosecution of those juveniles and adults that violate those laws.

4. Facts • Many people that become addicted to drugs started out using what they thought was a “harmless” drug, such as marijuana, or using prescribed pain medication for a legitimate injury or pain management. • This casual or legitimate use then turns into a desire to try something else or a need to self medicate when the prescription runs out. • Oftentimes this leads to opioid abuse or dependency. • Your child’s friendly marijuana supplier may offer something providing a little more “kick” than just marijuana.

5. Kids & drug related issues: • What are they using? • How are they using it? • Where are they getting it? • What are they doing after taking drugs? • What role does social media play? • Where are they hiding it? • What do the drug laws say? • What is Law Enforcement doing? • What new approaches are out there?

6. Kids & drug related issues: • What are they using?

7. Almost 50% used marijuana by 12th grade. Source: 2015 CT School Health Survey Report

8. Going in the right direction. Source: 2015 CT School Health Survey Report

9. Small percentage started early. Source: 2015 CT School Health Survey Report

10. Going in the right direction. Source: 2015 CT School Health Survey Report

11. Marijuana supplier may introduce student to other drugs. Almost 30% are using marijuana by 12th grade. Source: 2015 CT School Health Survey Report

12. Going in the right direction. Source: 2015 CT School Health Survey Report

13. Synthetic Marijuana The director of Day Kimball Hospital's Emergency Department said “What we've seen in terms of reaction to this drug has been profound.” Patients have come in with hypertension, rapid heart beats, nausea, vomiting, difficulty breathing and chest pains. Their vital signs can be off the charts. Patients can be completely confused or violent. “But someone using marijuana is typically more sedate,” said Dr. Miro. “With synthetics, it's the complete opposite. They're violent. They're thrashing about. They're frightened. They don’t know what's happening to them. It's awful to see.”

14. Seems like a small amount. Source: 2015 CT School Health Survey Report

15. Small percentage have used cocaine. Source: 2015 CT School Health Survey Report

16. Going in the right direction. Source: 2015 CT School Health Survey Report

17. Higher than heroin use? Source: 2015 CT School Health Survey Report

18. Going in the right direction. Source: 2015 CT School Health Survey Report

19. Increased popularity among seniors. Source: 2015 CT School Health Survey Report

20. Going in the right direction. Source: 2015 CT School Health Survey Report

21. Seems like a small amount. Source: 2015 CT School Health Survey Report

22. Going in the right direction. Source: 2015 CT School Health Survey Report

23. Connecticut Accidental Drug Intoxication Deaths Office of the Chief Medical Examiner That’s a 233% increase in just four years. In 2012 there were 357 total accidental drug intoxication deaths in the state. By 2015 there were 729. In just the first three months of 2016, there were 208. Officials predict a total of 832 in 2016.

24. Connecticut Accidental Drug Intoxication Deaths Office of the Chief Medical Examiner There were 416 heroin-related deaths in 2015. 110 of which included just heroin. An additional 108 toxicology reports showed victims had died from a heroin-fentanyl mix. 106 deaths showed both heroin and cocaine in the victim’s bloodstream. .

25. “Fentanyl is a highly dangerous synthetic opioid which can be up to 50 times more potent than heroin.  In the wrong hands, it’s deadly.  Here in Connecticut, like other parts of the country, we are battling an escalating epidemic of opioid abuse,” United States Attorney for the District of Connecticut Deirdre M. Daly . Authorities said just 3 to 4 grains, which is a similar size to a grain of sand or salt, can kill someone.   The street value of fentanyl is $100 a gram. There are 1,000 grams in a kilogram, so that means $100,000 per kilogram.

26. Connecticut Accidental Drug Intoxication Deaths Office of the Chief Medical Examiner In 2015, fentanyl was involved in 80 other non-heroin-related deaths–31 involved just fentanyl, 43 showed fentanyl and cocaine in the blood stream and 23 were from a mix of fentanyl and prescription opioids.

27. Connecticut Accidental Drug Intoxication Deaths Office of the Chief Medical Examiner • By the end of 2016, it is predicted that there will be a nearly 76% increase in deaths related to fentanyl than in 2015. • When compared to 2012, there’s expected to be a whopping 2,300% increase in deaths involving the drug. From January 1 through March 31, there were 110 heroin-related deaths–26 involved just heroin, 39 involved a mix of heroin and fentanyl and 26 involved a mix of heroin and cocaine. There were 47 other fentanyl-related deaths that did not involve heroin.

28. Heroin overdoses could get more common as W-18 makes its way to Connecticut MAY 9, 2016, BY JOHN CHARLTON • An additive called W-18 is popping up in parts of New England. • It looks like heroin or fentanyl, it's a white powder, • Fentanyl is is up to 50 times more potent than heroin. • W-18 is 100 times more potent than fentanyl and 10,000 times more potent than morphine. • It is similar to drugs used to tranquilize large animals like bears and elephants. • Two fatal W-18 overdoses recently happened in Massachusetts. • Experts say it's just a matter of time until W-18 shows up here. • Dr. Craig Allen of the Rushford Center said "Fentanyl was on the scene last year and led to a big increase in the overdose deaths, so it's very frightening.” • The drug is currently unregulated by the DEA, despite its dangerously high potency and recent appearances in heroin circulating the Northeast.

29. Seems to be increasing at early ages. Source: 2015 CT School Health Survey Report

30. Going in the right direction. Source: 2015 CT School Health Survey Report

31. Could lead to illegal opioid use later. Source: 2015 CT School Health Survey Report

32. Could lead to illegal opioid use later. Source: 2015 CT School Health Survey Report

33. Going in the right direction. Source: 2015 CT School Health Survey Report

34. Kids & drug related issues: • How are they using it?

36. Reluctance to inject drugs. Source: 2015 CT School Health Survey Report

37. Kids & drug related issues: • Where are they getting it?

39. Almost 1/3 are exposed to drugs at school. Source: 2015 CT School Health Survey Report

40. Going in the wrong direction. Source: 2015 CT School Health Survey Report

42. Kids & drug related issues: • What are they doing after taking drugs, other than driving?

43. Over 13% have gone to school under the influence. Source: 2015 CT School Health Survey Report

44. Going in the right direction. Source: 2015 CT School Health Survey Report

45. Risky behavior after risky behavior. Source: 2015 CT School Health Survey Report

46. Going in the wrong direction. Source: 2015 CT School Health Survey Report

47. Kids & drug related issues: • What role does social media play?

48. Social media can and does: • introduce unsuspecting children and youths to the drug culture; • glamourize the use and effects of alcohol and drugs; • enhance the influence of pop culture idols; • give the appearance that “everyone is doing it;” • provide encouragement and instructions on the use of drugs; • provide access to illegal substances; • direct children and youths to social events where drugs will be available and/or used;

49. Kids & drug related issues: • Where are they hiding it?