ACOPC Allegheny County Overdose Prevention Coalition Presents

1. ACOPCAllegheny County Overdose Prevention CoalitionPresents PERMEATING BORDERS OVERDOSE PREVENTION Summer Conference 2014 July 24, 2014

2. District Attorney’sCrime Prevention Strategy as it relates to Substance Abuse Kevin McCarthy Assistant District Attorney Allegheny County

3. Notice • This presentation includes information on pending legislation. • This presentation is only intended to inform the community as of the date it was presented in late July 2014.   • Until legislation is approved, if approved, the content may undergo many revisions. Please refer to http://www.legis.state.pa.us/ for updates to these bills.”

4. Senate Bill 1180 Assistant District Attorney Kevin McCarthy

5. Why Address Prescription Drug Abuse? • 80% of recent heroin users started by abusing prescription pain medication

6. Why Address Prescription Drug Abuse? • Pennsylvania’s Statistics: • Fourteenth in the country for drug overdose mortality

7. Why Address Prescription Drug Abuse? • Pennsylvania’s Statistics: • Third highest rate of heroin abuse in the country

8. Why Address Prescription Drug Abuse? • Pennsylvania’s Statistics: • Heroin-related deaths have doubled between 2009-2012

9. Why Address Prescription Drug Abuse? • Pennsylvania’s Statistics: • Drug-related deaths outnumber death by motor vehicles

10. Why Address Prescription Drug Abuse? • Pennsylvania’s Statistics: • In 2012, deaths by heroin outnumbered deaths by gunshot in Philadelphia

11. Prescription Drug Monitoring Saves Lives and Reduces Addiction • One of the most effective ways of combatting prescription drug abuse is through the operation of a robust prescription drug monitoring program

12. Prescription Drug Monitoring Saves Lives and Reduces Addiction • These programs help identify major sources of prescription drug diversion such as: • Prescription Fraud, • Forgeries, • Doctor Shopping, and • Improper prescribing and dispensing

13. Prescription Drug Monitoring Saves Lives and Reduces Addiction • In Pennsylvania, only Schedule II drugs are permitted to be collected

14. Prescription Drug Monitoring Saves Lives and Reduces Addiction • Almost every other state authorizes the collection of at least Schedule II, III, and IV substances

15. Prescription Drug Monitoring Saves Lives and Reduces Addiction • SB 1180 remedies these defects in Pennsylvania law by: • Increasing the types of controlled substances collected; and • Ensuring appropriate access for those who can identify, stop, and address prescription drug abuse

16. Prescription Drug Monitoring Saves Lives and Reduces Addiction • Prescription drug monitoring programs work • After the inception of Florida’s prescription drug monitoring program doctor shopping declined 35% during the FY 2012

17. Prescription Drug Monitoring Saves Lives and Reduces Addiction • Prescription drug monitoring programs work • A survey of prescribers in Oklahoma revealed that 63% of respondents reported that its program helped them identify patients abusing prescription medications

18. Prescription Drug Monitoring Saves Lives and Reduces Addiction • Prescription drug monitoring programs work • In Kentucky, 70% of respondents found its program very or somewhat important in helping them decide what drug to prescribe a patient

19. Prescription Drug Monitoring Saves Lives and Reduces Addiction • Prescription drug monitoring programs work • In Maine, 97% of surveyed prescribers and pharmacies found its program useful in monitoring prescriptions and controlling doctor shopping

20. Prescription Drug Monitoring Saves Lives and Reduces Addiction • Prescription drug monitoring programs work • According to a 2010 study, when program data was used in an emergency room: • 41% of cases had altered prescribing after the clinician reviewed the data, • With 61% of patients receiving fewer or no opiod pain medications than had been originally planned by the physician, and • 30% receiving more than previously planned because the physician was able to confirm the patient did not have history of drug abuse

21. SB 1180 is Constitutional • SB 1180 balances privacy interests and appropriate access to information by law enforcement

22. Balancing Privacy Interests and Appropriate Access to Information by Law Enforcement • Law enforcement can only access such information if we obtain a court order • Must prove by a preponderance of the evidence: • There is reasonable suspicion that criminal activity occurred, and • This information is relevant to an active investigation

23. Balancing Privacy Interests and Appropriate Access to Information by Law Enforcement • Whether a search warrant should be required to access the database is a policy question, and not a legal issue

24. Balancing Privacy Interests and Appropriate Access to Information by Law Enforcement • SB 1180 mandates that controlled substances entered into it cannot be accessed by law enforcement unless a judge concludes that there is reasonable suspicion related to an active investigation of illegal activity

25. Balancing Privacy Interests and Appropriate Access to Information by Law Enforcement • The bill does not create any new crimes related to drug possession or use

26. Balancing Privacy Interests and Appropriate Access to Information by Law Enforcement • Those most likely to be flagged in the expanded database would be crooked doctors and those who sell controlled substances to others

27. Senate Bill 1164-proposed • Drug Over Dose Response Immunity

28. Senate Bill 1164-proposed • Person reported the drug overdose to law enforcement, the 911 system, campus security, or emergency services personnel • The person provided his identification and location • Remained with the person in need

29. Senate Bill 1164-proposed • Statute would prohibit that person from being charged, prosecuted or violated for a probation or parole offense for the following: • Alteration of a controlled substance, § 113(a)(5); possession of a controlled substance § 113(a)(16); purchase of a controlled substance without

30. Senate Bill 1164-proposed • (Cont.) authorization; § 113(a)(19); possession small amounts of marijuana authorization; § 113(a)(31); possession of drug paraphernalia authorization; § 113(a)(32); delivery or possession with intent to deliver drug paraphernalia authorization; § 113(a)(33); possession of anabolic steroids authorization; § 113(a)(37)

31. Senate Bill 1164-proposed • This section would not bar prosecution if: • law enforcement obtains information prior to the call for assistance • Delivery or distribution of a controlled substance, drug-induced homicide, or any other crime not set forth in section B

32. Allegheny County Drug Court

33. What is Drug Court? “A special court given the responsibility to handle cases involving drug-addicted offenders through an extensive supervision and treatment program." Represents a non-traditional approach to prosecute offenders who are addicted to drugs. Rather than focusing only on the crime and the punishment, drug courts attempt to solve some of their underlying problems.

34. Goals and Objectives • Promote community safety and well-being in order to reduce criminal behavior among offenders. • Increase the ability of offenders and their dependents to live independently and responsibly. • Conserve judicial system resources by reducing direct costs of arrest and incarceration of offenders. • Rehabilitate and improve the treatment outcomes for addicted offenders. • Assist offenders in regaining their lives and re-uniting with families.

35. Key Components • Drug Courts promote team approaches and collaboration amongst Judges, prosecutors, defense counsel, treatment providers, probation, law enforcement, and the community • Use a non-adversarial approach

36. Key Components • Eligible participants are identified early and promptly placed into Drug Court • Drug Courts provide access to a continuum of alcohol, drug and other related treatment and rehabilitation services. When treatment doesn’t work…try more treatment

37. Key Components • Frequent Random Observed Urinalysis Testing • A coordinated strategy governs Drug Court responses to participants’ compliance. Reinforce the positive responses and sanction the negative

38. Key Components • Ongoing judicial interaction with each Drug Court participant is essential • Monitor and evaluate achievement of program goals on a regular basis to gauge effectiveness

39. Key Components • All Drug Court staff should participate in interdisciplinary education and training • Forge partnerships among Drug Courts, public agencies, and community-based organizations www.NDCI.org

40. Referrals to Drug Court • Can come from: • District Attorney’s Office • Public Defender’s Office • Defense Attorneys • Probation Office All referrals are reviewed by District Attorney’s Office for Sentencing Guideline eligibility and Prohibited Offenses, then sent to Probation for screening.

41. Offender Eligibility • Consideration for Drug Court begins at the District Attorney’s office. An individual must be a level 3 or 4 offender under state sentencing guidelines and cannot have committed any of the prohibited offenses. • Individuals with drug related offenses who meet the aforesaid criteria are considered, as well as, those with non-violent offenses associated with drug dependence. • An individual’s case must be past the Formal Arraignment stage before it can be considered for Drug Court. • After a case is determined to be appropriate, it is then screened by Probation and Justice Related Services.

42. Sentencing Matrix

43. What is a level 3 or 4 Offender? A level 3 or 4 offender is an offender who is facing a state sentence

44. Prohibited Offenses • 18 Pa. C.S. 2502 (relating to Murder) • 18 Pa. C.S. 2503 (relating to Voluntary Manslaughter) • 18 Pa. C.S. 2702 (relating to Aggravated Assault) • 18 Pa. C.S. 2703 (relating to Assault by Prisoner) • 18 Pa. C.S. 2704 (relating to Assault by Life Prisoner) • 18 Pa. C.S. 2901 (relating to Kidnapping) • 18 Pa. C.S. 3121 (relating to Rape) • 18 Pa. C.S. 3122.1 (relating to Statutory Sexual Assault) • 18 Pa. C.S. 3123 (relating to Involuntary Deviate Sexual Intercourse) • 18 Pa. C.S. 3124.1 (relating to Sexual Assault) • 18 Pa. C.S. 3125 (relating to Aggravated Indecent Assault) • 18 Pa. C.S. 3126 (relating to Indecent Assault) • 18 Pa. C.S. 3301(relating to Arson and related offenses) • 18 Pa. C.S. 3502 (relating to Burglary of the First Degree) • 18 Pa. C.S. 3701 (relating to Robbery) • 18 Pa. C.S. 3923 (relating to Theft by Extortion) • 18 Pa. C.S. 4302 (relating to Incest) • 18 Pa. C.S. 5121 (relating to Escape)

45. Screening Process • Probation screens candidates for the following: • Criminal History • History of Supervision (potential Probation violations) • Warrants • Once an offender is determined to be appropriate by Probation, they are then assessed by Justice Related Services to determine an appropriate level of care.

46. Assessment • JRS assessment • Designed to capture information needed for the dimensions of the PCPC (Pennsylvania Client Placement Criteria) 1. Acute Intoxication or Withdrawal 2. Biomedical Conditions and Complications 3. Emotional/Behavioral Conditions and Complications 4. Treatment Acceptance/Resistance 5. Relapse Potential 6. Recovery Environment

47. Plea • Once an offender meets all screening requirements and a level of care is established, the offender is able to voluntarily plea into the program. • If an offender chooses not to plea into Drug Court, the charges proceed in the originally assigned court room as scheduled.

48. Sentencing • Standard Drug Court sentences include • 18 months Intermediate Punishment • 12 months consecutive Probation • Sentences can be extended, if needed, to complete the program. Incentives exist to reduce the period of supervision.

49. Special Conditions • Drug and Alcohol evaluation • Comply with all treatment recommendations • Random urine screens • Complete “Criminality Group”

50. Supervision Monthly Reviews - Monthly review hearings before Judge Nauhaus Reporting - Minimum weekly contact with Probation - Urine testing at each contact Community Contact - Every individual will maintain contact with the Drug Court Team while in the community