Transcript Document

ACOPC
Allegheny County Overdose Prevention Coalition
Presents
PERMEATING
BORDERS
OVERDOSE PREVENTION
Summer Conference 2014
July 24, 2014
District Attorney’s
Crime Prevention Strategy
as it relates to
Substance Abuse
Kevin McCarthy
Assistant District Attorney
Allegheny County
Notice
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This presentation includes information on pending legislation.
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This presentation is only intended to inform the community as
of the date it was presented in late July 2014.
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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.”
Senate Bill 1180
Assistant District Attorney
Kevin McCarthy
Why Address Prescription Drug Abuse?
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80% of recent heroin users started by abusing prescription
pain medication
Why Address Prescription Drug Abuse?
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Pennsylvania’s Statistics:
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Fourteenth in the country for drug overdose mortality
Why Address Prescription Drug Abuse?
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Pennsylvania’s Statistics:
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Third highest rate of heroin abuse in the country
Why Address Prescription Drug Abuse?
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Pennsylvania’s Statistics:
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Heroin-related deaths have doubled between 2009-2012
Why Address Prescription Drug Abuse?
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Pennsylvania’s Statistics:
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Drug-related deaths outnumber death by motor vehicles
Why Address Prescription Drug Abuse?
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Pennsylvania’s Statistics:
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In 2012, deaths by heroin outnumbered deaths by gunshot in
Philadelphia
Prescription Drug Monitoring Saves Lives and
Reduces Addiction
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One of the most effective ways of combatting prescription
drug abuse is through the operation of a robust prescription
drug monitoring program
Prescription Drug Monitoring Saves Lives and
Reduces Addiction
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These programs help identify major sources of prescription
drug diversion such as:
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Prescription Fraud,
Forgeries,
Doctor Shopping, and
Improper prescribing and dispensing
Prescription Drug Monitoring Saves Lives and
Reduces Addiction
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In Pennsylvania, only Schedule II drugs are permitted to be
collected
Prescription Drug Monitoring Saves Lives and
Reduces Addiction
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Almost every other state authorizes the collection of at least
Schedule II, III, and IV substances
Prescription Drug Monitoring Saves Lives and
Reduces Addiction
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SB 1180 remedies these defects in Pennsylvania law by:
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Increasing the types of controlled substances collected; and
Ensuring appropriate access for those who can identify, stop, and
address prescription drug abuse
Prescription Drug Monitoring Saves Lives and
Reduces Addiction
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Prescription drug monitoring programs work
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After the inception of Florida’s prescription drug monitoring program
doctor shopping declined 35% during the FY 2012
Prescription Drug Monitoring Saves Lives and
Reduces Addiction
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Prescription drug monitoring programs work
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A survey of prescribers in Oklahoma revealed that 63% of
respondents reported that its program helped them identify patients
abusing prescription medications
Prescription Drug Monitoring Saves Lives and
Reduces Addiction
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Prescription drug monitoring programs work
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In Kentucky, 70% of respondents found its program very or
somewhat important in helping them decide what drug to prescribe a
patient
Prescription Drug Monitoring Saves Lives and
Reduces Addiction
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Prescription drug monitoring programs work
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In Maine, 97% of surveyed prescribers and pharmacies found its
program useful in monitoring prescriptions and controlling doctor
shopping
Prescription Drug Monitoring Saves Lives and
Reduces Addiction
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Prescription drug monitoring programs work
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According to a 2010 study, when program data was used in an
emergency room:
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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
SB 1180 is Constitutional
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SB 1180 balances privacy interests and appropriate access
to information by law enforcement
Balancing Privacy Interests and Appropriate Access
to Information by Law Enforcement
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Law enforcement can only access such information if we
obtain a court order
Must prove by a preponderance of the evidence:
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There is reasonable suspicion that criminal activity occurred, and
This information is relevant to an active investigation
Balancing Privacy Interests and Appropriate Access
to Information by Law Enforcement
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Whether a search warrant should be required to access the
database is a policy question, and not a legal issue
Balancing Privacy Interests and Appropriate Access
to Information by Law Enforcement
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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
Balancing Privacy Interests and Appropriate Access
to Information by Law Enforcement
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The bill does not create any new crimes related to drug
possession or use
Balancing Privacy Interests and Appropriate Access
to Information by Law Enforcement
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Those most likely to be flagged in the expanded database
would be crooked doctors and those who sell controlled
substances to others
Senate Bill 1164-proposed
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Drug Over Dose Response Immunity
Senate Bill 1164-proposed
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Person reported the drug overdose to law enforcement, the
911 system, campus security, or emergency services
personnel
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The person provided his identification and location
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Remained with the person in need
Senate Bill 1164-proposed
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Statute would prohibit that person from being charged,
prosecuted or violated for a probation or parole offense for
the following:
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Alteration of a controlled substance, § 113(a)(5); possession
of a controlled substance § 113(a)(16); purchase of a
controlled substance without
Senate Bill 1164-proposed
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(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)
Senate Bill 1164-proposed
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This section would not bar prosecution if:
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law enforcement obtains information prior to the call for
assistance
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Delivery or distribution of a controlled substance, druginduced homicide, or any other crime not set forth in
section B
“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.
1.
Promote community safety and well-being in order to reduce criminal
behavior among offenders.
2.
Increase the ability of offenders and their dependents to live
independently and responsibly.
3.
Conserve judicial system resources by reducing direct costs of arrest and
incarceration of offenders.
4.
Rehabilitate and improve the treatment outcomes for addicted
offenders.
5.
Assist offenders in regaining their lives and re-uniting with families.
1.
2.
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
3.
4.
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
5.
6.
Frequent Random Observed Urinalysis
Testing
A coordinated strategy governs Drug
Court responses to participants’
compliance. Reinforce the positive
responses and sanction the negative
7.
8.
Ongoing judicial interaction with each
Drug Court participant is essential
Monitor and evaluate achievement of
program goals on a regular basis to
gauge effectiveness
9.
10.
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
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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.
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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.
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Individuals with drug related offenses who meet the aforesaid criteria are
considered, as well as, those with non-violent offenses associated with
drug dependence.
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An individual’s case must be past the Formal Arraignment stage before it
can be considered for Drug Court.
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After a case is determined to be appropriate, it is then screened by
Probation and Justice Related Services.
A level 3 or 4 offender is an offender who is facing a state sentence
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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)
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Probation screens candidates for the following:
 Criminal History
 History of Supervision (potential Probation violations)
 Warrants
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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.
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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
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Once an offender meets all screening requirements and a
level of care is established, the offender is able to voluntarily
plea into the program.
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If an offender chooses not to plea into Drug Court, the
charges proceed in the originally assigned court room as
scheduled.
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Standard Drug Court sentences include
 18 months Intermediate Punishment
 12 months consecutive Probation
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Sentences can be extended, if needed, to complete the
program. Incentives exist to reduce the period of supervision.
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Drug and Alcohol evaluation
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Comply with all treatment recommendations
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Random urine screens
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Complete “Criminality Group”
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
Team while in the community
the Drug Court
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Housing Services Coordination
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Contingency Funds: Clothing, Food, State ID, Vital Records
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Transportation assistance
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Linking to Benefits: Medical assistance/Social Security/VA
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Positive drug test
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Window violations
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Treatment non-compliance
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Behavioral non-compliance
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New arrest
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Restriction
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Team Intervention
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Swift Intervention
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Re-evaluation
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Formal violation hearing (Gagnon I and II)
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Revocation
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Complete IP Sentence
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Maintain at least one year sobriety after stepping to the period of
Probation following the IP sentence
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Complete all treatment requirements
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Obtain a High School Diploma or equivalent
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Maintain independent housing
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Sustain employment
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Previous Residences
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Family History
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Financial Circumstances
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Education
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Current and Past legal issues both as a juvenile and an adult
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Medical Conditions
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Psychiatric History
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Substance Abuse History
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Interpersonal relations and other social dynamics
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Personal Goals
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Mental Health
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Drug and Alcohol
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Dual Programming
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Specialized Supports
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Parenting Classes
LGBTQI
Women’s Groups
Non-Secular Recovery Groups
1.
Acute Intoxication and Withdrawal
2.
Biomedical Conditions and Complications
3.
Emotional/Behavioral Conditions and Complications
4.
Treatment Acceptance/Resistance
5.
Relapse Potential
6.
Recovery Environment
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Level 1
 A: Outpatient
 B: Intensive Outpatient
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Level 2
 A: Partial Hospitalization
 B: Halfway House
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Level 3
 A: Medically Monitored Detox
 B: Medically Monitored Short-Term Residential
 C: Medically Monitored long-Term Residential
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Level 4
 A: Medically Managed Inpatient Detox
 B: Medically Managed Inpatient Residential
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Greenbriar
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Gaiser
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Pyramid
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Sojourner House
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Cove Forge
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Mon Yough Community Services
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Renewal
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Mercy Behavioral Health
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Family Links
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Alpha House
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VA