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MINNESOTA FAMILY SUPPORT & RECOVERYCOUNCIL

2019 ANNUAL CONFERENCE

Minnesota Family Support and Recovery Council 2019

“What is and What Should NeverBe”

9/16/2019 MFSRC Annual Conference 1

Minnesota Family Support and Recovery Council 2019  “What is and What Should Never Be”

Rick Moldenhauer, MS, LADC, ICADC, LPCC |Human Services Rep. 2  State Opioid Treatment Authority Representative | Behavioral  

Health Division, DHS

9/16/2019 | Minnesota Department of Human Services | mn.gov/dhs

• Presented by Rick Moldenhauer, MS, LADC, ICADC, LPCC

Human Services Representative 2/State Opioid Treatment Authority  

P: (651) 431 2474

F: (651) 431 7449

Behavioral Health Division, DHS  

PO Box 64977

St Paul, Minnesota 55164‐0977  

richard.moldenhauer@state.mn.us

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Please remember…

• These are not justnumbers, they arePeople…

0

5000

10000

15000

20000

25000

30000

Alcohol Marijuana Methamphetamine Cocaine/Crack Heroin OtherOpiates Other Injection DrugUse

Primary Substance at Admission to SUD Treatment Services for Adults CY1995 ‐ CY2018

Source: Minnesota Department of Human Services, BHD, DAANES (7/8/2019)

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18000

16000

14000

12000

10000

8000

6000

4000

2000

0

Marijuana Methamphetamine Cocaine/Crack Heroin OtherOpiates Other Injection DrugUse

Primary Substance at Admission to SUD Treatment Services for Adults CY1995 ‐ CY2018

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (7/8/2019)

Who are we, Minnesota?

84.4

1.4

6.5

0.07

5.1

2.55.4

% of total population estimate, July 1, 2017

white black AI Asian NH/PI two ormore Hispanic

8SOURCE: https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk

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Admissions to chemical dependency treatment  by primary substance, by CY, by %

40.1

34.431.5

28.4

17.3

12.4 13.111.6

10.4

176.21

23.5

27.3 26.61

12.1 12.7

8.46.8 5.8

13.9310.9

15.2 16.4

24.422

26.424.9

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0

5

10

15

20

25

30

35

40

45

2013 2014 2015 2016 2017 2018

alcohol

marijuana/hashish

heroin

other opioids

meth

SOURCE: ADAD, DAANES 4/3/2019

%

What we give our children, we give our  grandchildren…..

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What we teach our children, we teach our  grandchildren…….

Heroin, other opioid and  methamphetamine growth in Minnesota,

by county of residence at time of admission by theprimary drug of use being heroin, other opioid, ormethamphetamine

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by calendar years 1995‐2017,

controlled for in incidents per 1,000 of  general population

All slides transition by calendar years

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Growth patterns, showing increase and  decline in three major substances

Including injection drug use as a route of administration……

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10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

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16000

14000

12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

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16000

14000

12000

10000

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6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

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16000

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12000

10000

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0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

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12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

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0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

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0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

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0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

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0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

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12000

10000

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0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

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12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

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0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

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16000

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12000

10000

8000

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0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

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Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

16000

14000

12000

10000

8000

6000

4000

2000

0

Methamphetamine Heroin OtherOpiates Injection DrugUse

Primary Substance of Heroin, other opioids, or methamphetamine at Admission to SUD

* Alcohol not included in chart

Source: Minnesota Department of Human Services, BHD, DAANES (9/11/2018)

Heroin as primary substance

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Here’s the basic rule of thumb…

The darker the color, the more people living  in that county seeking treatment admission

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methamphetamine as primary substance

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If you were wondering

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If the use of syringes has declined in Minnesota..

Syringe use growth from 2007‐2017

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Epidemicadjectiveep∙i∙dem∙ic | \ ˌe‐pə‐ˈde‐mik \Definition of epidemic1 : affecting or tending to affect a disproportionately large number of  individuals within a population, community, or region at the same time  typhoid was epidemic2a : excessively prevalent  b : contagious sense3 : characterized by very widespread growth or extent : of, relating to, or  constituting an epidemic the practice had reached epidemic proportions

SOURCE https://www.merriam‐webster.com/dictionary/epidemic

Remember, all these numbers you see here…..

Are real people….

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Any Questions ?

WHY?

This infographic focuses on the rates (per 100,000) of drug poisoning deaths of adolescentsand young adults ages 10‐24 from 2014‐2016

Drug poisoning is an improper use of illicit drugs or medicine that is either prescribed or  over‐the‐counter

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SOURCE: https://www.childrenssafetynetwork.org/sites/childrenssafetynetwork.org/files/Disparities%20in%20Drug%20Poisoning%20Infographic%20FINAL.pdf

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Nutt, D; King, LA; Saulsbury, W; Blakemore, C (2007). "Development of a rational scale to assess the harm ofdrugs of potential misuse". Lancet 369 (9566): 1047–53

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tachyphylaxis

92

ED50

LD50

TW

3x2x1x

T1/2

93

Intoxication/Withdrawal

0 2 4 6 8 10 12 14

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“Speedballing”

“Your livin' harder, yeah, harder  than you know

Tell me, how fast,  

Can ya burn?,

And how far can ya go?”

‐Zakk Wylde “What You’re Look’n For”

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STIGMA

“When the truth is found, to be lies….”

• Truth ‐‐‐‐stigma‐‐‐‐‐lies,

• Stigma is planted in ignorance,  watered and fertilized by denial and  projection…

• Don’t confuse anonymity with silence..

Comforting lie vs. painful truth

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Tradition is prevention, culture is treatment

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Canku luta omani