2015 WNA Northwoods Clinical Practice UpdateSession 3: Northwest Wisconsin Drug Trends
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Drugs: Synthetic and RealWisconsin Nurses Association (WNA)
WITC - Rice Lake 9/25/15
Chris Fitzgerald, Sheriff
Barron County Sheriff’s Department
Ron Baures, Captain
Barron County Sheriff’s Department
Heroin
Synthetics
K2 –synthetic marijuana
bath salts – synthetic cathinones
Flakka
Methamphetamine
Marijuana
Drug Trends in NW Wisconsin
Regional WI Drug Corridors HeroinProcessed from morphine, extracted from poppy plants
Commonly sold in WI - Columbian tan/Mexican brown South America - Columbian tan or off white Mexico - brown and black tarSouthwest Asia - white or tan powderSoutheast Asian – “China White” (more expensive)
HeroinInjected
Heroin
NW Wisconsin mainly snorted because of high purity Many young uses prefer to snort
Purity remains the sameNo paraphernalia or worry about contracting diseases from needle sharingNo evidence of intravenous use “tracks”
Smoked
Snorted
2015 WNA Northwoods Clinical Practice UpdateSession 3: Northwest Wisconsin Drug Trends
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Addictive, 100x stronger than morphine
Users feel a warm “rush” (euphoria) followed by a state of sleep anddrowsiness.
Users often buy enough to support theirown drug habit and sell the rest to otherusers for $ to “re-up”.
May never know someone is using heroin
7-10 days to Detox
Physical withdrawal can be severe, sometimes occurring 6-12 hours after last use depending on the user
Vomiting, cramping, sweating, muscle aches, agitation, diarrhea
Heroin Usage
•Hub city for heroin in NW WI is Chicago (controlled by street gangs)
•Most heroin is transported via vehicles like Greyhound buses to avoid police intervention (visit, dump, and run)
•Increase in high school use among teens who many are already abusing prescription narcotic pain relievers like Oxy’s and Hydrocodone
•18-25 year old white male - most predominant to use and sell
Heroin- Trends in NW WI
HeroinNW WI is targeted by street gangs from Chicago and
Milwaukee…untapped users with $.
Nigerian and Dominican criminal organizations are the primary heroin transporters into Milwaukee/Racine. Then regulated by African American and Hispanic gang members.
More difficult to detect compared to other drugs because of smaller quantities transported, stored, and sold.
Majority of heroin in WI is controlled by street gangs from Chicago and Milwaukee.
HeroinAverage street quantities are 1/4g-1/2g / also sold in “doses”
Average cost
¼g = $100 .1g=$25
Average purity in WI is
estimated up to 42-63%
Can be “cut” or “stepped on” w/impurities for more profits
Cutting agents are often lactose based powders like baking soda, corn starch, mannitol, dormin, and caffeine.
Needle Exchange Programs (NEP)
When the Milwaukee based program started in the 90's, their average age of an injector was about 35-years-old.
Now 17,18,19-years-old are pretty common.
9 NEP locations in WI 1). Prevent disease transmission2). Improperly discarded syringes are hazardous
to police, ems, sanitation workers, ect.3). The programs are recommended disease reduction
intervention programs at many locations aroundthe state.
Heroin- OD and Death rates in WI
Significant increases in Madison and Milwaukee
Recent reports in Hudson and Eau Claire
Narcan is used to reverse the effects
2015 WNA Northwoods Clinical Practice UpdateSession 3: Northwest Wisconsin Drug Trends
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Methamphetamine Methamphetamine
NW WI -increase in needle useHepatitis B and CHIVNeedle use among hardcore drug users
Methamphetamine Methamphetamine
“One Pot” MethodWI - Increase in “One Pot” methodQuicker, faster manufacturing methodOften less product manufactured, but more concealableMore cases in southwestern portion of the state
aka “Shake and Bake” method1 method or cook in 2 liter bottle
Video
“Shake and Bake” Meth
2015 WNA Northwoods Clinical Practice UpdateSession 3: Northwest Wisconsin Drug Trends
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Methamphetamine
Marijuana
Increase in high quality THC produced in sophisticated indoor grow operations
1960’s THC 3-5% “ditch weed”
2012 THC range is 15-30 %
aka “nugs” “bc bud”
Marijuana
Marijuana- DTO Grows
Continued DTO marijuana grow operations in NW WI by Hispanics w/ties to California and Mexico Locations- State/Federal forest locations to
conceal their grow
5-6 DTO grows in past 3 years in NW WI, each grow
may have 8,000-15,000 plants
Hispanic growers “rancheros” are often armed with guns to protect the crop. Funds go back to Mexico.
Better strains of THC = more grows per year = $$$
Marijuana Use and the Brain
Healthy Brain
16 year old
Marijuana User
16 year old daily user
2015 WNA Northwoods Clinical Practice UpdateSession 3: Northwest Wisconsin Drug Trends
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Marijuana- Signs & Symptoms
Rapid, loud talking & bursts of laughter (early intoxication)
Sleepy or daze in the later stages
Forgetfulness in conversation
Odor similar to burnt rope on clothing or breath
Brown residue on fingers
Inflammation in whites of eyes; pupils unlikely to be dilated
Tendency to drive slowly - below speed limit
www.theantidrug.com
“Synthetic” or “Designer” Drugs
NOT YOUR EVERYDAY “SPICE”
Spice, K2, Herbal Incense
Marketed as herbal incense “Not for Human Consumption” to avoid FDA inspection
K2- Signs and Symptoms Paranoia and Hallucination
Increased Heart Rate
Elevated Blood Pressure
Agitation and Anxiety
Dizziness and nausea
Vomiting and tremors
Chest pain
Suicidal or other harmful thoughts/actions
Where it’s Manufactured
Overseas (Asia and Europe)
Manufactured in WI clandestine locations (Eau Claire –Washburn Co case)
Made with chemicals (JWH-018, JWH-017,ect) sprayed and dried on foliage leaves
The illegal substance “JWH” and Acetone are sprayed on foliage leaves (binion)…then dried.
Nov 2010, DEA listed “K2” as Schedule 1 substance under their emergency powers
2015 WNA Northwoods Clinical Practice UpdateSession 3: Northwest Wisconsin Drug Trends
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American Association of Poison Control Center K2 Data
May 17, 2015
Calls to poison centers about exposures to synthetic marijuana:
Year Number of Calls
2010 2,906
2011 6,968
2012 5,205
2013 2668
2014 3680
As of 5/17/15 3291
Bath Salts- “MDPV”Synthetic Cathinones
Marketed as soothing bath salts“Not for Human Consumption”
•MDPV and Mephedrone are 2 of 6 illegal “bath salts” in WI.
•Bath salts are a synthetic stimulant that gives the user a combination effect of using ecstasy, cocaine, and meth all at the same time.
•Wisconsin passed a law in
July 2011 banning both the
bath salts and K2.
Bath SaltsSynthetic Cathinones
*
Appeared in southern US in 2009 and WI in 2010
MDPV was first detected in Germany in 2007
Marketed as “plant food” and believed by many as legitimate “bath salts”
Shipments originated from China, India, and Pakistan, manufactured by rogue chemists, and packaged to appear as beauty/household goods/plant food.
Once sold at head shops with an inference they are like “legal” cocaine, methamphetamine, and MDMA. Users report the high is like cocaine/meth/mdma all mixed together.
Primarily purchased via the Internet through email and shipped to PO box(s) or other conspirator residence to avoid detection by police, postal service inspectors, and US Customs
What About “Bath Salts”?Synthetic Cathinones
Ingestion Methods
Snorted (most common) Injected Smoked (similar to crack) Mixed with food Mixed with drink Airborne mist
2015 WNA Northwoods Clinical Practice UpdateSession 3: Northwest Wisconsin Drug Trends
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Sign/SymptomsIncreased Heart Rate
High Blood Pressure
Confusion
Hyper – alertness
Compulsive water drinking
Tremors / Seizures
Super-human strength consistent to excited delirium
Sign/Symptoms Agitation and Seizures
Paranoia & Suicidal thoughts
Hallucinations / Delusions Seeing demons, spiders,
monsters
Chest Pain
Violent Behavior
Bath Salts- MDPV
It’s in our area and it’s use is expected to continue.
American Association of Poison Control Center Bath Salts Data
March 31, 2014
Calls to poison centers about exposures to bath salts:
Year # of Calls
2010 306
2011 6,137
2012 2,691
2013 995
2014 582
As of 3/31/15 103
Effects- What Happens?
• Each user can be affected differently
Smoked / effects 5 – 10 minutes
Injected / effects can be immediate
Effect can have a “lag time” so users can double dose therefore leading to an overdose
Multiple users = Multiple EMS calls/ER visits at the same time (City of Barron cases)
June 24, 2011 Governor Walker signed Act 31 into law becoming effective in July 2011.
Now illegal to sell the drug in head shops and gas stations. Illegal to possess and distribute.
Act 31 makes the following illegal:•Synthetic Cannabinoids (Marijuana)•MDPV & Mephedrone (Bath Salts)•2C-I and “Analogs” of these substances
New Law
2015 WNA Northwoods Clinical Practice UpdateSession 3: Northwest Wisconsin Drug Trends
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Flakka (alpha-PVP)
• Stimulant - form of alphapyrrolidinopentiophenone• First report in 2014 in the US – Florida• Pronounced “”flocka” Smoke or “vaped” using an e-cigarette but can
be snorted, swallowed, injected, smoked on foil Physical appearance similar to meth (off white) Elivated heart rate, mild anxiety, paranoia, and
psychosis Highly addictive and users report feeling of
euphoria. Users known to become gressive and combative
Often mixed with other drugs like meth, cocaine, and MDMA
Flakka (alpha-PVP)
New Trends
Dangerous New Products and Trends
Alcoholic Energy Drinks 31% of 12-17 year olds
report regular consumption of energy drinks
*CDC
Beer VS. Alcoholic Energy Drinks
Miller Lite: 4.2% alcohol x 12oz = .5oz of pure alcohol
Joose= 12% alcohol x 23.5oz = 2.82oz of pure alcohol
What does this mean?
Beer VS. Alcoholic Energy Drinks
ONE 23.5oz can of JOOSE
= FIVE cans of beer!!
=
2015 WNA Northwoods Clinical Practice UpdateSession 3: Northwest Wisconsin Drug Trends
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Flasks on the Fly
Pocket Shots Disposable Flasks
Booze Bears
Alcohol Use & the BrainHealthy normal brain
Heavy teen alcohol user
Social DrinkingTeen heavy weekend user
Amen clinics
Sign/Symptoms- Alcohol Use Odor on breath
Intoxication/drunkenness
Difficulty focusing glazed apperance of the
eyes
Unexplained bruises and accidents
Irritability
Flushed Skin
Cocaine and the BrainHealthy Brain vs. Cocaine
2015 WNA Northwoods Clinical Practice UpdateSession 3: Northwest Wisconsin Drug Trends
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Prescription Drugs- Disposal
A Med Return drop box is located at the Barron County
Sheriff’s Department just outside
the dispatch office for 24/7 access.
Accepted items- Prescription
Medications, controlled and non-controlled, over the counter medications, medication samples, vitamins, medicated ointments/lotions, inhalers.
Non-accepted items- needles,
thermometers, IV bags, bloody or infectious waste, personal care products, empty containers, aerosol cans, business waster, and liquid medications
Tobacco
TAKE A L K
Can you easily pick out the tobacco?
Trends are changing…for the worse
Despite the tobacco industry’s claims of reduced health risks, these products are still deadly.
The amount of nicotine in dissolvable products varies, some have 3 times the amount in 1 cigarette.
Talk to Your Kids
Parental disapproval of underage drinking is
the number one reason that youth choose not
to drink alcohol.
Help your kids live above the influence. Talk to your kids about not using drugs and alcohol.
Talk to Your Kids
Teens whose parent’s talk to them regularly
about drugs are 42% less likely to use than those whose parent’s don’t.
Help your kids live above the influence. Talk to your kids about not using drugs and alcohol.
Talk to Your Kids
In 2008, 14% of Barron County high school
students reported using smokeless tobacco in
the past month, compared to just 7.7% in the rest of Wisconsin.
Help your kids live above the influence. Talk to your kids about not using drugs and alcohol.
2015 WNA Northwoods Clinical Practice UpdateSession 3: Northwest Wisconsin Drug Trends
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Social Networking
45% of employers are now
seeing this
and this!
Social Networking
24% of college admissions
officers are seeing it too!
Games
Flippy cup, beer pong, and beer bongs
Role Models? It’s Not Just Alcohol
“Its actually not a leaf but the bud i broke up and shaped to the picture i
drew.”
2015 WNA Northwoods Clinical Practice UpdateSession 3: Northwest Wisconsin Drug Trends
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Cyberbullying
•42% of kids have been bullied
online
•1 in 4 have had it happen more
then once
•9 of 10 Middle School students have
had their feelings hurt online
•75% have visited a site bashing
another kid
•Girls are twice as likely as boys to be victims
What Really Happens to my Messages?
•Every time you send a message:
•It gets stored on the cell phone company's computer server.
•Government safety agencies may have screened your messages (“Patriot Act”).
•Your parents can access your messages from the web site.
•Deleted messages are retrievable.
•You can’t control who forwards your
messages.
What Can I do?
•Stay involved in your child’s life
•Be nosy
•Get your own Facebook/MySpace account.
•Create family technology contracts.
•Talk to your kids, explain expectations.
•Have access to their username and passwords.
•Check their room
•Keep the computer in a common area, where you can monitor its use.
•Call and confirm where they are going to be
•Watch what you are doing in regards to alcohol
•Don’t provide alcohol to anyone under 21
•Talk to your kids!
Do you know something that you think law enforcement
should know?
Text an ANONYMOUS Tip to Law EnforcementText the keyword “BCTIPS” and your tip information to tip411
Barron County Sheriff’s Department
Barron Co Sheriff’s Dept
Sheriff Chris Fitzgerald(715) 637-6737
Captain Ron Baures(715) 637-6870
website: www.barronsheriff.org
Questions?