Cuyahoga County Opiate Task Force Report2014

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Overview of the EpidemicThe number of deaths directly related to prescription drug abuse increased nearly 500% from 1999 to 2013. These accidental deaths now outnumber traffic crash fatalities in both Ohio and across the nation. Prescription pain relievers continue to be the key factor behind this epidemic and are responsible for more overdose fatalities statewide than heroin and cocaine combined.

Fatal and non-fatal drug poisonings cost Ohioans $3.6 billion annually, or $303 per resident.

Contributing factors that led to this epidemic include:•Changesmadetoclinicalpainmanagement

guidelinesduringthelate1990s

• Improperstorageanddisposalofunusedmedication

•Marketingmedicationsdirectlytoconsumers

•Over-prescribing

•Substanceabuseandunderlyingmentalhealthissues

•Widespreaddiversionofmedicationssuchas:doctorshopping,illegalonlinepharmacies,andtheestablishmentandrecentclosureofpillmills

Steps taken to reduce the use of pain pills may have inadvertently

produced a dramatic rise in heroin use.

2010Enoughprescription

opioidswereprescribedtomedicateevery

Americanadultaroundtheclockforamonth

2011 NearlyfiveOhioansdiedeachdayduetoadrugoverdose,an

averageofonepersoneveryfivehours

2013 CuyahogaCountylost340residents

toopioids

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The Cuyahoga County Opiate Task ForceTheCuyahogaCountyOpiateTaskForce,undertheleadershipoftheCuyahoga County Board of Health (CCBH),hasplayedasignificantroleinbringingpeopletogethertohelpfightthisgrowingpublichealthepidemicandreducethenumberofdeaths.

Dedicatedprofessionalsfromareassuchasdrugtreatment&recovery,education,healthcare,lawenforcement,medicine,mentalhealthservices,preventionspecialists,andpublichealthcollaborateatthelocal,stateandnationalleveltoshareinformationandeffectchange.

Recognizingthataddictionisadisease,themembersstrivetoincreaseawarenessofthedangersassociatedwiththemisuseofopiatesaswellastoimplementstrategiesandpoliciesthatwillhaveapositiveimpact.

TheOpiateTaskForcereceivedthe2014ExemplarAwardfromRecovery Resources,aCleveland-basednon-profitorganizationdevotedtohelpingpeoplewithmentalillness,alcoholism,drugandotheraddictions.Thisawardhonorsmembersofthecommunitywhohavedemonstratedalonganddistinguishedrecordofexemplaryserviceandsupportintheareasofpreventionandeducation.

CCBHwaschosenbytheOhio Department of HealthtobeoneofthreerecipientsoftheCentersforDiseaseControl’sPreventativeHealthandHealthServicesBlockGrant.From2014to2018,CCBHwillreceiveatotalof$400,000tocoverprojectactivities.ThesedollarsreflectODH’scommitmenttomeettheneedsofCuyahogaCountyresidentsthroughspecificprogrammingimplementedatthelocallevel.

Thegoalofthisgrantistosignificantlyreducefatalitiesassociatedwithprescriptiondrugabusethroughthedevelopmentofcomprehensive,multi-faceted,population-basedprogramsandpolicies.

M i s s i O nTo serve the residents of Cuyahoga County by actively working to raise public awareness, promote community action, and provide education related to the dangers and devastating effects of drug abuse.

V i s i O nTo create a healthier community by reducing accidental fatalities associated with opiate abuse through collaborative partnerships that focus on prevention, treatment, and recovery.

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CCBH has partnered with several members of the Opiate Task Force to fulfill the goals of the grant.

First year sub-grantees include:The MetroHealth system toprovidephysicianeducationonproperprescribingguidelines,toincreaseutilizationoftheOhio Automated Prescription Reporting system,adatabasethatcanhelppreventdoctorshopping,overprescribing,andabuse,andtheexpansionofNaloxonedistributionsites.

The Cuyahoga County Medical Examiner’s Office torevamptheexistingstructureofthePoison Death Review Committeetobeinclusiveofprescription

opiates.Thedatathatisgainedfromthiscommitteewillbeusedtotargetfutureeducationandpreventionefforts.

Baldwin Wallace University and Case Western Reserve University toconductassessments,provideeducationtofacultyandstaff,andcreatepoliciesgearedtowards

reducingprescriptiondrugabuseoncollegecampuses.

WehavealsopartneredwithDiscount Drug MartandMarc’stoprovideoutreachtotheirpharmacycustomers.Methodsincludein-persondistributionofrelevanteducational

materialaswellasprintandsocialmediamessagingtoraiseawarenessoftheprevalenceoftheprescriptiondrugepidemic.

How the Cuyahoga County Opiate Task Force is addressing this problem

Drug Court FollowingtheappointmentofJudge David Matia,theCuyahoga County Common Pleas Court beganbuildingitsDrug Court Program.Thegoalwastohelpparticipantsbreakthecycleofrecidivismbyofferingeitherincarcerationorparticipationinanextensivedrugtreatmentprogram.InitialparticipantswereacceptedintotheprograminMay2009.

Todate,over350participantshaveenteredthetreatmentprograminlieuofincarceration.In2013alone,thecourtwasreferred118cases,87wereadmittedintotheprogram,andatotalof54clientssuccessfullygraduated.Supportedbyanintensivetreatmentprogramandtheofferofaccesstolifelong

resources,theseindividualswereabletoreturntotheircommunitiesassobercitizens,parents,andemployees.

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Proper DisposalJudgeMatiaandtheCuyahogaCountySheriff’sOfficewereinstrumentalintheestablishmentofpermanentmedicationdropboxesinover33localcommunities.Thedropboxes,locatedinsidelocalpolicedepartments,areapermanentandsustainablewayforresidentstoproperlydisposeoftheirunwantedorexpiredmedication,significantlyreducingtheriskofmisuseortheft.Ofthosewhoreportedmisusingprescriptiondrugs,70%gotthedrugsfromarelativeorfriend.

To locate a drug drop box in your area, please call 211 or visit:www.rxdrugdropbox.org|www.sheriff.cuyahogacounty.us/rx

The national Drug Take Back Day,locallypromotedasOperation Medicine Cabinet,isasemi-annualeventwhichallowsresidentstosafelydisposeofunwantedandexpiredmedications.ThroughitspartnershipwiththeDrug Enforcement Agency,thecountysheriff’soffice,andlocallawenforcement,theefforthasremovedover40,000poundsofpotentiallydangerousmedicationfrommedicinecabinetsacrossNortheastOhio.Followingcollection,themedicationisincinerated,whichkeepsitoutofthelandfillsandwaterwaysaswellasthehandsofabusers.

Youth Prevention EducationSupportedbyfundingfromCardinal Health,asub-committeeofthe Opiate Task Force focusedheavilyonyouth-ledpreventioninordertoraiseawarenessaboutthemisuseandabuseofprescriptiondrugs,todevelopmulti-mediamessagespertainingtotheimpactofprescriptiondrugs,andtoincreaseadvocacyskills.

Contrarytomanymediamessages,stateandlocalsurveyscontinuetoshowthatthemajorityofmiddleandhighschoolkidscontinuetomakehealthychoicesanddonotpartakeintheuseofdrugsandalcohol.The Ohio Youth-Led Prevention network,aleadershipgroupmadeupofhighschoolstudents,developedthe“We are the Majority” themetogetthatpositivemessageouttotheirpeers.

InJune2013,eightstudentsfromacrossCuyahogaCountyhadtheopportunitytoattendtheYouth to Youth international Conference heldinColumbus,Ohio.Thisfourdayconferenceassistedbothyouthandtheprofessionalswhoservethembyofferingnewstrategiesandtechniquesinpreventionandprogramdevelopment.ThestudentsformedbondswithfellowOhiostudents,allowingthemtheuniqueopportunitytocontinuetostrengthentheirpreventionmessagingandprogramsintheirrespectiveschools.

Inthefallof2013,severaleventswerealignedwiththe“We are the Majority” theme.YouthleadershiptrainingwasheldonSeptember21at Cleveland state University,engagingover100youngpeoplefromacrossCuyahogaCountyinyouth-ledpreventioninitiativesfocusedonprescriptiondrugabuse.

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Participatingorganizationshadanopportunitytoreceivea$500stipendfortrainingabouttheimplementationofthepHARMinG Effectsprogram.TheeightgroupsthatwereselectedgatheredattheCuyahoga County Board of HealthonNovember16.

Researchshowsthatyoutharemorelikelytochangebehaviorbasedonpeerinfluenceratherthanadultspresentations.ThepHARMINGEffectsutilizesthevoiceandleadershipofyouthtoreachotheryouthanddeterrisktakingbehaviorthroughskits,videos,andaudienceparticipation.Followingthistraining,thepHARMINGEffectsprogramhasbeendeliveredtoover1000school-ageyouth.

For more information please visit:www.cardinalhealth.com/us/en/generationrx/

OrganizedbytheYouth Advisory Committee of the Ohio state University Extension,aYouthSummitwasheldNovember9atCleveland state University.

Topicswerecomprehensiveandincludedhealthyliving,entrepreneurship,youthvoice,socialissues,andserviceopportunities.Allsessionswereyouth-led.

OnApril30,over100youngpeoplefromacrossCuyahogaCountytookpartinthe“We are the Majority”rallytocelebratetheirdecisiontostayalcoholanddrugfree.Students,youthleaders,schoolofficials,parents,andprofessionalsgatheredattheCleveland Public Library,heardpreventionmessagingandparticipatedinteambuildingactivities.Afterward,theymarchedtoCityHalltolistentospeakerswhoinspiredthemtocontinuetomakegoodchoices.

AmongthespeakerswereJudge Michael Astrab, County Medical Examiner Dr. Gilson, Judge Michael Ryan, Jaclyn and nolan Brandt of Robby’s Voice,severallawenforcementofficialsandcitycouncilrepresentatives.

TheseinitiativesweredevelopedincollaborationwiththeCommunity Awareness and Prevention Association,theCuyahoga County Board of Health,Drug Awareness and Prevention,Ohio state Extension of Cuyahoga County,thesAY Coalition,andtheWestshore Enforcement Bureau.

To view coverage of the rally provided by WKYC Channel 3, please visit:

http://www.wkyc.com/story/news/local/cuyahoga-county/2014/04/30/drug-free- we-are-the-majority-community-awareness-and-prevention/8532615

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Understanding the shift towards heroin Localheroinuseisnotonlyontherise,itistakinglivesatunprecedentedlevels.AccordingtotheCuyahogaCountyMedicalExaminer,heroinisnowthemostcommonly-abuseddrugassociatedwithoverdosedeathsinCuyahogaCounty.

The shift toward heroin is due to a number of factors:

• IncreasingavailabilitythroughoutOhio•TheshutdownofsouthernOhiopillmills•Morehospitalsadoptingproper

prescribingguidelines

Withfewerpillsonthestreet,heroinhasbecomeacheaperalternativeforabusers.Althoughprescriptionpillsarestillreadilyavailable,theincreasedpresenceandpurityofheroinaswellaschangesintheformulationofsomepillstomakethemtamperresistanthavecauseduserstomaketheswitch.

For more information, please visit the microsite produced by the Cuyahoga County Prosecutor’s Office:

www.letsfaceheroin.com

Cuyahoga County lost 194 residents

to heroin in 2013

Heroin deaths have risen nearly 400%

since 2007

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Local steps taken to combat the epidemicOver600publicofficials,medicalandlegalprofessionals,educators,addictionspecialistsandindividualswhoseliveshavebeenimpactedbyheroingatheredattheCleveland CliniconNovember21inanefforttofindpracticalsolutionstotheregion’sheroinepidemic.

ACommunity Action Planwasformulatedoverthecourseofseveralplanningmeetingsandfinalizedduringthesummit.

The Action Plan is divided into four specific areas: PreventionandEducation|HealthcarePolicy|LawEnforcement|Treatment

LedbyU.S.AttorneyStevenDettelbachoftheUnited states Department of Justice,acommitteewasformedfollowingthesummittocontinuethemomentumofimplementingahighimpact,comprehensiveapproachtowardsreducingtheprevalenceofheroininCuyahogaCounty.Thiscommittee’sworkhasreceivednationalattentionandisbeingusedasamodelacrossthecountry.

The national Association of Medical ExaminersrecognizedtheresearchofCuyahoga County Medical Examiner Dr.TomGilsonwiththeSusan P. Baker Public Health impact Award.

CamilleHerby,aformergraduateinternattheMedical Examiner’s Office,receivedtheOutstandingPracticumPosterawardfromCase Western Reserve Universityattheinnovations in Population Health

Conferenceforherworkonthecounty

heroinepidemic.

A PDF version is available at:http://medicalexaminer.cuyahogacounty.us/pdf_medicalexaminer/en-US/HEROINACTIONPLAN.pdf

ODHViolenceandInjuryPreventionProgram

CuyahogaCountyMedicalExaminer’sOffice

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Itiscommonknowledgeamonglawenforcementofficialsthattheycannotarresttheirwaythroughthisepidemic.However,asawaytosendamessageabouttheseverityofthisepidemic,prosecutorscannowchargeheroindealerswithinvoluntarymanslaughterforbeingresponsibleinthedeathofacustomer.

TheAlcohol Drug Addiction and Mental Health services Board of Cuyahoga Countyalsolaunchedamulti-mediacampaigninthewinterof2013whichcontinues

toruntoday.ThecampaignincludedradioandTVspots,billboards,andbussigns.Thepreventioncampaigntargetedthefollowingdemographicsandthepeoplewhocareforthem:

Youth/Teens ages 12-17Middle aged men

Women aged 18-25

Sincethelaunchofthecampaign,monthlycallsreceivedhaveincreasedfrom105-260.Approximately50%ofthecallerswereseekinghelpforthemselves.

Duetotheoverwhelmingnumberofheroinaddictsseeninhiscourtroom,CuyahogaCountyCommonPleasJudgeMichaelAstrabwenttoseveralcommunitieswithatownhallstyleprogram:Heroin in the suburbs.Hisgoalwastoraiseawarenessoftheprevalenceofheroinandalsoinformparentsaboutkeepingtheirfamiliessafe.

Theprogramhasbeendeliveredtoanaverageof60communitymembersateachevent.SeveralmembersoftheOpiateTaskForcehaveservedasexpertpanelistsrepresentingpublichealth,thecourtsystem,lawenforcement,medicine,preventionandtreatment.

ODHViolenceandInjuryPreventionProgram

ODHViolenceandInjuryPreventionProgram

AgeGroup

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Project DAWn: an antidote to heroin overdoseProject DAWn (Deaths Avoided With naloxone)isa

community-basedoverdoseeducationandnaloxonedistributionprogramthatwascreatedasawaytocombatOhio’sopioidoverdoseepidemic.

Naloxone(alsoknownasNarcan)isamedicationthatcanreverseanoverdosecausedbyanopioiddrug(heroinorprescriptionpainmedications).When

administeredduringanoverdose,Naloxoneblockstheeffectsofopioidsonthebrainandquicklyrestoresbreathing.

Naloxonehasbeenusedsafelybyemergencymedicalprofessionalsformorethan40yearsandhasonlyonecriticalfunction:toreversetheeffectsofopioidsinorderto

preventoverdosedeath.

Key Points:

• Nalaxonehasnopotentialforabuse.

• Ifgiventoapersonwhoisnotexperiencinganopioidoverdose,itisharmless.

• Ifadministeredtoapersonwhoisdependentonopioids,itwillproducenonlife-threateningwithdrawalsymptoms.

• Itdoesnotreverseoverdosesthatarecausedbynon-opioiddrugs,suchascocaine,benzodiazepines(Xanax,Klonopin,Valium),methamphetaminesoralcohol.

It takes less than 30 minutes to obtain a kit that could save a life.

Attendees learn to:• Recognizethesignsandsymptomsofoverdose

• Distinguishbetweendifferenttypesofoverdose

• Performrescuebreathing

• Callemergencymedicalservices

• AdministerintranasalNaloxone

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The kit includes:

• 2vialsofNaloxonemedication

• 2nasalatomizers(the medication is sprayed into the nose of the individual experiencing an overdose)

• 1facemask

• 1educationalDVD

• 1educationalbooklet

MetroHealth Hospital,akeypartneroftheTaskForceandsub-granteeoftheODHgrant,dispenseskitstoeligiblepatientsintheEmergencyDepartmentaswellasseveralcommunitysitesincluding:

Cuyahoga County Board of Health:Fridaysfrom9a.m.–noon

Free Clinic of Greater Cleveland:Fridaysfrom1–5p.m.

Cuyahoga County launched Project DAWN on March 1, 2013 and has since registered over 500 participants and

documented at least 31 lives saved.

Registrant Data• 67%aremale

• 80%arewhite

• Averageageis36

• Agesrangefrom18-74

• 60%identifiedwithbeingaddictedtoprescriptionopioidspriortousingheroin

• 45%haveexperiencedanoverdose

• 7%reporttakingopioidsprescribedbyaphysicianformanagementofchronicpain

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Dr. Joan Papp,MetroHealthphysicianandOpiateTaskForcemember,hasbeeninstrumentalinadvocatingforlegislationsurroundingProject DAWn,playingakeyroleinthepassageofHouseBill170.Priortothepassageofthisbill,Naloxonehadtobegivendirectlytotheaddict.Nowafamilymember,friend,orlovedonecanobtainakit.Thislawalsoextendsaccesstofirstresponders(police,fire,paramedics)inadditiontoextendingprescribingabilitiestonursepractitioners.

Dr. PappandtheOpiate Task ForcearealsoinsupportofHouse Bill 363,a911Good samaritan Bill,whichaimstoencourageindividualstoseekmedicalassistance

intheeventofanoverdose.Thislawwouldprovidelimitedimmunityfromthearrestofaminordrugpossessionforvictimsandwitnesseswhocall911intheeventof

anoverdose.

A recent survey conducted at the Scioto County and Cuyahoga County Project DAWN locations found that 75% of survey participants had

witnessed an overdose.

Only 58% of those who had witnessed an overdose reported calling 911.

Project DAWn is funded by Cuyahoga County Executive Ed Fitzgerald’s Office, MetroHealth system, and

the Ohio Department of Health.

For more information please visit:www.metrohealth.org/projectdawn|www.ccbh.net

Physician Education Knowingthatthereisadirectrelationshipbetweentheheroinepidemicandprescriptionopioidabuse,emphasisisplacedoneducatingmedicalpractitionersaboutopioidprescribingguidelines,Naloxone,andthecurrentstateoftheepidemic.

InadditiontoDr. PappandtheMetroHealth systemprovidingeducationalguidanceasadeliverablefortheODHgrant,Opiate Task Forcemembersaredeliveringeducationtofirst-yearresidentsatCase Western Reserve school of Medicine.Aonedaytraining

forphysicians,co-sponsoredbytheAcademy of Medicine northern OhioandtheCuyahoga County Board of Health,willtakeplaceinthefallof2014.

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A Face to the EpidemicThewords“drugaddict”presentavarietyofmentalimagesdependingonourindividualexperiences.Perhapswethinkofascruffy,under-educated,unsuccessfulindividualoraschoolmatewhorarelyattendsclassandhasnofriends,orahomeless“junkie”hidinginanalley.

It’stimetothrowawaythosementalimages.Opiateaddictionknowsnoboundarieswhenitcomestosocioeconomicstatus,age,race,gender,sexualorientation,orreligiousaffiliation.

ThefollowingisthestoryofRobbyBrandt,abrightyoungmanwithaloving,supportivefamily,livinginthesuburbsofCuyahogaCountyaswrittenbytheBrandtfamily.

Robby’s story

How do you even start to tell the story which defines the peak of happiness and the depth of despair for any parent?

Hissmile,probablythemostdefinablecharacteristicofRobby.Everyonealwaystalkedabouthissmile,andtheyshouldhavebecauseitwashistrademark.Didn’tmatterifitwasasmileofcelebration,orthewrygrinhewouldgetwhenhewaseitherengaginginorfinishingmischief.Itwasasmilethatputeveryoneatease,madeyoufeelgoodnomatterwhatthesituationwas.

Robbywas,well,Robby.AnX-generationdaredevil,therewasnothingtoofast,nothingtochallengingforhimtotry.Allthethingsthatwouldcauseyourstomachtotwistarounditselfwerethethingshethrivedupon.Onhisbike,skateboardorrollerblades,

therewasneveraramporjumptoobigtochallenge.Norollercoastertohighorfast,andunfortunately,nospeedlimithedidn’tliketotest.Idon’tknowifheenjoyedconqueringtheobstacle,orthereactionofthoseofuswhowitnessedthesefeatsofdaring,maybeabitofboth.

Robbylovedtogetariseoutofpeople,andtherewasnoendtohiscreativity.Thehairspraydrivenpotatolauncherwasamonghisgreatestachievements,butitwasHalloweenwhereheshinedeveryyearashedressedasMichaelMyersandrantheneighborhoodwithhischainsaw,scaringanychildoradultthathecouldsneakupupon.Hewasanaturalatwhateverhetried;athletics,music,motorcycles,horsebackriding,didn’tmatter,hewasasgoodashewantedtobeinamatterofminutes.

Pointis,Robbylovedlifeandlivedeverymomenttoexperienceallithadtooffer.Sometimesthatmeantimportantthings,likeschool,werepushedtotheside,buttohim,therewasmorethatlifehadtoofferthanjustbooks.Hispresencewasinfectiousandhisabilitytotalk,well,relentless…

ButitwasRobby’sheartthatmadehimspecial.Robbycaredaboutpeople;hewasthegotooguywhenthingsweretough.Hewastheguythatspenttime

Robby Brandt

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withthe“oldfolks”atthenursinghomewhereheworked(Iguesstheywerehappytohavesomeonetotalkto,andhetalkedaslongastheylistened).EvenafterhejoinedtheOhioNationalGuard,notextrapush-upordrillsergeantscouldcontainhiszestforlifewhichwascapturedbythetattoostencileddownhisentireside–“CarpeDiem,”seizetheday.

Robbywasthesonanyparentwouldbeproudof,andwewere.But,Robbywasalsoanaddict,andhiszestforlivingwasrivaledbyhisstruggletobeatthegripsofaddiction.

Likemanykids,Robbyexperimentedwithpotwhileinhighschool.Unfortunately,hispersonalityalwaysdrovehimtopushalittlefurther,anddrugswerenodifferent.Afterhavinghiswisdomteethremoved,Robbybecameaddictedtoprescriptionpainkillers.Thataddictionslowlychangedhim,astheeffectsofthe

highs,lowsandwithdrawalsweremanifestedinhisactionsandattitudes.HewasabletokickthehabitpriortoleavingforbootcampinOctoberof2010,butwhenhe

returnedhomeforChristmasbreak,hewasintroducedtothedevil–heroin.

Robbyreturnedtothearmy,finishedhistraining,andreturnedhomeonlytoseekoutthedrugthatwasnowimprintedonhisbrain.Hisbehaviorrapidlychanged,andallthe

signswerethere,andwewerefinallyabletoputenoughpiecestogethertouncoverhisaddiction.Weasked,andhehappilyprovidedeverydetail,almostrelievedthathewould

finallyhavethesupportofhisfamilytogetthehelpheneeded.

Robbycompletedinpatientrehabwithflyingcolorsandaresolvetostayclean,butthedrugandthosewhosurroundedhimweretoostrongapull,andherelapsedacoupleofmonthsafter.Inpatientrehabseemedtohelp,butitwasclear;thiswasgoingtobealongbattle.

Overthecomingmonths,Robbyfoughthard,butcouldneverreallygiveupthedrawofagoodchemicallydrivenbuzz.Chewingtobacco,snuff,energydrinks,poppyteaandanynumberof“legal”alternativesservedassubstitutesforthedrughisbodyreallycraved.

Evenatthat,itappearedRobbywasontherighttrack.HewaspreparingtodeploytoAfghanistan,adreamofhis,wasworking,andhadevenstartedtotalkaboutmovingout.Thingsseemedpromising,althoughwewerealwaysawarethatanotherrelapsewasaprobability,wehopedagainsthopethatthatdaywouldnotcome.

OnOctober20th,Robbydisappearedfromworkandwasnotrespondingtocallsortexts.Wesearched,invain,tofindhim,tobetheretohelphim,tobetheretosavehim,buttheeffortswerenotsuccessful.OnthemorningofOctober21st,thesceneyouwatchahundredtimes,athousandtimes,ontvplayedoutforreal.WewereinformedbyPolicethatoursonhadbeenfound;hisbattlewasover.

Robbydidnotwanttobeanaddict.Heworkedhardtobreakawayfromthedeath-gripofaddiction.Hehaddreams,vividdreamsofhisfuturewhichhewroteaboutinletters.Heplannedontalkingtoschools,educatingothersonthetolladdictiontakesontheaddict

andthefamily.Hewasstartingafoundation,“LiveClean,”todeliverthatmessage.

Robbymaynotbeheretodeliverthemessage,totellhisstory,buthisspiritandhisdreamsareverymuchalive.Now,throughthisfoundation,hisvoicewillbeheard,

thesilencewillbebroken,andhismissionofservicetootherswillbefulfilled.

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We Are and Will Always Be Robby’s VoiceRobby’sVoicehasbeenagreatadditiontotheOpiateTaskForce.MembersofRobby’sVoicecontinuetobeheardbyseveralgroupsandorganizations.Theyhavespokentoover150parents,familiesandindividualswhoarelookingforguidance.Theysurpassedthe10,000markintermsofthenumbersofstudents,parents,schoolofficialsandcommunitymemberstheyhaveeducated.

Robby’sVoicemessageissustainedbyover2,000Facebookfriendsandtheyhavehadover250,000visitstotheirwebsite.RaceIVAwarenessisanannual5Krun/walkhostedbyRobby’sVoicewhereover400participantsshowtheirsupport.

For more information, please visit:www.robbysvoice.com

The Cuyahoga County Opiate Task Force is committed to significantly

reducing fatalities associated with opiate abuse.

For more information or to become a member, please visit our newly redesigned website:

www.opiatecollaborative.cuyahogacounty.us

Questions?

Pleasecontact:Allisyn Leppla, injury Prevention Coordinator Cuyahoga County Board of Health216-201-2001 ext. 1252|aleppla@ccbh.net

ThisworkisfundedeitherinwholeorinpartbyagrantawardedbytheOhio Department of Health, Bureau of Healthy Ohio, Violence and injury Prevention Programandasasub-awardofagrantissuedbytheCenters for Disease Control and Prevention (CDC),Preventive Health and Health services Block Grantunderthegrantawardnumber3B01DP009042-13s1andCFDA number 93.991.

Twitter.com/OpiateTaskForce Facebook.com/CuyahogaCountyOpiateTaskForce

AcademyofMedicineNorthernOhio|www.amcno.org

ADAMHSBoardofCuyahogaCounty|www.adamhscc.org

BaldwinWallaceUniversity|www.bw.edu

BuckeyeCommunityHealthPlan|www.bchpohio.com

CaseWesternReserveUniversity|www.case.edu

Cenpatico|www.cenpatico.com

CityofClevelandDepartmentofHealth|www.clevelandhealth.org

CityofGarfieldHeights|www.garfieldhts.org

CityofIndependence|www.independenceohio.org

ClevelandClinic|www.my.clevelandclinic.org

CommunityAwarenessandPreventionAssociation|www.bbhcapa.org

ConcernedMembersoftheCommunity

Connections|www.connectionscleveland.org

CuyahogaCountyBoardofHealth|www.ccbh.net

CuyahogaCountyCourtofCommonPleas|www.cp.cuyahogacounty.us

CuyahogaCountyMedicalExaminer|www.medicalexaminer.cuyahogacounty.us

CuyahogaCountyOfficeofHealth&HumanServices|www.cuyahogacounty.us

CuyahogaCountySheriff’sOffice|www.sheriff.cuyahogacounty.us

DiscountDrugMart|www.discount-drugmart.com

DrugAwarenessandPrevention,Inc.|www.drugawarenessandprevention.org

EuclidPoliceDepartment|www.euclidpd.org

Glenbeigh|www.glenbeigh.com

Marc’s|www.marcs.com

MetroHealthSystem|www.metrohealth.org

NewDirections|www.newdirect.org

OhioAttorneyGeneral’sOffice|www.ohio.gov

OhioStateUniversityExtensionCuyahogaCounty|www.osu.edu

ParentAdvocates

PartnershipforaHealthyNorthRoyalton|www.partnershipnr.com

PremierPhysicians|www.premierphysicians.net

RecoveringAddicts

RecoveryResources|www.recres.org

Robby’sVoice|www.robbysvoice.com

RockyRiverMunicipalCourts| www.rrcourt.net

SocialAdvocatesforYouth(SAY),BellefaireJCB|www.bellefairejcb.org/say/say-social-advocates-for-youth

St.VincentCharityHospitalRosaryHall|www.stvincentcharity.com

StellaMaris,Inc.|www.stellamariscleveland.com

TheNorthernOhioAcademyofPharmacy|www.northernohioacademyofpharmacy.org

UnitedStatesDepartmentofJustice| www.justice.gov

UnitedStatesAttorney’sOffice| www.justice.gov/usao

UnitedWayCleveland|www.unitedwaycleveland.org

UniversityHospitals|www.uhhospitals.org

WestshoreEnforcementBureau

WKYCChannel3|www.wkyc.com

Community Partners