The document summarizes techniques used by the Keweenaw Bay Indian Community (KBIC) to combat prescription drug abuse, including establishing a Healing and Wellness Court in 2011. The Wellness Court uses a multi-phase program involving treatment, drug testing, court supervision, and community support groups to help offenders address substance abuse issues. Data showed high prescription drug rates in KBIC communities from 2007-2008, prompting research into grants and a coordinated community response through the Wellness Court program.

1. Techniques Used in Combating Prescription Drug Abuse
Becky Tussing, RN - Associate Director
KBIC DHHS
November 28, 2012
Bemidji Area I/T/U
Appleton, WI

3. Graph 1: Rate of prescriptions per 1,000
persons by county, Jan 07-Dec 08 (data from
Michigan Automated Prescription System,
MAPS, city-data.com and 2000 US Census)
4507
2468
1876
1223
0
1000
2000
3000
4000
5000
Baraga Houghton Marquette Ontonagon
0
0.05
0.1
0.15
0.2
0.25
Jan-11
Feb-11
Mar-11
Apr-11
May-11
Jun-11
Jul-11
Aug-11
Sep-11
Oct-11
Nov-11
Dec-11
Baraga County Unemployment Rate 2011
Baraga County
Michigan
U.S.

4.  In 2007 and 2008, Baraga County had more than
twice the prescriptions, per person, of the most
dangerous prescription drugs (i.e. Oxycontin,
Hydrocodone, etc.) than Marquette County, and
nearly four times that of Ontonagon County.
 The average amount of prescriptions in Baraga
County is 4.5 per person, two more than Houghton
County (2.5), and substantially higher than
Marquette (1.9) and Ontonagon (1.2).

5. Graph 1: Rate of prescriptions per 1,000
persons by county, Jan 07-Dec 08 (data from
Michigan Automated Prescription System,
MAPS, city-data.com and 2000 US Census)
4507
2468
1876
1223
0
1000
2000
3000
4000
5000
Baraga Houghton Marquette Ontonagon

6. 0 10 20 30 40 50 60 70
Assaults
Burglary
Child Abuse
Domestic Dispute
Domestic Violence
Drug Related
Harassment
Juvenile
Larceny
Sex Offense
Stalking
Number of Calls
2011 KBIC Tribal Police Calls

7. “To promote education through public
awareness with the specific objective to
eliminate the use of “illegal drugs” for the
betterment of the health, welfare, and safety
of the Keweenaw Bay Indian Community and
our neighboring communities.”

9.  Prescription Drug Abuse Contract
 Direct Observation Random Drug Screens
 PDSA Cycle for Controlled Substance Refill requests
 MAPS/ Evaluation of prescribing history
 Case Management Meetings
 Medically assisted Treatment: Vivitrol
 Referral network for outpatient substance abuse
evaluation
 Tribal Council approved Abusive Behavior Policy
 Strong administrative support for Medical Staff
 Drug Tip Line

10.  KB Tribal Police- K-9 dog, Meth Officer
 New Day Treatment Center
 Outpatient Treatment/ATR
 Transitional Housing
 On-Staff Neuro Psychologist
 Medically Assisted Treatment- Vivitrol
 Wellness Court
 Ojibwa Housing
 Job Training

11.  Makes it criminal to obtain or attempt to
obtain a controlled substance ( or a
prescription) for a controlled substance by
fraud from a health care provider.
 This statue also says that the medical records
(or information released) for patients who do
this are not protected by the physician-patient
privilege, dentist-patient privilege, or any
other health professional-patient privilege
created or recognized by law.

12.  Any person who shall do any act, or who
shall fail to do any act, involving a
substance defined as a controlled substance
by the Michigan Controlled Substances Act,
shall be guilty of a misdemeanor if such act
or omission shall occur within the
jurisdiction of this court.
 A conviction upon a violation of the
provisions of this section shall constitute a
conviction of a Class B misdemeanor.

13.  Simultaneously obtaining controlled substances
from more than 1 physician.
 Getting a controlled substance prescription for
the same condition from more than 1 provider.
 Getting a controlled substance in someone
else’s name.
 Using altered or falsified information to get a
controlled substance.
 Simultaneously filling the same controlled
substance prescription at more than 1
pharmacy.

14.  Health care providers may disclose
protected health information when that
information contains what the provider
believes to be evidence of a crime
committed on the health care facility’s
premises. 45 CFR 164.512(f)(5).
 Information regarding fraudulently
obtaining or attempting to obtain controlled
substances by fraud is evidence of a crime
committed on the premises of the health
care facility.

15. In 2009 and 2010, in an effort to address the substance abuse problem
in the Keweenaw Bay Indian Community, research into various grants
began.
Through a community-wide effort, in February 2011, the KBIC Healing
and Wellness Court was created.

16.  FACT: Unless substance abusing/addicted
offenders are regularly supervised and held
accountable, 70% drop out of treatment
prematurely.
 FACT: Drug Courts are six times more likely to
keep offenders in treatment long enough for them
to get better.

17.  FACT: Nationwide, 75% of Drug Court graduates
remain arrest-free at least two years after leaving
the program.
 FACT: Rigorous studies examining long-term
outcomes of individual Drug Courts have found
that reductions in crime last at least 3 years and
can endure for over 14 years.
 FACT: The most rigorous and conservative
scientific “meta-analyses” have all concluded that
Drug Courts significantly reduce crime as much as
45 percent more than other programs.

18. It starts with the Team:
A diverse team of individuals include:
Court Advocate
Prosecutor
Police Commissioner
Probation Officer
Healing and Wellness Coordinator
Police Officer
Psychologist-Educator
Judge
 All team members have a “say” in the final
decision that is made.

19.  In conjunction with Medical and Mental health
consultation such as: Vivitrol, Mental Health
Counseling, Outpatient Treatment.
 Clients work through four phases.

20. • Must attend at least two support network meetings (AA, NA, Smart
Recovery)
• Follow all after care treatment plan as recommended by treatment provider
• Curfew
• Report to Drug Court Coordinator Twice a week. Drug test twice a week plus
random testing
• Submit to court ordered mental health counseling recommendations
• Random home visits which include searches and drug tests
• Must attend Academy Psychology Positive Peer Culture Groups
• Thirty consecutive clean days required to move ahead to Phase Two

21. • Meet with Drug Court Coordinator once per week
•
• Drug test once a week plus random testing
• Random Home Visits
• Participate in Treatment Plan
• Employment Ready
• Community Service
• Participate in three support network meetings and Academy
Psychology Positive Peer Culture
• Sixty consecutive days clean to move to Phase Three

22. • Drug Court Coordinator office visits two times a month
• Random Home Visits
• Drug Tests two times a month in addition to random testing
•
• Educational/Vocational/GED
• Community Service
• Participate in at least 3 Support Network Meetings and Academy
Psychology Positive Peer Culture
• Develop Recovery Plan- Implement the Healthy Living Plan and
submit a written narrative describing your lifestyle changes
• Sixty consecutive clean days required to move to Phase Four

23. • Attend Court Review Hearing once a month
• Participate in Treatment Plan
• Drug Court Coordinator office visits- (1) once a month
•
• Random Home Visits
• Drug Tests (1) once a month plus random testing
• No new criminal involvement
• Follow all previous Court Orders
• Employment Ready (resume, interviewing skills)
• Educational/Vocational/GED
GRADUATION!!!

25. This is what Wellness Court is about…

26. REFERENCES
 Drug Courts Work. (n.d.). Retrieved October
19, 2012.
 Tussing, B., & Pinnow, S. (2012). Regional
Health Assessment (Rep.).
 KBIC Drug Court
 KBIC Drug Task Force
 Mark Panasiewicz, Academy Psychology
btussing@kbic-nsn.gov