Kansas Prescription Drug and Opioid Advisory …...• Over 72,000 drug overdose deaths in 2017 –...
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Krista Machado Kansas Prescription Drug and Opioid Advisory Committee
Transcript of Kansas Prescription Drug and Opioid Advisory …...• Over 72,000 drug overdose deaths in 2017 –...
Krista Machado
Kansas Prescription Drug and Opioid Advisory Committee
Drug Poisoning Mortality, U.S.
• Over 72,000 drug overdose deaths in 2017 – Nearly 200 people a day
• 49,068 involved an opioid – 134 people a day
• 19,354 involved a opioid pain reliever
• 15,958 involved heroin
• 29,406 involved other synthetic opioids such as fentanyl
Drug Poisoning Mortality, U.S.
Drug Poisoning Mortality in Kansas
• 310 drug poisoning deaths in 2016
• 104 caused by natural or semi-synthetic opioids
• 36 caused by heroin
• Drug poisoning death rate decreased 8% in 2016 compared to 2015
• Drug poisoning death rate increased in 2017 to 326
Opioid Prescribing 2017
• Nationally, Opioid prescription and dispensation rates have been declining in recent years
• U.S. – 58.7 opioid prescriptions per 100 people
• Kansas – 81.1 opioid prescriptions per 100 people
Data Sources: CDC, APPRISS Health Tableau Data Dashboard – K-TRACS CDC Metrics Table
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This map shows prescription opioid dispensation rates by PATIENT ADDRESS. Counties with highest dispensation rates are in SE KS – Greenwood County is the highest with 183 opioid prescriptions per 100 residents. Potentially biased by population size Average KS Rate = 81.1 prescriptions per 100 Kansans
Statewide Grants
Partnerships for Success (PFS) 2015 Prescription Drug Initiative
Prescription Drug Overdose: Data-Driven Prevention Initiative (DDPI)
Opioid Overdose Crisis Cooperative Agreement
State Targeted Response (STR) to the Opioid Crisis
State Opioid Response (SOR)
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PFS – state planning, funds coalitions, data collection pilot, medication disposal pilots, safe storage pilot, annual opioid conference DDPI – state planning, data enhancements, KTRACS enhancements, NAS prevention, LE and provider education STR – Mainly treatment (MAT, telehealth, peer recovery, LE ed/Naloxone) some for prevention (opioid awareness campaign)
Partnerships for Success (PFS) 2015 Prescription Drug Initiative
• Coordinates Advisory Committee• Funds community coalition pilot sites • Data collection pilot project• Medication disposal pilot projects• Safe storage pilot project
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coordinates the Kansas Prescription Drug and Opioid Advisory Committee provides sub-recipient grant funding to community coalitions in high-risk areas to develop a strategic plan and implement selected evidence-based strategies in their community to prevent the incidence of non-medical use of prescription drugs among individuals between the ages of 12-25. –LWLA, SSW, LWFC The Kansas City Metro Methadone Program (KCMMP) data collection pilot project digs deeper into the assessment of the prescription drug epidemic in Kansas by obtaining new data on patients seeking and receiving treatment for Opioid Use Disorder. The data is utilized to assess potential risk factors and guide resources and planning for the reduction of the incidence and prevalence of prescription drug misuse and abuse among individuals between the ages of 12-25 in Kansas. 82.1% initiated use between the ages of 11-25 73.5% report family history of addiction 53.6% report initiation drug taken by prescription 24.7% report Hydrocodone or Vicodin as initiation drug The goal of the medication disposal pilots is to increase safe disposal of prescription opioids using medication disposal products, in target populations, to decrease social availability for individuals between the ages of 12-25. The project is targets independent pharmacies located in counties with high risk prescribing areas to provide a resource for disposing of leftover medications with new or non-maintenance opioid prescriptions. –Salina, Pratt, Hesston, Erie, Ottawa, Hutchinson, and La Cygne KS The safe storage pilot project provides medication lockboxes to all foster families within the DCCCA Child Placing Agency, promoting safe use, storage, and transportation of medication for children in foster care and help to prevent accidental poisoning and misuse.
State Opioid Response (SOR)
• Increase access to treatment and recovery services• Increase capacity of healthcare settings to implement SBIRT• Increase Buprenorphine waived physicians • Enhance care coordination • Overdose prevention education• Increase Naloxone utilization by first responders, behavioral health
providers, and healthcare providers
Kansas State Targeted Response to the Opioid Crisis (STR)
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The Kansas Opioid State Targeted Response to the Opioid Crisis project (STR) focuses on increasing access to treatment, and reduce opioid overdose-related deaths through the provision of prevention, treatment, and recovery activities for opioid use disorder. Some of the strategies being implemented are: medication assisted treatment (MAT), telehealth, peer recovery, LE/naloxone education
DCCCA’s STR InitiativeJuly – November 2018
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The Kansas Opioid State Targeted Response to the Opioid Crisis project (STR) focuses on increasing access to treatment, and reduce opioid overdose-related deaths through the provision of prevention, treatment, and recovery activities for opioid use disorder. Some of the strategies being implemented are: medication assisted treatment (MAT), telehealth, peer recovery, LE/naloxone education
Kansas Data-Driven Prevention Initiative
• Statewide Planning
• Data• Drug-related mortality data• Syndromic surveillance drug poisoning data from EDs• Hospital admission and d/c data (KHA)• K-TRACS dispensation data• Work with coroners to increase specificity of drug poisoning deaths• Behavioral Risk Factor Surveillance System
• Prevention in Action• K-TRACS Enhancements • Education for providers, pharmacists, students, LEOs, general public• CDC Guidelines • CDC Rx Awareness Campaign • VON NAS Universal Training Program • Community mini-grants
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Cooperative agreement with the CDC Prescription Drug Overdose: Data-Driven Prevention Initiative Objective: decrease prescription and illicit opioid abuse, misuse, and dependence, to decrease rates of fatal and non-fatal poisoning deaths in Kansas Implements a three-pronged approach to reach the initiative’s goals Planning, Data, and “Prevention in Action” Prevention Main focus: Enhance Kansas’s PDMP (K-TRACS) and increase its use by prescribers and pharmacists Aim – prevent diversion, misuse and abuse of controlled substances while protecting legitimate medical use Strategies Enable registration, use, and access of K-TRACS (EHR integration) Expand proactive reporting Public health surveillance with K-TRACS
Opioid Overdose Crisis Cooperative Agreement
• LHD mini-grants for secondary prevention and crisis response
• Naloxone law enforcement survey
• Education for professionals
• LEOs, EMS personnel, MDs, DOs, APRN/PAs, RN/LPNs, PharmD/RPh, public health, students
Kansas Prescription Drug and Opioid Advisory CommitteePartners
Kansas Department for Aging and Disability ServicesKansas Department of Health and EnvironmentDCCCAKansas Bureau of InvestigationKansas Hospital AssociationKansas Foundation for Medical CareUniversity of Kansas School of Medicine- WichitaUniversity of Kansas Medical CenterKansas Poison Control CenterUS Department of Health and Human ServicesKansas State Child Death Review BoardKansas Pharmacists AssociationKansas Department of CorrectionsKansas Attorney General’s Office
Kansas Board of PharmacyKansas Board of Healing ArtsKansas Medical SocietyKansas Association of Chiefs of PoliceKansas Sheriffs AssociationKansas Native American AffairsUS Attorney's Office – District of KansasKansas Healthcare CollaborativePrairie Band Pottawatomie TribeKickapoo Social ServicesIowa Tribe of Kansas and NebraskaSubstance Abuse Center of KansasHutchinson ClinicBeacon Health OptionsMidwest HIDTA
Greenbush- Southeast Kansas Education Service CenterKansas Department for Children and FamiliesMirror Inc.Sunflower Health PlansShawnee Mission Medical CenterTopeka Police DepartmentShawnee Mission Medical CenterAmerican Association of Oral & Maxillofacial SurgeonsKansas Family PartnershipAllen County Multi-Agency TeamSafe Streets WichitaValley HopeBlue Valley School DistrictDouglas County Health Department
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In 2016 KDADS, KDHE, and DCCCA worked in collaboration to establish the multi-disciplinary Kansas Prescription Drug and Opioid Advisory Committee. The goal of this committee is to develop and implement a coordinated multi-disciplinary statewide strategic plan that not only fulfills grant requirements, but also extends beyond current grant funding providing a comprehensive approach to the crisis in Kansas and hopefully putting us in a better position to apply for future grants. This includes significant collaboration between state agencies and partners with a vested interest in the opioid crisis is ongoing as the advisory committee works to ensure alignment and coordination of efforts across the state to address the crisis in Kansas.
Kansas Prescription Drug and Opioid Advisory Committee
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Presentation Notes
In 2016 KDADS, KDHE, and DCCCA worked in collaboration to establish the multi-disciplinary Kansas Prescription Drug and Opioid Advisory Committee. The goal of this committee is to develop and implement a coordinated multi-disciplinary statewide strategic plan that not only fulfills grant requirements, but also extends beyond current grant funding providing a comprehensive approach to the crisis in Kansas and hopefully putting us in a better position to apply for future grants. This includes significant collaboration between state agencies and partners with a vested interest in the opioid crisis is ongoing as the advisory committee works to ensure alignment and coordination of efforts across the state to address the crisis in Kansas From our needs assessment, the committee identified five main areas of need with the additional need for data and monitoring intertwined within each area. The five priority areas are: Prevention, provider education, treatment and recovery, law enforcement, and Neonatal abstinence syndrome
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Committee’s priority areas and subcommittee chairs - *KRISTA WILL DISCUSS THIS IN-DEPTH*
Kansas Prescription Drug and Opioid Advisory CommitteePartner Initiatives • Kansas Partnership for Pain Management• Project ECHO• Kansas Poison Control Center• KFMC Special Innovation Project
• Shawnee County Chronic Pain Collaborative• National Governor’s Association Learning Lab• Annual Opioid Conference
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Highlight Opioid Conference and PCC – Older adult medication safety program
Promising Strategies
• Telehealth initiatives to expand access to treatment in rural areas• ACEs questionnaire and building resiliency in youth• Provider education – CDC guidelines, best practices, alternative pain management• EHR/K-TRACS Integration and K-TRACS utilization • General public education• Data collection and monitoring – Crisis response planning • SBIRT in PCP offices, hospitals, EDs, LHDs, etc. • Increasing access to treatment including MAT, peer support, sober living, etc. • Project ECHO• Increase utilization of Naloxone• Safe use, storage, and disposal education – patient and general public
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In Kansas, over 75% of youth that report misusing prescription drugs report obtaining medications not prescribed to them from a friend or relative by either buying, stealing, or being given them. It is important that prevention happens at home by practicing safe use, storage, and disposal of prescription medications to decrease these access points. The misuse of prescription drugs can be just as dangerous as using illegal drugs. Some medicines, such as opioids, may be especially harmful and, in some cases, fatal with just one dose if they are used by someone other than the person for whom the medicine was prescribed. To prevent accidental exposure to, including ingestion of, these potentially dangerous medicines by children and others, including pets, it is recommended that these medicines be safely stored and disposed of quickly. Storing unused, unwanted, or expired medicines, especially medications with high abuse potential such as opioid pain relievers, stimulants, or depressants, can lead to accidental poisoning, drug abuse, and even drug trafficking. When medications are expired or no longer needed it is important to dispose of them properly to reduce the chance that others may accidentally take or intentionally misuse the unneeded medicines. Other Methods: If the options listed above are not readily available, it is still important to dispose of the potentially harmful unused medications. In these circumstances, possible secondary disposal methods include: Some medications are approved by the Food and Drug Administration (FDA) to be disposed of by flushing them down the toilet or sink. A list of approved medications can be found by visiting: www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm#Flush_List Dispose of medications in the trash by mixing the medication with an undesirable substance such as dirt, kitty litter, or coffee grounds, in a sealed container, such as a sealed plastic bag.
Prescription Drug Prevention StrategiesMedia Campaigns – Free Resources
It Matters KansasThe It Matters Campaign resources aim help communities understand the extent and cause of multiple behavioral health concerns including substance use, depression, suicide and problem gambling.
• www.itmattersks.org
CDC Rx Awareness Campaign The goal of the campaign is to increase awareness that prescription opioids can be addictive and dangerous.
• https://www.cdc.gov/rxawareness/index.html
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The It Matters website and related free educational campaigns are sponsored by the Behavioral Health Services Commission at the Kansas Department for Aging and Disability Services (KDADS). Behavioral Health Services works to help communities understand the extent and cause of multiple behavioral health concerns including substance use, depression, suicide and problem gambling. The goal is to empower communities with tools and resources to make a positive change. The CDC Rx Awareness campaign tells the real stories of people whose lives were torn apart by prescription opioids. The goal of the campaign is to increase awareness that prescription opioids can be addictive and dangerous. The campaign also strives to decrease the number of individuals who use opioids recreationally or overuse them.
Opioid Prevention StrategiesProvider Education Resources
K-TRACSCDC Guidelines and Resources
K-TRACS
Project ECHO
Kansas Provider Toolkit
Providers Clinical Support System
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Highlight CDC resources for patients on pain management and how to talk to your doctor
Prescription Drug and Opioid Prevention StrategiesSafe Use, Storage, and Disposal
In Kansas, over 75% of youth that report misusing prescription drugs report obtaining medications not prescribed to them from a friend or relative.
Friend/Relative Gave them to
me
Bought them from Friend or
Relative
Took from Friend or Relative
Stranger
Drug DealerOnline
Safe Use, Storage, and Disposal Toolkit
Prescription Drug and Opioid Prevention Strategies
Disposal Options: • National DEA Take-Back Days, hosted by local law enforcement in the spring and fall • Medication Collection Sites, to find a collection site near you visit,
https://apps.deadiversion.usdoj.gov/pubdispsearch/spring/main?execution=e1s1• All Walmart pharmacies provide a free medication disposal resource upon request• Free medication disposal resources may also be requested from DCCCA
(https://www.dccca.org/partnerships-success-form/) or the Kansas Poison Control Center (Call toll free, 1-800-222-1222)
• Contact a local pharmacy or waste management authority to learn more about local disposal options
Presenter
Presentation Notes
In Kansas, over 75% of youth that report misusing prescription drugs report obtaining medications not prescribed to them from a friend or relative by either buying, stealing, or being given them. It is important that prevention happens at home by practicing safe use, storage, and disposal of prescription medications to decrease these access points. The misuse of prescription drugs can be just as dangerous as using illegal drugs. Some medicines, such as opioids, may be especially harmful and, in some cases, fatal with just one dose if they are used by someone other than the person for whom the medicine was prescribed. To prevent accidental exposure to, including ingestion of, these potentially dangerous medicines by children and others, including pets, it is recommended that these medicines be safely stored and disposed of quickly. Storing unused, unwanted, or expired medicines, especially medications with high abuse potential such as opioid pain relievers, stimulants, or depressants, can lead to accidental poisoning, drug abuse, and even drug trafficking. When medications are expired or no longer needed it is important to dispose of them properly to reduce the chance that others may accidentally take or intentionally misuse the unneeded medicines. Other Methods: If the options listed above are not readily available, it is still important to dispose of the potentially harmful unused medications. In these circumstances, possible secondary disposal methods include: Some medications are approved by the Food and Drug Administration (FDA) to be disposed of by flushing them down the toilet or sink. A list of approved medications can be found by visiting: www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm#Flush_List Dispose of medications in the trash by mixing the medication with an undesirable substance such as dirt, kitty litter, or coffee grounds, in a sealed container, such as a sealed plastic bag.
Gaps Remaining in Kansas
• Specific strategies/recommendations for: • Rural areas• Farming communities • Older adults
• Access to treatment in rural areas • SBIRT• Primary Prevention
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Remaining gaps/concerns/needs Specific strategies/recommendations for Rural areas Farming communities Older adults Expand access to treatment in rural areas (western KS) Expansion of telehealth initiatives
Resources
• Kansas Prescription Drug and Opioid Prevention Data, Plan, and Resources: www.preventoverdoseks.org
• DCCCA: www.dccca.org/prevention-services
• Kansas Prevention Collaborative: http://kansaspreventioncollaborative.org/
• Kansas Communities that Care Student Survey: www.kctcdata.org
• Project ECHO: http://www.kumc.edu/community-engagement/ku-center-for-telemedicine-and-telehealth/project-echo.html
• PCSS-O: https://pcss-o.org/education-training/core-curriculum/
• PCSS-MAT: https://pcssmat.org/management-of-opioid-withdrawal-and-overdose/
• Substance Abuse and Mental Health Services Administration (SAMHSA): www.samhsa.gov• SAMHSA Treatment Locator: https://findtreatment.samhsa.gov/• KS Treatment Referral Line: 1-866-645-8216
• Centers for Disease Control and Prevention (CDC): https://www.cdc.gov/drugoverdose/opioids/index.html
