10/12/2016 Required Disclosure Opioids and Maine: the state of the state Text Font typically Times New Roman at least 20 point Try to have size consistent throughout Christopher Pezzullo, DO State Health Officer Maine DHHS|Maine CDC October 16, 2016 Department of Health and Human Services 2 Number of drug deaths involving specific drug Unintentional Injury Deaths in Maine, by type: types*: 2014** 2009‐2014 250 70 208 200 More than one in three 57 overdose deaths involved In 2014, there were 208 150 43 benzodiazepines. 42 drug related overdose 30 deaths compared to 131 100 131 24 More than one in four motor vehicle related overdose deaths involved deaths. 50 heroin/morphine . 0 2009 2010 2011 2012 2013 2014 *Some deaths may be caused by more Motor vehicle‐related injury deaths 159 161 136 164 145 131 than one key drug. **2014 results are preliminary Drug‐related overdose deaths 179 167 155 163 176 208 ***Deaths caused by known pharmaceutical morphine removed Source: Office of the Chief Medical Examiner, Maine Bureau of Highway Safety/Maine Department of Transportation from total. Source: Marci Sorg, Margaret Chase Smith Policy Center at University of Maine, 3 4 Office of the Chief Medical Examiner 1
10/12/2016 Number of drug affected baby notifications*: Heroin related death overdoses, 2005‐2014 Maine vs. Nation: 2002‐2013 In 2014, there were a total of 976 1000 976 927 5.0 reports of drug affected babies Rates/100,000 4.3 and 995 in 2015 . 779 800 Maine 4.0 667 3.3 Nation From 2005 to 2014, the 572 600 number of drug affected baby 2.7 2.8 3.0 notifications increased by 451 2.4 2.2 480% . 2.1 343 400 1.9 1.8 2.0 *This measure reflects the number of infants 274 1.5 born in Maine where a healthcare provider 1.4 1.9 201 reported to OCFS that there was reasonable 1.1 165 1.0 cause to suspect the baby may be affected 200 0.8 by illegal substance abuse or demonstrating 1.0 0.7 0.7 0.7 0.7 0.6 1.0 1.0 withdrawal symptoms resulting from prenatal drug exposure (illicit or prescribed 0.7 appropriately under a physician’s care for 0.5 0 the mother’s substance abuse treatment) or 0.0 who have fetal alcohol spectrum disorders. Source: Office of Child and Family Services (OCFS), Maine Automated Child Welfare Information System (MACWIS). Source, National Data: USCDC; Multiple Cause of Death Files from the Source, Maine Data: Maine Department of Health and Human 5 6 National Vital Statistics System, 2002‐2013. Services, Office od Research, Data and Vital Statistics Implementation Additional Maine facts….. Timeline for 488 (PMP Legislation) August 1, 2016 • 100 MME limit for new Rxs • Maine #1 state per capita long acting • Exempted: ED/inpatient LTCF/Residential care extended release opioids (USCDC 2102) • Exceptions: cancer pain (active • 80 million discrete opioid pills rx’d per and aftercare)/palliative year care/hospice/MAT • 300 MME limit if over 100 MME until 7.1.17, or documented medical necessity with no limit until 1.1.17 Department of Health and Human Services 8 2
10/12/2016 Implementation Implementation Timeline Timeline January 1, 2017 July 1, 2017 • Required PMP check for new benzo or opioid, and every 90 • All opioids must be electronically prescribed by this date, unless days thereafter for chronic opioid Rxs a hardship waiver is requested and granted by DHHS • 7d/30d: acute/chronic December 31, 2017 • Must have three credits of CME in opioid • Pharmacists and veterinarians auto-enrolled by this date use/abuse/risks/benefits by this date, then every two years thereafter • Consider PCSS http://pcss-o.org/ Department of Health and Human Services 9 Department of Health and Human Services 10 Other DHHS Questions? Initiatives Dr. Christopher Pezzullo • 211 Maine State Health Officer • Methadone christopher.pezzullo@maine.gov • MaineCare PA • Education Department of Health and Human Services 11 Department of Health and Human Services 12 3
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