AGENT IN CHARGE Brian Veazey OKC Diversion AIC Brian Veazey - PowerPoint PPT Presentation

AGENT IN CHARGE Brian Veazey OKC Diversion AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

Protect ectin ing g Oklah lahom omans ans  Prescr escription iption Drug g Abuse Protecting the security of citizens against foreign and  Mexica can n Cartel els . domestic threats to their lives,  Methamphetamine hamphetamine Labs well-being, and the prosperity of  Huma man n Trafficking icking our communities.  Syn ynthe thetic tic Drugs gs AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

 DIVERSION  ENFORCEMENT  HUMAN TRAFFICKING/MONEY LAUNDERING  TRAINING/EDUCATION  LEGAL AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

s more e than n 19,00 ,000 doctor  OBN Divers rsion ion overs rsee ees ors, , pharmaci acists ts, , and hospit ital al prescri cription tion licens enses. es.  OBN Divers rsion ion investi stiga gate tes s allega egations tions of prescript ription ion fraud a.k.a. . “Doctor Shopping” and other forms of prescription diversion. ains the nation’s only Real-Time Time  OBN Divers rsion ion maint ntains Prescri cripti ption on Monit itoring oring Program ram (PMP) that began on July ly 1, 2006. 6. PMP provid ides s regis istrant trants s and profess ssional ional board investi stigat gator ors with h direct ct comput uter er access ss to a database that tracks s and mainta tains ins controll trolled prescri cription tion infor orma mation. tion. AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

 The deviation from legitimate use of prescription drugs for illegal purposes (obtaining, using and/or selling)  Types: “doctor shopping”, forged/altered prescriptions, employee theft; AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

◦ Manufacturer to Wholesaler ◦ Wholesaler to Distributor ◦ Distributor to Pharmacy, Hospital, or Doctor’s Office AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

2013 - 5 th overdose deaths 19.4 per 100,000 and 3 rd in use number of pain pills prescribed per capita AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

OBN L Baker 6/16/2016 Source: State ME 2015 Data is not complete. AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

Pharmaceutical deaths: there is at least one prescription drug or over the counter drug 31% 31% Street 69% 69% Pharmaceutical OBN L Baker 6/16/2016 SOURCE : STATE ME 2015 Data is not complete AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

STATE OF OKLAHOMA 2015 DRUG OVERDOSE DEATHS INVOLVING THE TOP 9 ABUSED DRUGS The majority of all drug overdose deaths are due to a combination “cocktail” of drugs rather than just one specific drug. This chart reflects the total number of deaths each drug was involved in, even though another drug may have been the primary cause of death. 50 50 Alpraz Alpr azolam olam 61 61 70 70 122 122 73 73 Methamphetamine Met hamphetamine 270 270 80 80 Oxy Oxycod codone one Hy Hydr drocodone ocodone OBN 158 158 L Baker 135 135 6/16/2016 Source: State ME 2015 Data not complete AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

600 496 496 493 493 462 462 460 460 500 452 452 390 390 377 377 370 370 364 364 400 346 346 R OF 300 BER 200 HS DEATHS NUMBE 100 0 2011 2012 2013 2014 2015 MALE LE 462 462 460 460 452 452 493 493 490 490 346 346 390 390 370 370 377 377 360 360 FEMALE ALE OBN L BAKER AIC Brian Veazey 6/16/2016 Oklahoma Bureau Chief Div. Mark Stewart SOURCE: STATE M.E. Of Narcotics 2015 Data is not complete

Nearly half of young people who inject heroin surveyed reported abusing prescription opioids before starting to use heroin. Some individuals reported taking up heroin because it is cheaper and easier to obtain Overdose Deaths Middle than prescription opioids. Aged Men 45-55 Non Medical Usage 16-25 AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

 The US makes up only 4.6% of the world’s population but consumes 80% of the worlds opioids.  99% of the world ’ s Hydrocodone is consumed by the US (a bcnews.go.com )  More than half of all fatal overdoses involved a “cocktail” of several prescription drugs . ( Centers for Disease Control and Prevention ) Opiate + Benzodiazepine + Muscle Relaxer “Trio” or “Trinity” – combination of Hydrocodone, Alprazolam, & Carisoprodol “Holy Trinity” – Oxycodone, Alprazolam, & Carisoprodol AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

Institute of Medicine Relieving Pain in America 2011 AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

OpioidsIncreasing AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

Oxycodo odone ne  OxyContin Percocet Hydrocodone  Vicodin Zohydro Dilaudid  Fentanyl  AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

Opioid Side Effects Mentally Impairing  Depression  Anxiety  Delay Recovery  Increase Medical Costs  Double the chance of Disability  Increase Falls  Cardiac  Neurobiological Changes  Addiction  Death  AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

Who is at Risk of Addiction from These Medications Family History  Personal History of Addiction  Mental Health Diagnosis  Adverse Childhood Events  Stress  Prolonged Prescription  Diagnosis of:  Back Pain  Headaches  Fibromyalgia  AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

Summary O pioids are not “powerful painkillers”  Ibuprofen is better  Opioids have many side effects that are much  worse than NSAIDS and Acetaminophen Opioids cause brain changes  By reducing the prescribing of Opioids,  we improve pain treatment Most people on chronic opioid therapy do better when  weaned off Most people with addiction to Opioids need Methadone  or Buprenorphine AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

Statewide electronic database that collects designated data on CDS from dispensers such as Real- physicians, Time veterinarians, and pharmacists. The goal of the PMP Clinical is to provide a Tool clinical tool for physicians to guard against prescription drug diversion and abuse. AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

 According to WCRI, 55 to 85 percent of all injured workers in the United States received narcotic painkillers between 2008 and 2010, despite medical recommendations to limit such prescriptions to extreme pain or when other methods fail. AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

2013 Oklahoma’s legislature successfully passed a comprehensive  workers’ comp reform bill, Senate Bill 1062 the system from a court- based system to an administrative one, and creates an alternative insurance option for employers, The bill also addresses the problem of controlled substances.  Calls for the adoption of guidelines to be drafted by the Physician  Advisory Committee “for the prescription and dispensing of any controlled substance included in Schedule II of the Uniform Controlled Dangerous Substances Act” if those substances are not addressed in the current edition of the Official Disabilities Guidelines (ODG). The bill also limits reimbursement to physicians who dispense  prescription drugs to “no more than ten percent (10%) above cost.” AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

Workers Comp and the PMP  Nearly 30 people filed eight civil actions in Mingo County, West Virginia, Circuit Court between 2010 and 2012 that alleged three physicians and four medical centers “negligently prescribed and dispensed” drugs that led them to abuse and become addicted to opioids, court records show.  Experts urge workers compensation payers to take steps to avoid overprescribing or doctor shopping following a state Supreme Court's decision allowing patients to sue physicians and pharmacies for contributing to their addiction to opioids.  Drug monitoring programs helpful What payers in most states can — and should — do to curb overprescribing is to ask workers comp physicians if they're accessing prescription drug monitoring programs, experts said. http://www.businessinsurance.com/article/20150521/NEWS08/150529964/opioid-addiction-suit-puts- workers-comp-payers-on-alert?tags=%7C75%7C79%7C92%7C304%7C309%7C329 AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics

Brian Veazey 405- 530-3129 bveazey@obn.state.ok.us AIC Brian Veazey Oklahoma Bureau Chief Div. Mark Stewart Of Narcotics