NC Opioid and Prescription Drug Abuse Advisory Committee (OPDAAC) Coordinating Workgroup Meeting January 11, 2018 Happy New Year!
Welcome! and Introductions of Attendees • Welcome! − Susan Kansagra − Steve Mange • Introductions of Attendees − Your name − Your organization/affiliation
Updat Update on on Metrics Metrics NC Opioid Action Plan, Measuring Impact NC Opioid Action Plan, Measuring Impact Scott Proescholdbell
Metrics f Metrics for NC’s Opioid r NC’s Opioid Action Plan Action Plan Baseline Baseline Data Data 202 2021 T Trend end/Goal /Goal Me Metrics trics (20 (2016, Q4) 6, Q4) OVERALL OVERALL 20% reduction in expected 2021 Number of unintentional opioid-related deaths to NC Residents (ICD-10) 335 number 20% reduction in expected 2021 Number of ED visits that received an opioid overdose diagnosis (all intents) 998 number Reduce o ce over ersupply of supply of pres escript cription op ion opioid ioids Average rate of multiple provider episodes for prescription opioids (times patients received opioids from ≥ 5 prescribers dispensed at ≥ 5 pharmacies in a six month period), per Decreasing trend 100,000 residents 29.9 per 100,000 Total number of opioid pills dispensed 145,997,895 Decreasing trend Percent of patients receiving more than an average daily dose of >90 MME of opioid Decreasing trend analgesics 6.7% Percent of prescription days any patient had at least one opioid AND at least one Decreasing trend benzodiazepine prescription on the same day 25.3% Reduce Divers Reduce Diversion/ n/Fl Flow of ow of Ill Illici cit t Drugs Drugs Percent of opioid deaths involving heroin or fentanyl/fentanyl analogues -------------------------------- 58.7% Number of acute Hepatitis C cases 43 Decreasing trend Increase A ease Acce cess ss to Nalox loxone Number of EMS naloxone administrations -------------------------------- 3,185 Number of community naloxone reversals 817 Increasing trend Treatm Treatment and Recovery ent and Recovery Number of buprenorphine prescriptions dispensed Increasing trend 133,712 Number of uninsured individuals and Medicaid beneficiaries with an opioid use Increasing trend disorder served by treatment programs 15,187 Number of certified peer support specialists (CPSS) across NC 2,352 Increasing trend
Number of Unintentional Opioid-R mber of Unintentional Opioid-Related Deaths to elated Deaths to NC R NC Residents sidents 2021 Q4 expected 700 deaths based on 2013-2016 trend 600 Number of deaths per quarter GOAL 500 400 300 200 Actual deaths 100 Goal : 20% reduction from expected 0 *2017 data are preliminary and subject to change Source: NC State Center for Health Statistics, Vital Statistics-Deaths, ICD10 coded data, includes NC Resident deaths occurring out of state, 1999-2017 Q1 Previously, trendline calculations began in 2010; trendline calculations now start in 2013 due to the increased availability of illicitly manufactured fentanyl beginning around that time. Detailed technical notes on all metrics available from NC DHHS; Data now depicted quarterly; Updated December 2017
Number of Opioid Over mber of Opioid Overdose ED Visits dose ED Visits 1,800 2021 expected 1,600 rate based on Number of ED visits per quarter 2013-2016 trend 1,400 1,200 GOAL 1,000 800 600 Actual ED visits 400 200 Goal : 20% reduction from expected 0 *2017 data are preliminary and subject to change Source: NC Division of Public Health, Epidemiology Section, NC DETECT, 2009-2017 Q3 Previously, trendline calculations began in 2010; trendline calculations now start in 2013 due to the increased availability of illicitly manufactured fentanyl beginning around that time. Detailed technical notes on all metrics available from NC DHHS; Data now depicted quarterly; Updated December 2017
Average Rate of multiple provider Average Rate of multiple pr ovider episodes f episodes for prescription opioids r prescription opioids (times patients received opioids from (times patients received opioids fr om ≥ 5 prescriber 5 prescribers dispensed at s dispensed at ≥ 5 5 pharmacies in a pharmacies in a Six month period), per 1 Six month period), per 100,000 residents 00,000 residents 90.0 Rate per 100,000 residents per six-months 80.0 70.0 Actual rate 60.0 50.0 40.0 30.0 20.0 2021 expected rate based on 10.0 2013-2016 trend 0.0 *2017 data are preliminary and subject to change Source: NC Division of Mental Health, Controlled Substance Reporting System, 2011-2017 Q2 Previously, trendline calculations began in 2010; trendline calculations now start in 2013 due to the increased availability of illicitly manufactured fentanyl beginning around that time. Detailed technical notes on all metrics available from NC DHHS; Data now depicted quarterly; Updated December 2017
Total N l Number of Opioid Pills Dispensed mber of Opioid Pills Dispensed 250,000,000 2021 expected pills Number of opioid pills dispensed per quarter dispensed based on 2013-2016 trend 200,000,000 150,000,000 Actual pills dispensed 100,000,000 50,000,000 0 *2017 data are preliminary and subject to change Source: NC Division of Mental Health, Controlled Substance Reporting System, 2011-2017 Q3 Previously, trendline calculations began in 2010; trendline calculations now start in 2013 due to the increased availability of illicitly manufactured fentanyl beginning around that time. Detailed technical notes on all metrics available from NC DHHS; Data now depicted quarterly; Updated December 2017
Percent of patients recei Per ent of patients receiving more than an average daily g more than an average daily dose of >90 MME of opioid analgesics dose of >90 MME of opioid analgesics 25% 20% Percent per quarter 15% 10% 2021 expected Actual percent percent based on 5% 2013-2016 trend 0% *2017 data are preliminary and subject to change **This update excludes patients receiving Buprenorphine and Methadone; the June 2017 Version 1 metric did not make these exclusions Source: NC Division of Mental Health, Controlled Substance Reporting System, 2011- 2017 Q3 Previously, trendline calculations began in 2010; trendline calculations now start in 2013 due to the increased availability of illicitly manufactured fentanyl beginning around that time. Detailed technical notes on all metrics available from NC DHHS; Updated December 2017
Percent of prescription days Per ent of prescription days any any patient had at least one opioid patient had at least one opioid AND at least one benzodiazepine AND at least one benzodiazepine prescription on the same day prescription on the same day 50% 40% Percent per quarter 30% Actual percent 2021 expected percent based on 20% 2013-2016 trend 10% 0% *2017 data are preliminary and subject to change Source: NC Division of Mental Health, Controlled Substance Reporting System, 2011- 2017 Q3 Previously, trendline calculations began in 2010; trendline calculations now start in 2013 due to the increased availability of illicitly manufactured fentanyl beginning around that time. Detailed technical notes on all metrics available from NC DHHS; Updated December 2017
Percent of Opioid Deaths Involving Her Per ent of Opioid Deaths Involving Heroin or in or Fentanyl/Fent Fent nyl/Fentanyl Analogues anyl Analogues 100% 90% 2021 expected percent based on 80% 2013-2016 trend 70% Percent per quarter 60% 50% 40% 30% 20% Actual percent 10% 0% *2017 data are preliminary and subject to change **Increasing numbers of deaths due to other classes of designer opioids are expected Source: NC Office of the Chief Medical Examiner (OCME) and the OCME Toxicology Laboratory, 2010-2017 Q3 Previously, trendline calculations began in 2010; trendline calculations now start in 2013 due to the increased availability of illicitly manufactured fentanyl beginning around that time. Detailed technical notes on all metrics available from NC DHHS; Data now depicted quarterly; Updated December 2017
Number of Acute Hepatitis mber of Acute Hepatitis C Cases C Cases 2021 expected 90 number based on 2013-2016 trend 80 Number of cases per quarter 70 60 50 40 30 20 10 0 Actual cases *2017 data are preliminary and subject to change Source: NC Division of Public Health, Epidemiology Section, NC EDSS, 2000-2017 Q1 Previously, trendline calculations began in 2010; trendline calculations now start in 2013 due to the increased availability of illicitly manufactured fentanyl beginning around that time. Detailed technical notes on all metrics available from NC DHHS; Data now depicted quarterly; Updated December 2017
Number of EMS Naloxone Administr mber of EMS Naloxone Administrations tions 2021 expected number based on 5,000 2013-2016 trend 4,500 Number of administrations per quarter 4,000 3,500 3,000 Actual administrations 2,500 2,000 1,500 1,000 500 0 *2017 data are preliminary and subject to change Source: NC Office of Emergency Medical Services (OEMS), EMSpic-UNC Emergency Medicine Department, 2010-2017 Q3 Previously, trendline calculations began in 2010; trendline calculations now start in 2013 due to the increased availability of illicitly manufactured fentanyl beginning around that time. Detailed technical notes on all metrics available from NC DHHS; Data now depicted quarterly; Updated December 2017
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