Narcotic Abuse & Drug Disposal National Survey on Drug Use and - PDF document

ITAC 12/13/2016 Narcotic Abuse & Drug Disposal National Survey on Drug Use and Health (NSDUH) ITAC I T 2014 Narcotic Abuse T AKES Substance Abuse and Mental Health Services Administration (SAMSA) Drug Disposal A › Survey published by SAMSA on the use of illegal drugs, alcohol C OMMUNITY and tobacco by the civilian, noninstitutionalized population of Drug and Alcohol the US aged 12 and over. P REVENTION C OALITION › 27 million people aged 12 and older used an illicit drug in the past 30 days (10.2%) – Aged 12 to 17 2.3 million (9.4%) – Aged 18 to 25 7.7 million (22.0%) – Aged ≥ 26 17 million (8.3%) Karl Fiebelkorn, MBA, RPh Senior Associate Dean Clinical Associate Professor of Pharmacy Practice & Administration University at Buffalo School of Pharmacy & Pharmaceutical Sciences Deaths from Prescription Opioids National Survey on Drug Use and Health (NSDUH) CDC Statistics 2014 Substance Abuse and Mental Health Services Administration (SAMSA) › 1999 ‐ 2014 › 27 million people aged 12 and older used an illicit drug in the – 165,000 deaths – Aged 25 ‐ 54 most common past 30 days. – Overdose rates highest – 4.3 million Americans reported current non ‐ medical use of › Non ‐ Hispanic whites prescription pain relievers › Deaths Men > women – Approximately 1.9 million Americans met criteria for prescription pain › 2014 reliever use disorder based on their use of prescription pain relievers – 14,000 deaths in the past year. › Most common drugs in prescription overdose › 1.4 million people used prescription painkillers non ‐ medically – Methadone for the first time in the past year. – Oxycodone – The average age for prescription painkiller first ‐ time use was 21.2 in – Hydrocodone the past year. http://www.cdc.gov/drugoverdose/data/overdose.html Accessed October 27, 2016 NYS Drug Overdoses NYS Opioid Crisis: Statistics › 1.4 million New Yorkers suffer from a substance abuse › Nearly 80% of recent heroin uses started with opioid disorder analgesics › Upstate NY had a 222% increase in admissions to OASAS certified treatment programs among 18 ‐ 24 year old for heroin and other opioids › 2014 – 2,028 New Yorkers died of a drug overdose › 30% in New York City Jones, CM (2013). Heroin Use and Heroin Use Risk Behaviors among Nonmedical Users of Prescription Opioid Pain Relievers: United States, 2002 -2004 and 2008- 2010. Retrieved September 27, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/23410617 NYS Heroin and Opioid Task Fore Report June 9, 2016 Karl D. Fiebelkorn, MBA, RPh 1

ITAC 12/13/2016 Narcotic Abuse & Drug Disposal Narcotic Abuse Deaths in Erie County Due to Overdose of Opioids › NYS Combatting the Heroin and Opioid Crisis › 2014 127 – Heroin and Opioid Task Force Report › 2015 256 › June 9, 2016 › 2016 320 ‐ 350* › 31 page report by governor’s task force – *estimate by Erie County Department of Health › https://www.governor.ny.gov/sites/governor.ny.gov/files/atoms/files/HeroinTas › Typical overdose victim kForceReport_3.pdf › Heroin overdose is now the leading cause of accidental death – 38 y.o. white male › Fentanyl is behind sharp rise in overdose deaths in NYS http://www.wgrz.com/news/projected ‐ opiate ‐ overdose ‐ deaths ‐ down/362428788 http://buffalonews.com/2016/09/01/fentanyl ‐ behind ‐ sharp ‐ rise ‐ overdose ‐ deaths/ New York State Office of Alcoholism and Substance Abuse Services (2016) Fentanyl et al (CHINA WHITE) Analogs include: Acetylalphamethyl ‐ fentanyl Acetyl fentanyl Alfentanil Alphamethylfentanyl Alphamethylthiofentanyl Betahydroxy ‐ fentanyl Beta ‐ hydroxy ‐ 3methylfentanyl Fentanyl 3 ‐ methylfentanyl 3 ‐ methylthio ‐ fentanyl Parafluoro ‐ fentanyl Remifentanil Sufentanil Thiofentanyl Carfentanil http://www.wsj.com/articles/this ‐ is ‐ u ‐ 47700 ‐ once ‐ a ‐ lab ‐ experiment ‐ now ‐ a ‐ killer ‐ opioid ‐ 1478269461: accessed 11/4/2016 http://www.cdc.gov/vitalsigns/heroin/index.html, accessed 10/30/2016 http://www.emcdda.europa.eu/publications/drug ‐ profiles/fentanyl: accessed 11/10/2016 This is U ‐ 47700, Once a Lab Experiment (1973 Upjohn) , Now a Killer Opioid “It’s hard to keep track of what’s killing people,” says Karl Williams, chief medical examiner in Allegheny County, which includes Pittsburgh. OPIOID OVERDOSE PREVENTION TRAINING ERIE ERIE COUNT UNTY DE DEPARTMEN MENT OF OF HE HEAL AL TH TH http://www.wsj.com/articles/this ‐ is ‐ u ‐ 47700 ‐ once ‐ a ‐ lab ‐ experiment ‐ now ‐ a ‐ killer ‐ opioid ‐ 1478269461: accessed 11/4/2016 Karl D. Fiebelkorn, MBA, RPh 2

ITAC 12/13/2016 Narcotic Abuse & Drug Disposal Recalled: Mucosal Atomization Device (MAD) Availability of Naloxone in NYS › Listing of pharmacies by county who are listed on the › The affected MAD300 lot numbers are: 160108, 160117, 160126, 160145, 160146, 160200, 160219, 160225, 160231, 160300, 160313, 160327, 160400, NYS Naloxone Standing Order 160409, 160422, 160432, 160440, 160500, 160518, 160602, 160611, 160621, 160631, 160701, 160708, 160718, 160728, 160800, 160804, 160814, 160816, › http://www.health.ny.gov/diseases/aids/general/opioid_over 160823 . dose_prevention/docs/pharmacy_directory.pdf 13 DEA Drug Take Back Programs Prescription Drop Boxes /Locations Twice a Year / 35 sites in WNY https://www.health.ny.gov/professionals/narcotic/medication_drop_boxes/ › April 30, 2016 › October 22, 2016 › 32 sites › 35 sites › 13,348 pounds › 4,842 pounds › 4,666 car › 1,537 cars › 55 degrees/mild/sun › 37 degrees/windy/rain List of Drop Boxes in Erie County List of Drop Boxes in Erie County https://www.health.ny.gov/professionals/narcotic/medication_drop_boxes/erie.htm https://www.health.ny.gov/professionals/narcotic/medication_drop_boxes/erie.htm › Kenmore Police Department › Erie Community College South Public › Erie County Sheriff Substation › Erie County Sheriff's Substation Elma 2395 Elmwood Avenue Safety Springville 1600 Bowman Road Kenmore, NY 14217 4041 Southwestern Blvd Bldg # 5 65 Franklin Street Elma, NY 14059 Orchard Park, NY 14127 Springville, NY 14141 › New York State University Police › Erie County Sheriffs Office › Medialle College Public Safety Office › Erie County Community College North Bissell Hall 10 Delaware Avenue Lobby Buffalo, NY 14260 2 Agassiz Circle Public Safey Buffalo, NY 14202 Buffalo, NY 14214 6205 Main Street › Erie County Sheriff's Substation › Canisius College Williamsville, NY 14221 › Depew Police Department Clarence 2001 Main Street Bosch Building Public › Erie Community Public Safety 6185 Goodrich Road 85 Manitou Street Security Clarence, NY 14031 Depew, NY 14043 121 Ellicot Street Buffalo, NY 14208 Buffalo, NY 14260 › Erie County Substation Colden › Erie County Sheriff Substation Grand › Lancaster Police Department › Town of Hamburg Police 8812 State Road Island Criminal Justice Bldg. Lancaster Town Colden, NY 14033 1856 Whitehaven Road S6100 South Park Avenue Bldg. 529 Pavement Road Grand Island, NY 14072 Hamburg, NY 14075 Lancaster, NY 14086 Karl D. Fiebelkorn, MBA, RPh 3

ITAC 12/13/2016 Narcotic Abuse & Drug Disposal Drug Disposal DEA Rule Federal Register Receptacle September 9, 2014 › Pharmacies are now allowed to take back › Must be in area where employee can be vigilant – Community prescription medications › when pharmacy is open – Community, & Hospitals for households – Hospital – Nursing homes for nursing home residents only › not in emergency department – Must be registered – Nursing home – Disposal regulations › For resident’s medications only › Must get approval from resident › No questions asked › May not look at what is being destroyed. 19 Karl D. Fiebelkorn, MBA, RPh 4