Opioid Task Force Kick-Off Meeting February 29, 2016
Scope of the Opioid Problem and Data Review Olivia Kasirye, MD, MS County Public Health Officer
OVERVIEW The Opioid Epidemic Opioid Task Force Development Prevention Strategies 3 2/29/2016 Opioid Task Force Kick-Off Meeting
The Opioid Epidemic 4 2/29/2016 Opioid Task Force Kick-Off Meeting
Definition: Opioids are any of various compounds that bind to specific receptors in the central nervous system and have analgesic (pain relieving) effects including prescription medications such as oxycodone (OxyContin), hydrocodone (Vicodin), morphine, methadone, codeine and illicit substances such as heroin and fentanyl. 2/29/16 Opioid Task Force Kick-Off Meeting 5
Adverse Effects of Opioids on the Brain 2/29/16 Opioid Task Force Kick-Off Meeting 6
National Statistics Since 2000, the rate of deaths from drug overdoses has increased 137%, with a 200% increase in deaths due to opioids* Nearly 2 million Americans age 12 or older abused or were dependent on opioids in 2013** 20% to 30% of opioids prescribed for chronic pain are being misused*** Rate of addiction is 10%*** Sources: *MMWR/January 1, 2016/Vol.64/ **CDC National Center for Health Statistical Vital Statistics Report ***International Association for the Study of Pain 7 2/29/2016 Opioid Task Force Kick-Off Meeting
Teen Prescription Drug Misuse & Abuse 23% report having abused Rx medication at least once in their lifetime 31% believe “it’s okay to use prescription drugs that were not prescribed to them to deal with an injury or pain, as long as they are not getting high” 22% say their parents don’t care as much if they are caught using Rx drugs without a prescription, compared to getting caught with illegal drugs. Source: US DEA Office of Diversion 8 2/29/2016 Opioid Task Force Kick-Off Meeting
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DEA EATH THS BY O OPIOID D POISO SONING (2006-2013) 2013) YEAR 2006 06 2007 07 2008 08 2009 09 2010 10 2011 11 2012 12 2013 13 CALIFORN RNIA IA 1,469 469 1,65 651 1,784 84 1,971 971 1,909 909 1,898 898 1,712 712 1,934 34 106 106 79 79 94 94 83 83 89 89 68 68 64 64 111 111 SACRA CRAME MENTO TO COUNTY TY Source: California Department of Public Health EpiCenter Injury Online Database 14,328 Deaths in California from 2006-2013 694 Deaths in Sacramento County from 2006-2013 12 2/29/2016 Opioid Task Force Kick-Off Meeting
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Opioid Task Force Development 14 2/29/2016 Opioid Task Force Kick-Off Meeting
Purpose of Opioid Task Force Identify and implement numerous high priority initiatives Share resources & knowledge Provide coordinated provider & community education Develop policy recommendations & best practices the opioid epidemic! 15 2/29/2016 Opioid Task Force Kick-Off Meeting
Structure of Opioid Task Force Quarterly meetings beginning February 2016 Subcommittees 1. Engaging Medical community, overdose prevention 2. Public education, media and advocating for change 3. Early intervention, treatment, and recovery 4. Safe medication disposal 16 2/29/2016 Opioid Task Force Kick-Off Meeting
Who Are The Players? Alcohol & Drug Services Public Health Pharmacies Behavioral Health Probation Emergency Services Hospitals & Service Providers Schools & Universities Social Services Dept. of Human Assistance Law Enforcement Waste Management Youth Representatives Non-profits & community Not exhaustive - others? groups 17 2/29/2016 Opioid Task Force Kick-Off Meeting
Prevention Strategies 18 2/29/2016 Opioid Task Force Kick-Off Meeting
Understanding the Local Epidemic Data Sources Analysis Identify high prescribers, Prescription data CURES database unsafe prescribing etc. Death & Injury Data Look at trends, Multi-cause of death files distribution, populations OSHPD Hospital ED & affected Patient discharge data 19 2/29/2016 Opioid Task Force Kick-Off Meeting
Access to Resources Disseminate Information Resource Availability • Provider newsletters • Treatment & referrals o Substance abuse o Mental health • Community education o Pain management o Patients o Parents & teens • Support groups o Older adults • Poison Control • Naloxone 20 2/29/2016 Opioid Task Force Kick-Off Meeting
Current Treatment Available and Need for Capacity Building Uma K. Zykofsky, LCSW Director, Behavioral Health Services Alcohol & Drug Administrator
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What Works and Leads to Positive Outcomes? Prevention Self-Motivation for Treatment Mandated Treatment Partnerships/Collaborations Evidence-Based Practices Appropriate length and type of treatment episodes based on need Balanced continuum of care inclusive of all types of treatment, sober living environments, and recovery support services 23 2/29/16 Opioid Task Force Kick-Off Meeting
Alcohol and Drug Services Continuum of Care • Prevention Services • Education Services-DUI Programs • Outpatient Treatment Services • Intensive Outpatient Treatment Services • Medication-Assisted Treatment • Detoxification & Residential Treatment Services • Transitional Housing/Sober Living Environments Handout: Alcohol & Drug Services Continuum of Care 2/29/16 Opioid Task Force Kick-Off Meeting 24
Countywide Collaborations Jail/Corrections Public Health Primary Health Community Collaborations Contracted Providers Child Protective Services Community-Based Mental Health Organizations (CBOs) Dept. of Human Assistance Prevention Initiatives Probation (Coalition) Sacramento Steps Forward (Homeless Services) 25 2/29/16 Opioid Task Force Kick-Off Meeting
Collaborations with Criminal Justice • Driving Under the Influence (DUI) Programs • Drug Diversion Program • Prop 36 Program • Adult Drug Court • Juvenile Drug Court • Co-Occurring Mental Health Court • In Custody Alcohol and Drug Screening and Assessments-Jail/Department of Corrections 26 2/29/16 Opioid Task Force Kick-Off Meeting
Collaborations with Public Health & Primary Health Public Health • Opioid Task Force Development • Human Immunodeficiency Virus (HIV) Services • Sexually Transmitted Disease (STD) Services Primary Health • Primary Care Center Alcohol and Drug Screenings • Case Management Services • Linkage to Appropriate Alcohol and Drug Treatment 27 2/29/16 Opioid Task Force Kick-Off Meeting
Collaborations Child Protective Services Nationally Recognized Family Drug Courts • Dependency Drug Court • Early Intervention Family Drug Court (EIFDC) • These courts refer clients to outpatient treatment, residential treatment, detox, and case management/recovery support services 28 2/29/16 Opioid Task Force Kick-Off Meeting
Collaborations with Mental Health • Homeless Services (Guest House) Alcohol and Drug Assessment and Referral Education Groups, Outreach • Co-Occurring Mental Health Court Services Outpatient Treatment Residential Treatment • CalWORKs Program (Mental Health & Dept. of Human Assistance) Outpatient Treatment Detox, Residential Treatment • Mental Health Navigators Linkage to services 29 2/29/16 Opioid Task Force Kick-Off Meeting
Alcohol & Drug Services Treatment Data Fiscal Year 2014-15 Number of Admissions % of Clients with Total Number Modality Opiates as Opiates as Primary Admissions Drug of Choice Primary Drug of Choice Outpatient - Adult 1,985 186 9% Outpatient - Youth 567 9 2% Residential 1,058 201 19% Detoxification 335 103 31% Medication-Assisted 99% Treatment 2,159 2,139 43% TOTALS 6,104 2,638* 2/29/2016 Opioid Task Force Kick-Off Meeting 30
Current Challenges Lack of Increased Service Demand • Sober Living Environments • Residential Treatment • Aftercare Services • Detoxification Services • Y outh Residential Facilities • Medication-Assisted Treatment • Re-entry/Support Services Need for Capacity Building Limited Targeted Services • Severely Mentally Ill Limited Funding • Homeless • Residential Treatment • Developmentally Disabled • Detoxification Services • Older Adults Wait Lists = Delay in Treatment Access to Care • Residential Treatment • Locations • Detoxification Services • Transportation 31 2/29/2016 Opioid Task Force Kick-Off Meeting
Residential Treatment Services Increased demand for Residential Treatment Residential Treatment Facilities for Adults Only No Youth Residential Treatment Facilities Limited capacity due to funding constraints Total Beds = 319 Average Wait Time = 3 months 2/29/16 Opioid Task Force Kick-Off Meeting 32
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