TN Save a Life TN Save a Life Program Program Op Opio ioid id - PowerPoint PPT Presentation

TN Save a Life TN Save a Life Program Program

Op Opio ioid id Cr Cris isis is in in Te Tenn nnes essee see 6, 6,879,698 79,698 painkiller prescriptions in 2017: enough for 1.02 prescriptions for every ma man, , woma man, n, and d chil ild d in TN In 2017, 1,26 268 people died of an opioid overdose; the current Overdose Death rate is 19.3 .3 per 100,000 00,000 people ople From 2013 to 2017: Heroi oin overdose deaths incre reased sed by y ove over r 300% and Fentan anyl yl related overdose deaths incre reased ased by ove y over r 800% (TN Department of Health, 2019)

TN TN Sa Save ve a L a Lif ife e Pr Prog ogra ram m Co Comp mpone onents nts 1. Regional Overdose Prevention Specialists (ROPS) 2. State-wide media campaign 3. Development of regionally-specific resource guides 4. ECHO hub and spoke tele-education program

Re Regi gion onal al Ov Over erdo dose se Pr Prev even ention tion Sp Spec ecia ialists lists • 13 Regional divisions across the State • 20 ROPS in total • Goals: Increase public awareness/education, and distribute naloxone Macon Pickett Clay Robertson Hancock Sullivan Montgomery Sumner Stewart Claiborne Fentress Campbell Johnson Hawkins Lake Trousdale Jackson Scott Cheatham Overton Obion Grainger Weakley Henry Washington Houston Union Carter Smith Hamblen Greene Dickson Davidson Wilson Anderson Morgan Putnam Benton Unicoi Jefferson Humphreys Dyer Knox Gibson De Kalb Carroll Cumberland White Cocke Rutherford Williamson Cannon Roane Crockett Hickman Sevier Lauderdale Henderson Loudon Van Buren Blount Warren Madison Perry Maury Rhea Bledsoe Haywood Decatur Lewis Bedford Meigs Tipton Coffee Chester Marshall Monroe Grundy McMinn Sequatchie Moore Wayne Fayette McNairy Lawrence Shelby Hardeman Hardin Giles Franklin Bradley Hamilton Marion Lincoln Polk

Ke Key Go y Goal als s of of t the he RO ROPS PS 1. Increase Public Awareness through train inings ings and d me medi dia camp mpaign ign 2. Harm Reduction through Naloxone oxone Dis istribu ribution tion 3. Reduce Stigma through educati tion on and me media activiti ivities es 4. 4. Ra Rapi pid d Respo ponse se

In Incr crea ease se Pu Publ blic ic Aw Awar aren eness ess • ROP OPS S trainings inings cover topics such as: – The Opioid Crisis – Harm Reduction – Reducing Stigma – How to administer Naloxone • Med edia ia Campaig mpaign – Range of activities tailored to each region • Billboards, radio ads, TV commercials, etc.

Ha Harm rm Re Redu duct ction ion Ha Harm m Red educ uction tion is a way of pr preven enting ting di disea ease se and pr promoti moting ng hea ealt lth h that me meets s pe peopl ple e wher ere they ey are. Not everyone is rea eady dy or abl ble e to stop p dr drug g use; therefore, sci cien entif tifical ically ly pr proven oven ways of decreasing risks are es essen ential tial . (e.g., MAT, Naloxone, Syringe Exchange) (Harm Reduction Coalition, 2019)

Ha Harm rm Re Redu duct ction ion Co Core re Pr Prin inci ciples ples • Non-ju judgment dgmental al approac ach • Behavior change is an incre rement ental al process ss • Focus on en enhancin ncing g quality ity of life • Complex lex so social factor ors s influence luence vu vulner erabilit bility y to drug use and drug-related harm (e.g., poverty, social inequality, discrimination, and trauma) • Empower er th those se who use se dru rugs s to be the primary agents in reducing the harms of their drug use (Harm Reduction Coalition, 2019)

Ex Exam ampl ple: e: Ha Harm rm Re Redu duct ction ion in in Ac Acti tion on In the eve vent nt of an Opio ioid id ove overdose: se: 1. Prevent death through Naloxone ne 2. Call 911 to get the victim needed medical l att ttenti tion on 3. Ass sses ess s nee eeds: s: a. Is there a treatment/service that is appropriate/desired? b. b. What experiences (positive or negative) may influence willingness to utilize services? 4. Have ve conve versation sation about overdose prevention, Naloxone, and safer drug use strategies (Harm Reduction Coalition, 2019)

Re Redu duci cing ng St Stig igma ma • Ove ver r 50% of opioid prescriptions for pain in TN were paid for using insurance • Average number of pills prescribed afte ter r a su surge gery y in the U.S. is 82 82 • 12 12% of su surgical ical pa pati tien ents ts report a later opioid dependence or addiction • 66% of su surge geons ons report feeling pressure to prescribe more pills than necessary (Harvard Business Review, 2018; PT News, 2018, TDOH, 2019)

Re Redu duci cing ng St Stig igma ma • Do away with labels and use “person first” language (Person with substance use disorder not not Addict) • Drug use falls ls on a c continuum tinuum – Abstinence/low risk chronic dependence – Relapse do does s not t equ qual l a moral failure – 40% 40%-60% 0% will relapse at t least once • Other chronic diseases: 50%-70% with high blood pressure experience symptoms each year that require medical attention • Beware of unint ntent entional ional personal sonal bias as • Recognize addiction is often connected to traum uma (Harm Reduction Coalition, 2019)

Na Nalo loxo xone ne Mi Misc scon oncept ceptions ions • There is no evide idenc nce e that giving people Naloxone makes them more likely to use more drugs – Naloxone keeps people alive ve – Going through withdrawal is painful ful and unpleasan easant – Research shows injection drug users trained on naloxone re reduced ed use over time and increased knowledge and overdose response behavior (Bazazi et al., 2010, Seal et al, 2014, & Wagner et al., 2009)

Ra Rapi pid d Re Resp spon onse se • ROPS provide community ground response when needed (e.g., overdose spikes, clinic closures) – April il 17, 2019: : U. S. Department of Justice indicted 32 medical professionals in TN for illegal prescription and distribution of opioids/narcotics – ROPS worked with local law enforcement, community coalitions, and other key stakeholders providing naloxone, information on treatment/ recovery resources, flyers on clinic doors, media announcements, etc.

TN TN De Depa part rtmen ment t of of He Heal alth th Pa Part rtne nershi rship • Regionally-Specific Resource Guides – Current status: Knox County complete, 7 other in production/printing • Bi-weekly data briefs – Develop threshold for overdose spikes – Data sources: TN PDMP, Drug Overdose Reporting System, Vital Records, TBI

Pr Proj ojec ect t EC ECHO HO • Partnership with Vanderbilt University Medical Center (ECHO Hub) • Go Goal: provide tele-education to support clinics, EDs, and hospitals that want to enhance access to MAT services • Sp Spoke ke pa partner tnerships hips: supportive funding for 50% effort of case management position

TN TN Sa Save ve a L a Lif ife • ROP OPS have distributed ov over er 50 50,00 000 0 units of Naloxone across the state of Tennessee since October 2017 • Nalo loxone xone has saved ov over er 5, 5,00 000 0 li lives es in Tennessee since 2017 – This is a conservative estimate based on reported uses of Naloxone (TDMHSAS, 2019)