May 16, 2018 The Story of Opioid Use in Wyoming Rodney A. Wambeam, PhD, Senior Research Scientist WYPCA in Casper, Wyoming May 16, 2018
The SEOW Report https://wysac.uwyo.edu/wysac/projects/telling-the- story-of-opioid-use-in-wyoming-report/ Or go to wysac.uwyo.edu
Past Year Nonmedical Use 20% Figure 1: Past year nonmedical use of prescription pain relievers in 15% Wyoming is comparable to the national average 10% Self-reported prevalence of nonmedical use of prescription pain 5% 5% 5% 5% 5% 5% 5% 5% 5% 5% 5% 5% 5% 5% 5% 4% 4% Natio ion relievers in the past year among U.S. 5% 5% 5% 5% 5% 5% 4% 4% 4% 4% 4% 4% 4% 4% civilians ages 12 and older living in 3% Wyom 3% omin ing Wyoming and the U.S. 0% 2005-2006 2007-2008 2008-2009 2009-2010 2010-2011 2011-2012 2012-2013 2013-2014 Source: NSDUH, 2005-2014 ; Error bars represent 95% confidence intervals
Past Month Use 15% Figure 3: Past 30-day prescription drug misuse is more common among Wyoming high school 10% students than middle school students 6% 6% 6% 6% The percentage of Wyoming middle school (6 th 5% and 8 th graders) and high school students (10 th 4% 4% 3% 3% 3% 3% 10th h & 12th h grad ades and 12 th graders) who report using a 2% 2% 1% 1% 1% 1% 6th & 8th grade des 1% 1% 1% 1% prescription medication to get high in the past 0% 30-days on one or more occasion. 2008 2010 2012 2014 2016 Source: PNA, 2008-2016
Past Month Use 0% 2% 4% 6% 8% 10% 12% Wyoming 3.5% Albany 1.5 Big Horn 2.2 Campbell 5.5 Carbon 3.6 Figure 6: Nine counties exceed *Converse 3.2 the state average in prescription *Crook 2.6 Fremont 4.0 medication misuse among high Goshen 5.3 school students *Hot Springs 10.5 *Johnson 3.4 The percentage of Wyoming high school Lincoln 2.1 students (10 th and 12 th graders) who report Natrona 2.6 using a prescription medication to get high Park 4.2 in the past 30-days on one or more occasions, Platte 3.5 *Sublette broken down by county. 2.7 *Sweetwater 1.9 Teton 4.2 Source: PNA, 2012-2016 Uinta 3.8 Washakie 7.4
Young Adults Yes 7% 7% Figure 8: Majority of young adults deny lifetime misuse of prescription drugs Percent of lifetime prescription drug misuse among Wyoming young adults ages 18-29. No No 93% 93% Source: Wyoming Survey of Young Adults, 2016
Poisoning Deaths 12 Figure 10: Rates of poisoning Nation 10.4 deaths due to illicit and 10 8.6 6.7 prescription opioids are stabilizing 6.9 6.3 7.5 6.4 8 in Wyoming 7.3 5.7 5.4 6 7.5 4.9 Age-adjusted death rates per 100,000 7.3 4.4 6.5 6.7 Wyoming 3.9 5.2 5.9 6.2 population for opioid poisonings. Aggregate 4 4.3 of ICD-10 Codes: Underlying Causes: X40 2 2.6 X41 X42 X43 X44 X60 X61 X62 X63 X64 1.9 1.4 0 X85 Y10 Y11 Y12 Y13 Y14; Contributing 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-2010 2009-2011 2010-2012 2011-2013 2012-2014 2013-2015 2014-2016 Causes: T40.0, T40.1, T40.2, T40.3, and T40.4 Source: CDC Wonder, 2003-2016; Error bars represent 95% confidence intervals
Hospitalizations Figure 11: There is variability in 0 5 10 15 20 25 30 35 40 45 prescription opioid-related Wyoming 16 Albany 4 Big Horn 0 inpatient discharges across the Campbell 14 Carbon 38 state of Wyoming Converse 7 Crook 7 The rate per 100,000 of prescription opioid- Fremont 31 Goshen 4 related inpatient discharges from Wyoming Hot Springs 31 Johnson 0 hospitals 2014-2015, excluding urgent care Laramie 19 Lincoln 8 facilities. The county data presented here is the Natrona 21 Niobrara 0 county of residence of the patient for the Park 12 Platte 6 discharge, not the county of the facility. Sheridan 17 Sublette 5 Aggregate of ICD9 Codes: 965.00, 965.02, Sweetwater 30 Uinta 12 965.09, E850.1, and E850.2. Washakie 30 Weston 0 Source: Wyoming Hospital Association, 2014-2015
Delivered to Pharmacies Figure 13: Distributed 1200 morphine milligram 987 987 equivalent doses per 975 975 967 967 1000 943 943 917 917 896 896 895 895 capita in Wyoming is 845 845 Natio ion 840 840 803 803 consistently below the 800 706 706 818 818 818 818 808 808 798 798 national average, with gap 761 Wyom 761 omin ing 738 738 732 732 687 687 668 668 600 closing 609 609 571 571 The cumulative amount of opioid 400 medication distributed at the retail level in per capita morphine 200 milligram equivalents. 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Source: ARCOS, 2006-2016
Prescribing Rate 1200 Figure 14: Wyoming’s opioid prescribing 1000 rate is generally 815 815 810 810 810 810 809 809 808 808 804 804 805 805 799 799 782 782 754 754 800 above the national 711 Wyom 711 omin ing 812 812 809 809 813 813 795 795 782 782 781 781 759 759 756 756 724 724 average 706 706 600 665 665 Natio ion Retail opioid prescriptions dispensed per 1,000 persons 400 in the state of Wyoming and 200 the U.S. 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Source: QuintilesIMS Transactional Data Warehouse (TDW) 2006 – 2016
Uinta 1,075 Prescribing Rate Hot Springs 997 Park 964 Washakie 954 Fremont 906 Sweetwater 892 Natrona 846 Lincoln 795 Figure 15: One county Laramie 779 in Wyoming Carbon 767 Campbell 760 prescribes more Teton 735 opioids than people Johnson 671 Converse 634 Retail opioid prescriptions Sublette 596 dispensed in pharmacies by Big Horn 589 Weston 578 county per 1,000 Platte 561 persons,2014-2016 Sheridan 560 Albany 514 Goshen 377 Niobrara 23 Source: QuintilesIMS Transactional Data Warehouse (TDW) 2006 – 2016 Crook 5
Fremont 286 Naloxone Use Sweetwater 249 Laramie 176 Carbon 147 Wyoming 126 Park 129 Figure 12: Naloxone Weston 124 Sheridan administration rate by county 113 Albany 102 of incident per 100,000 of Teton 99 county population from Sublette 92 January 2016 through June Converse 92 Natrona 89 2017 Platte 81 Naloxone is administered at the highest Uinta 77 rate in Fremont County. Campbell 70 Lincoln 52 Goshen 45 Big Horn 42 Source: WATRS, 2016-2017 0 50 100 150 200 250 300
So…How Big is Wyoming’s Problem?
Thank You! Rodney A. Wambeam, PhD 307-760-8928 rodney@uwyo.edu
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