Atlanta	
  Marrio+	
  Marquis	
  
Atlanta,	
  Georgia	
  
April	
  22,	
  2014	
  
Disclosure	
  Statements	
  
 Mike	
  Small	
  has	
  disclosed	
  no	
  relevant,	
  real	
  or	
  
apparent	
  personal...
Learning	
  ObjecGves	
  
1.  Explain	
  how	
  using	
  PDMP	
  data	
  can	
  develop	
  a	
  
Rx	
  drug	
  abuse	
  pr...
Tina	
  Kim,	
  Ph.D.	
  
Los	
  Angeles	
  County	
  Department	
  of	
  Public	
  Health	
  
In	
  Los	
  Angeles	
  County…	
  
 Drug	
  overdose	
  is	
  the	
  2nd	
  leading	
  cause	
  of	
  
injury-­‐related	...
PrescripGon	
  Drugs	
  Filled	
  in	
  LAC,	
  2012	
  
(Scheduled	
  II-­‐IV)	
  
OTHER,	
  4.2	
  
HORMONES	
  
3.2	
  ...
~27%	
  of	
  Prescribers	
  wrote	
  95%	
  of	
  
prescripGons	
  (Scheduled	
  II-­‐IV)	
  
37.0%	
  
0.5%	
  
36.4%	
 ...
Doctor	
  Shopping	
  
  Defined	
  as	
  paGents	
  who	
  received	
  
prescripGon	
  opioids	
  from	
  at	
  least	
  ...
CURES/PDMP	
  Data	
  for	
  Opioid	
  
PrescripGons	
  in	
  2002	
  
 4,142,662	
  million	
  prescrip3ons	
  
filled	
 ...
Gender	
  Difference	
  
42.0%	
   41.9%	
  
58.0%	
   58.1%	
  
0%	
  
10%	
  
20%	
  
30%	
  
40%	
  
50%	
  
60%	
  
70%...
Age	
  Difference	
  
0%	
  
5%	
  
10%	
  
15%	
  
20%	
  
25%	
  
30%	
  
≤17	
  years	
   18-­‐24	
  
years	
  
25-­‐34	...
Payment	
  Method	
  
50%	
  
15%	
  
8%	
  
3%	
  
24%	
  
52%	
  
14%	
  
8%	
  
3%	
  
24%	
  
0%	
  
10%	
  
20%	
  
3...
Short-­‐acGng	
  vs	
  Long-­‐acGng	
  
88.6%	
  
11.4%	
  
91.4%	
  
8.6%	
  
0%	
  
10%	
  
20%	
  
30%	
  
40%	
  
50%	...
Morphine	
  Equivalent	
  Dose	
  per	
  Day	
  
86.7%	
  
13.3%	
  
89.9%	
  
10.1%	
  
0%	
  
10%	
  
20%	
  
30%	
  
40...
Top	
  Opioid	
  Prescribed	
  
64%	
  
14%	
  
6%	
   5%	
   4%	
   3%	
  
67%	
  
10%	
   11%	
  
3%	
   2%	
   2%	
  
0...
Opioid	
  PrescripGons	
  per	
  PaGent	
  
Per	
  PaGent	
  
Doctor	
  
Shoppers	
  
Non-­‐doctor	
  
Shoppers	
  
Number...
Extreme	
  Cases	
  of	
  Opioid	
  PrescripGons	
  
PaGent	
  with…	
   Value	
   Gender	
   Age	
  
Highest	
  number	
 ...
Doctor	
  Shoppers	
  in	
  LAC…	
  
 Doctor	
  Shoppers	
  are	
  more	
  common	
  among:	
  
–  Females	
  
–  Residen...
To	
  Reduce	
  Doctor	
  Shopping/Over-­‐
Prescribing	
  in	
  LAC…	
  
 	
  Promote	
  CURES/PDMP	
  enrollment	
  and	...
Prescription
Drug Abuse
Roneet Lev, MD FACEP
Providers Need Drug Rehab
Before They Can Lead Our Nation
Into Recovery
PDA TF
and
PDA Medical Task Force
PDA Report Card
San Diego CURES Report
EMERGENCY
and
URGENT CARE
GUIDELINES
PAIN
AGREEMENT
–  For	
  Chronic	
  Pain	
  =	
  3	
  
months	
  of	
  short	
  ac3ng	
  
or	
  anyone	
  requiring	
  
lo...
PDMP
Makes
You a
Better
Doctor
Generated by CamScanner
Sandiegosafeprescribing.org
6 FEBRUARY 2014
(858) 673-6100
Melissa N. Kagnoff, MD
Neurology
Cardiff by the Sea
(619) 582-2...
DATA SUPPORTING ACTION – VENTURA COUNTY
PORTING ACTION – VENTURA COUNTY
data	
  suppor3ng	
  ac3on	
  –	
  Ventura	
  coun...
DATA SUPPORTING ACTION – VENTURA COUNTY
PORTING ACTION – VENTURA COUNTY
data	
  suppor3ng	
  ac3on	
  –	
  Ventura	
  coun...
DATA SUPPORTING ACTION – VENTURA COUNTY
PORTING ACTION – VENTURA COUNTY
data	
  suppor3ng	
  ac3on	
  –	
  Ventura	
  coun...
TARGETS FOR ACTION
Rx & HEROIN ABUSE: Ventura County RESPONDS
TARGET 1: PROFESSIONAL DEVELOPMENT
GOAL: Expand professional training and devel...
Rx & HEROIN ABUSE: Ventura County RESPONDS
GOAL: Expand professional training and development
opportunities across all sec...
Rx & HEROIN ABUSE: Ventura County RESPONDS
GOAL: Expand professional training and development
opportunities across all sec...
Rx & HEROIN ABUSE: Ventura County RESPONDS
GOAL: Expand professional training and development
opportunities across all sec...
Rx & HEROIN ABUSE: Ventura County RESPONDS
GOAL: Expand professional training and development
opportunities across all sec...
Rx & HEROIN ABUSE: Ventura County RESPONDS
ACTIONS
2.1 Safe and Secure Rx Disposal
Safe and confidential Rx disposal bins
...
Rx & HEROIN ABUSE: Ventura County RESPONDS
Ventura County Board of Supervisors
declaration: Every Day is Take Back Day	
  
Rx & HEROIN ABUSE: Ventura County RESPONDS
2.3 Ventura County Interagency Pharmaceutical Crimes Unit
Problem: Illegal pres...
TARGETS FOR ACTION
PDMP value begins with prescriber policies, and grows
local and even regional inter-agency cooperation....
Rx & HEROIN ABUSE: Ventura County RESPONDS
GOAL: Expand professional training and development
opportunities across all sec...
Rx & HEROIN ABUSE: Ventura County RESPONDS
GOAL: Expand professional training and development
opportunities across all sec...
Rx & HEROIN ABUSE: Ventura County RESPONDS
GOAL: Expand professional training and development
opportunities across all sec...
Rx & HEROIN ABUSE: Ventura County RESPONDS
TARGET 4: SAFE SCHOOLS
GOAL: Collaborate with schools, PTAs and Ventura
County ...
Rx & HEROIN ABUSE: Ventura County RESPONDS
4.2 Teacher Education
Teachers are vital for educating
students about substance...
Rx & HEROIN ABUSE: Ventura County RESPONDS
4.4 Systematic School-based Data Collection
The data collected from youth throu...
Rx & HEROIN ABUSE: Ventura County RESPONDS
TARGET 5: PREVENTION POLICY & RESEARCH
GOAL: Expand Advance continued research ...
Rx & HEROIN ABUSE: Ventura County RESPONDS
5.1 Tracking Local Data
To better understand the prevalence and impacts of pres...
Rx & HEROIN ABUSE: Ventura County RESPONDS
5.2 Special Local Research
HIGHLIGHTS
•  32% of respondents reported heroin use...
Rx & HEROIN ABUSE: Ventura County RESPONDS
5.4 Legislative Analysis
Active legislative analysis and reporting help inform ...
Rx & HEROIN ABUSE: Ventura County RESPONDS
5.5 Future Policy Actions
New policies and projects being studied and considere...
Pdmp 2 small kim_lev_zarate
Pdmp 2 small kim_lev_zarate
Pdmp 2 small kim_lev_zarate
Pdmp 2 small kim_lev_zarate
Upcoming SlideShare
Loading in …5
×

Pdmp 2 small kim_lev_zarate

981 views

Published on

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
981
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
20
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Pdmp 2 small kim_lev_zarate

  1. 1. Atlanta  Marrio+  Marquis   Atlanta,  Georgia   April  22,  2014  
  2. 2. Disclosure  Statements    Mike  Small  has  disclosed  no  relevant,  real  or   apparent  personal  or  professional  financial   rela3onships.    Tina  Kim  has  disclosed  no  relevant,  real  or   apparent  personal  or  professional  financial   rela3onships.    Roneet  Lev  has  disclosed  no  relevant,  real  or   apparent  personal  or  professional  financial   rela3onships.    Patrick  Zarate  has  disclosed  no  relevant,  real  or   apparent  personal  or  professional  financial   rela3onships.  
  3. 3. Learning  ObjecGves   1.  Explain  how  using  PDMP  data  can  develop  a   Rx  drug  abuse  program  strategy   2.  Outline  strategies  in  unifying  emergency   departments  under  uniform  controlled   substance  Rx  prescribing  protocols   3.  Demonstrate  how  a  state  PDMP  can  partner   with  cri3cal  local  efforts  to  reduce  Rx  drug   overdose  deaths.  
  4. 4. Tina  Kim,  Ph.D.   Los  Angeles  County  Department  of  Public  Health  
  5. 5. In  Los  Angeles  County…    Drug  overdose  is  the  2nd  leading  cause  of   injury-­‐related  death    1  out  of  20  adults  and  1  out  5  teens  misuse   prescrip3on  drugs    Rx  drug  abuse  cause:   500+  Deaths   1200  +     Treatment    Admissions   3000  +     HospitalizaGons   5000  +   Emergency  Department  Visits  
  6. 6. PrescripGon  Drugs  Filled  in  LAC,  2012   (Scheduled  II-­‐IV)   OTHER,  4.2   HORMONES   3.2   MUSCLE  RELAXANTS   1.9   STIMULANTS  6.6   SEDATIVES  40.3   HYDROCODONE   67.0   OXYCODONE  10.9   CODEINE     10.6   MORPHINE3.9   FENTANYL  2.1   OTHER  5.6   OPIOIDS    43.9   (N  =  9,763,887)  
  7. 7. ~27%  of  Prescribers  wrote  95%  of   prescripGons  (Scheduled  II-­‐IV)   37.0%   0.5%   36.4%   4.5%   20.0%   27.1%   6.6%   68.0%   0%   10%   20%   30%   40%   50%   60%   70%   80%   90%   100%   Prescribers   PrescripGons   Very  Frequent  Prescribers  500-­‐17,019   Rx/Year   Frequent  Prescribers  50-­‐499  Rx/Year   Occasional  Prescribers  4-­‐49  Rx/Year   Rare  Prescribers  1-­‐3  Rx/Year   26.6%   95%  
  8. 8. Doctor  Shopping     Defined  as  paGents  who  received   prescripGon  opioids  from  at  least  4   prescribers  AND  at  least  4  pharmacies  in   2012  
  9. 9. CURES/PDMP  Data  for  Opioid   PrescripGons  in  2002    4,142,662  million  prescrip3ons   filled    1,533,099  million  unique  pa3ents    55,819  unique  prescribers    4,621  unique  pharmacies   5,153 (0.3%) patients were identified as doctor shoppers.
  10. 10. Gender  Difference   42.0%   41.9%   58.0%   58.1%   0%   10%   20%   30%   40%   50%   60%   70%   Doctor  Shoppers    Non-­‐Doctor  Shoppers   Male   Female  
  11. 11. Age  Difference   0%   5%   10%   15%   20%   25%   30%   ≤17  years   18-­‐24   years   25-­‐34   years   35-­‐44   years   45-­‐54   years   55-­‐64   years   ≥65  years   Doctor  Shoppers   Non-­‐Doctor  Shoppers  
  12. 12. Payment  Method   50%   15%   8%   3%   24%   52%   14%   8%   3%   24%   0%   10%   20%   30%   40%   50%   60%   Commercial   Insurance   Private  Pay   Medicare   Medicaid   Other/Unknown   Doctor  Shopper   Non-­‐Doctor  Shopper  
  13. 13. Short-­‐acGng  vs  Long-­‐acGng   88.6%   11.4%   91.4%   8.6%   0%   10%   20%   30%   40%   50%   60%   70%   80%   90%   100%   Short-­‐Ac3ng   Long-­‐Ac3ng   Doctor  Shopper   Non-­‐Doctor  Shopper  
  14. 14. Morphine  Equivalent  Dose  per  Day   86.7%   13.3%   89.9%   10.1%   0%   10%   20%   30%   40%   50%   60%   70%   80%   90%   100%   ≤  100  MED  per  Day   >  100  MED  per  Day   Doctor  Shopper   Non-­‐Doctor  Shopper  
  15. 15. Top  Opioid  Prescribed   64%   14%   6%   5%   4%   3%   67%   10%   11%   3%   2%   2%   0%   10%   20%   30%   40%   50%   60%   70%   80%   Hydrocodone   Oxycodone   Codeine   Morphine   Hydromorphone   Fentanyl   Doctor  Shopper   Non-­‐Doctor  Shopper  
  16. 16. Opioid  PrescripGons  per  PaGent   Per  PaGent   Doctor   Shoppers   Non-­‐doctor   Shoppers   Number  of  Pills   1017.9   159.6   Number  of   PrescripGons   15.6   2.7   Days  of  Supply   239.8   40.2   Morphine  Equivalent   Doses  (MED)   946.2   157.3  
  17. 17. Extreme  Cases  of  Opioid  PrescripGons   PaGent  with…   Value   Gender   Age   Highest  number  of  opioid   prescripGons   203   Male   44   Highest  number  of   prescribers   79   Male   Female   48   40   Highest  number  of   pharmacies   32   Male   33   Highest  number  of  opioid  pills   30,000   Unknown   13   Highest  opioid  dosage  per  day   (MED)   157,377   Unknown   13  
  18. 18. Doctor  Shoppers  in  LAC…    Doctor  Shoppers  are  more  common  among:   –  Females   –  Residents  aged  35-­‐64  years    Compared  to  non-­‐doctor  shoppers,  doctor  shoppers   are  more  likely  to:   –  Pay  for  their  opioids  with  private  pay   –  Use  long-­‐ac3ng  opioids   –  Use  higher  drug  dosages  (MED  >  100)   –  Use  oxycodone,  morphine,  and  hydromorphone   –  Obtain  a  significantly  greater  number  of  pills  and   prescrip3ons  and  longer  days  of  supply  
  19. 19. To  Reduce  Doctor  Shopping/Over-­‐ Prescribing  in  LAC…      Promote  CURES/PDMP  enrollment  and  u3liza3on    Send  out  Rx  for  Preven3on  ar3cles  to  physicians    Con3nuing  Medical  Educa3on  Courses      Develop  standards  on  opioid  use  in  Eds    LAC  Prescrip3on  Drug  Abuse  Medical  Task  Force     Explore  policy  op3ons  to  become  an  authorized   user  of  iden3fied  CURES  data     Send  out  e-­‐mail  alerts  who  are  over-­‐prescribing  or   have  a  high  number  of  doctor  shopping  pa3ents  
  20. 20. Prescription Drug Abuse Roneet Lev, MD FACEP Providers Need Drug Rehab Before They Can Lead Our Nation Into Recovery
  21. 21. PDA TF and PDA Medical Task Force
  22. 22. PDA Report Card
  23. 23. San Diego CURES Report
  24. 24. EMERGENCY and URGENT CARE GUIDELINES
  25. 25. PAIN AGREEMENT –  For  Chronic  Pain  =  3   months  of  short  ac3ng   or  anyone  requiring   long  ac3ng  opioids   –  Only  1  provider  and  1   pharmacy   –  No  ED  visit   –  No  refills   –  Do  not  drive  if  impaired   !"#$%&#'(%)$*"#$+&'",-%%(%&#' ./0'!12342556078'"3926:;'(6<2=1:2/38'>:2?@513:78'13<'155'*/3:0/556<'>@A7:13=67' ' ' !"#$%&'$(')*+$,&'-.&)('/$%$0'/).)*'$12%1$2%-$0%*3$&)-4-5$62'$0'/).)*'$%7-"$ 2%-$-,'.)%7$7%8-$12%1$12'$/".1"&$%*/$,%1)'*1$0#-1$9"77"85$ $ :1$)-$)0,"&1%*1$12%1$3"#$9"77"8$%77$12'-'$)*-1&#.1)"*-;$<=>?6@!5$ ' ☐''''#B676'?6<2=2367'106'<13C60/@7D''#B6;'=13'=1@76'7602/@7'B615:B' ' E0/A56?78'23=5@<23C'<61:B8'6F63'2.':1463'17'E067=02A6<D''#B6;'106'157/' ' 1<<2=:23CD' ☐''''G/@'7B/@5<'C6:';/@0'?6<2=236'.0/?'/35;'+&%'E0/F2<60'13<'+&%' EB10?1=;D''#B27'B65E7'E06F63:'72<6'6..6=:7'13<'/F60</767D' ☐''''#146':B6'?6<2=1:2/3'/35;'17';/@'106':/5<D'')/'3/:':146'?/06'?6<2=236' ' :B13';/@'106'E067=02A6<D'#B6;'366<':/'517:';/@'@3:25';/@0'369:' ' 1EE/23:?63:D' ☐''''G/@0'?6<2=236'27'/35;'./0';/@D'')/'3/:'7B106';/@0'?6<2=236D')/'3/:' ' 155/H'/:B607':/'@76';/@0'?6<2=2367D''')/'3/:'7655'/0':01<6';/@0' ' ?6<2=2367D' ☐''''I66E';/@0'?6<2=1:2/37'76=@06D''J6'06=/??63<'5/=423C':B6?D''K/7:'/0' ' 7:/563'?6<2=1:2/3'?6137'/:B60'106'23'<13C60D' ☐''''"55'6?60C63=;'<6E10:?63:7'23'>13')26C/'13<'$?E60215'*/@3:267'B1F6'' ' 7:1:6<':B1:':B6;'H255'3/:'E067=02A6':B676'?6<2=1:2/37'2.';/@'5/76':B6?' ' /0'.665';/@'366<'?/06D' ☐''''#B6'<13C607'/.':B6'?6<2=236'106'C061:60'H2:B'13;:B23C':B1:'?1467';/@' ' 7566E;D''(2923C';/@0'?6<2=236'H2:B'15=/B/58'7:066:'<0@C78'7566E23C' ' E25578'/0'/:B60'<0@C7'=13'?146';/@'72=4'/0'<26D' ☐'''')/'3/:'<02F6'1'=10'/0'</'<13C60/@7'1=:2F2:267'2.';/@'106'3/:'.@55;'1560:''' ' HB63'/3':B676'?6<2=2367D''' ☐''''G/@0':061:?63:'H255'A6'?/32:/06<'23'<2..6063:'H1;7D''G/@'?1;'A6'1746<' ' :/'</'1'<0@C':67:D''G/@'?1;'A6'1746<':/'7B/H';/@0'E2557D'#B6'>:1:6'/.' ' *152./0321':01=47';/@0'E067=02E:2/37D' ☐''''$.';/@0'E0/F2<60'.6657':B1:';/@0'?6<2=236'27'3/:'B65E23C8':B6'?6<2=236' H255'A6'7:/EE6<D''G/@'H255'A6':061:6<'H2:B'/:B60'?6:B/<7D''' '
  26. 26. PDMP Makes You a Better Doctor Generated by CamScanner
  27. 27. Sandiegosafeprescribing.org 6 FEBRUARY 2014 (858) 673-6100 Melissa N. Kagnoff, MD Neurology Cardiff by the Sea (619) 582-2595 Brian W. Meyerhoff, MD Internal Medicine Escondido (760) 745-1551 (760) 745-1551 Ryan B. Viets, MD Diagnostic Radiology La Mesa (619) 460-2770 Escondido (760) 745-1551 Emmet W. Lee, MD Internal Medicine Escondido (760) 745-1551 www.SanDiegoSafePrescribing.org The No. 1 cause of unintentional deaths in San Diego County is from drugs, with almost one person a day dying in our county from this preventable cause. The San Diego and Imperial County Prescription Drug Abuse Medical Task Force is a coalition of medical leaders who have joined efforts to reduce deaths andaddictionduetoprescriptiondrugs.Thetaskforceincludespainspecialists, internal medicine physicians, emergency physicians, psychiatrists, dentists, pharmacists, hospital administrators, health department administrators, and our local DEA. The task force also includes broad health partners, including Kaiser Permanente, Scripps Health, Sharp HealthCare, UC San Diego Health System, Palomar Health, and the Community Clinics. The task force encourages all medical practitioners to use the materials provided at www. SanDiegoSafePrescribing.org to improve patient care. SDCMS features m physicians for their accomplishments i pages. If you would be considered for o “Featured Member please email Editor org. Thank you for membership in SD CMA! Becomean SDCMSFea Member! California: A T for Physicians ON JAN. 1, 2014, Californ exchange,CoveredCaliforni healthcoveragetomorethan statewide.Withthatfiguree theendofthe2014openenro iscriticalthatphysiciansand whattoexpect.Tothatend, MedicalAssociation(CMA)h sheet,“SurvivingtheSecond California,”availablefreeto members.Toreceivethistip canemailMembership@SDC
  28. 28. DATA SUPPORTING ACTION – VENTURA COUNTY PORTING ACTION – VENTURA COUNTY data  suppor3ng  ac3on  –  Ventura  county     DATA SUPPORTING ACTION – VENTURA COUNTY Selected Data Sources – mobilizing LOCAL action •  State PDMP: C.U.R.E.S. data ongoing •  State California Healthy Kids Survey bi-annual •  Local Medical Examiner/Coroner annual update •  Local Adolescent Treatment survey new/unique •  Local Jail Inmate survey new/unique
  29. 29. DATA SUPPORTING ACTION – VENTURA COUNTY PORTING ACTION – VENTURA COUNTY data  suppor3ng  ac3on  –  Ventura  county     VENTURA’S RX DRUG ABUSE WORKGROUP Convened in early 2012, including Alcohol and Drug Programs (ADP) Public Health Department Sheriff’s Department County Office of Education County Health Care Agency/Ambulatory Care Subject Matter Experts by invitation Focused on nature and scope of the LOCAL problems KEY: Membership rank- can speak for their agencies
  30. 30. DATA SUPPORTING ACTION – VENTURA COUNTY PORTING ACTION – VENTURA COUNTY data  suppor3ng  ac3on  –  Ventura  county     DATA-INFORMED STRATEGIES 1.  LOCAL MATTERS! – data speak to your needs, and community direction 2.  USE MULTIPLE INDICATORS – use PDMP and other sources; see our “Ventura County Responds” report 3.  PARTNERSHIP MAKES THINGS POSSIBLE – examples: custom survey administration in jails; data sharing agreements, “mining” existing data
  31. 31. TARGETS FOR ACTION
  32. 32. Rx & HEROIN ABUSE: Ventura County RESPONDS TARGET 1: PROFESSIONAL DEVELOPMENT GOAL: Expand professional training and development opportunities across all sectors.
  33. 33. Rx & HEROIN ABUSE: Ventura County RESPONDS GOAL: Expand professional training and development opportunities across all sectors. ACTIONS 1.1 Prescriber Training Problem: Low utilization of PDMP among prescribers locally. Local Action: Training for Health Professionals (DDS, RN, MD) Case Example: Elinore McCance-Katz, MD, PhD, Chief Medical Officer, Substance Abuse and Mental Health Services Administration (SAMHSA), presented one of the first in a projected series of health care professional trainings, What Every Prescriber Should Know About Addiction to Pain Medicines.
  34. 34. Rx & HEROIN ABUSE: Ventura County RESPONDS GOAL: Expand professional training and development opportunities across all sectors. ACTIONS 1.1 Prescriber Training (cont’d.) Problem: Limited opportunities for facilitated enrollment in CURES Local Action: C.M.E. events, Grand Rounds, physician registration Case Example: Medical Director for Behavioral Health hosting medical education with emphasis on importance of CURES, and ‘value added’ opportunity for real-time registration by attendees
  35. 35. Rx & HEROIN ABUSE: Ventura County RESPONDS GOAL: Expand professional training and development opportunities across all sectors. “Health care professionals who prescribe...are in a key position to balance the benefits of prescribing opioid analgesics to treat pain against the risks of serious adverse outcomes including addiction, unintentional overdose, and death. Opioid misuse and abuse, resulting in injury and death, has emerged as a major public health problem. Appropriate prescribing practices and patient education are important steps to help address this public health problem.” – FDA Blueprint for Prescriber Education, 2013 In Ventura County, we believe LOCAL ACTION matters…
  36. 36. Rx & HEROIN ABUSE: Ventura County RESPONDS GOAL: Expand professional training and development opportunities across all sectors. TARGET 2: ENFORCEMENT & SECURITY GOAL: Support law enforcement, monitoring and security to enhance public safety by deterring drug misuse, abuse and diversion.  
  37. 37. Rx & HEROIN ABUSE: Ventura County RESPONDS ACTIONS 2.1 Safe and Secure Rx Disposal Safe and confidential Rx disposal bins now actively used and supported by law enforcement in all 10 cities across the county. Board Supervisors raised local standard by unanimously declaring Every Day is Take Back Day in Ventura County.
  38. 38. Rx & HEROIN ABUSE: Ventura County RESPONDS Ventura County Board of Supervisors declaration: Every Day is Take Back Day  
  39. 39. Rx & HEROIN ABUSE: Ventura County RESPONDS 2.3 Ventura County Interagency Pharmaceutical Crimes Unit Problem: Illegal prescribing of Rx opioids at the local level Local Action: Established Pharmaceutical Crimes Task Force, Ventura County Sheriff’s Office (VCSO), the Ventura County Pharmaceutical Crimes Unit includes members of law enforcement from VCSO, Simi Valley PD, DA’s Office, others. Case Example: The main mission of the task force is combating the transfer of legal medication to the illegal market. * Fifty-four arrests were made in the first six months * 120,000 pharmaceutical pills seized * CURES records important to several recent MD investigations * 49 search warrants to date, with $1.5 million in assets seized, 12 guns
  40. 40. TARGETS FOR ACTION PDMP value begins with prescriber policies, and grows local and even regional inter-agency cooperation. “The Ventura County Interagency Pharmaceutical Crimes Unit, in conjunction with LA County Health Authority Law Enforcement Task Force (HALT) and the California Medical Board, concluded five month investigation into a “pill mill”. Detectives learned of this criminally operating medical clinic through a tip from a local Simi Valley pharmacist. The had previously contacted every pharmacy in Ventura County during the Summer of 2013 and made them aware of the task force.” One Case: Doctor Shopping, MDs at clinic investigated, 3,000+ scripts written in name of 1 doc, 5 arrests    
  41. 41. Rx & HEROIN ABUSE: Ventura County RESPONDS GOAL: Expand professional training and development opportunities across all sectors. GOAL: Support law enforcement, monitoring and security to enhance public safety by deterring drug misuse, abuse and diversion.   TARGET 3: EDUCATION & AWARENESS GOAL: Increase outreach and education for parents, patients and the public to raise awareness of prescription drug and heroin abuse problems and solutions.
  42. 42. Rx & HEROIN ABUSE: Ventura County RESPONDS GOAL: Expand professional training and development opportunities across all sectors. 3.2 Drug Disposal Campaign A multimedia campaign on the importance of safe and secure drug disposal was directed to the public from a variety of angles, including a billboard on CA Highway 33, newspaper and radio ads, medicine chest reminder magnets, clinic posters and brochures. Concurrent outreach to real estate professionals warned of the risks of medicine chest thefts during open houses.
  43. 43. Rx & HEROIN ABUSE: Ventura County RESPONDS GOAL: Expand professional training and development opportunities across all sectors. 3.4 Ventura County’s Rx Drug Abuse Summit More than 240 local treatment and prevention professionals, healthcare experts, law enforcement, policymakers and other key stakeholders learned about CURES and local strategies.
  44. 44. Rx & HEROIN ABUSE: Ventura County RESPONDS TARGET 4: SAFE SCHOOLS GOAL: Collaborate with schools, PTAs and Ventura County Office of Education (VCOE) to increase communication channels and prevention opportunities for teachers, parents, students and school personnel.
  45. 45. Rx & HEROIN ABUSE: Ventura County RESPONDS 4.2 Teacher Education Teachers are vital for educating students about substance abuse. A “Working Together” insert was developed especially for teachers as a companion to the “What You Need to Know About Rx Abuse and Heroin” brochure. The materials help teachers deliver concise prevention messaging to students at the most teachable moments.
  46. 46. Rx & HEROIN ABUSE: Ventura County RESPONDS 4.4 Systematic School-based Data Collection The data collected from youth through surveys administered in schools provides invaluable information for effective collaborative prevention efforts. The Rx Workgroup will continue support of systematic school- based data collection and reporting, like the California Healthy Kids Survey, to gauge the prevalence of prescription drug misuse and heroin abuse among students in Ventura County. LIFETIME USE BY VENTURA COUNTY STUDENTS: • 14% of 9th graders and 20% of 11th graders reported misusing Rx painkillers • 4% of 9th graders and 5% of 11th graders reported using heroin — California Healthy Kids Survey, Ventura County 2011–2012
  47. 47. Rx & HEROIN ABUSE: Ventura County RESPONDS TARGET 5: PREVENTION POLICY & RESEARCH GOAL: Expand Advance continued research and data analysis to develop key policy actions addressing Rx and heroin abuse.
  48. 48. Rx & HEROIN ABUSE: Ventura County RESPONDS 5.1 Tracking Local Data To better understand the prevalence and impacts of prescription drug and heroin abuse in Ventura County, relevant multiagency data from 2008 through 2012 were collected and analyzed. By developing an established baseline, the Rx Workgroup was able to create a tracking tool for ongoing monitoring, analysis and shared reporting of abuse trends over time. CURES data, in combination with local data, are now being used to: plan educational interventions, measure progress and plan new Targets for Action.  
  49. 49. Rx & HEROIN ABUSE: Ventura County RESPONDS 5.2 Special Local Research HIGHLIGHTS •  32% of respondents reported heroin use in their lifetime. •  Of those who reported lifetime heroin use, 45% indicated beginning with Rx opioids, then moving to heroin. •  Transition from prescription-type opioids to heroin was highest among the respondents in younger age groups. •  Of respondents who ever misused Rx opioids, 61% bought or received them from a friend or family member.  
  50. 50. Rx & HEROIN ABUSE: Ventura County RESPONDS 5.4 Legislative Analysis Active legislative analysis and reporting help inform and shape some Target Actions. EXAMPLE: Rx Workgroup carefully followed the recent introduction, amendments and approval of CA Senate Bill 809 establishing CURES database funding and expansion. Improvement of CURES will, in turn, advance Workgroup’s goal to improve data links between physicians, pharmacists and law enforcement, ultimately benefitting public safety.
  51. 51. Rx & HEROIN ABUSE: Ventura County RESPONDS 5.5 Future Policy Actions New policies and projects being studied and considered by the Rx Workgroup include: - Enhanced E.R. and ambulatory care opioid prescription policies to patients and the public; - Pharmaceutical product stewardship; - Overdose education and prevention programs; and - Drug-impaired driving.

×