The document summarizes a report by the Mayor's Task Force to Combat the Opioid Epidemic in Philadelphia. It finds that prescription opioid sales doubled from 2000-2012, fueling high rates of opioid use, overdoses, and deaths. The Task Force made recommendations in areas of prevention, treatment, overdose prevention, and criminal justice system involvement. Key recommendations included expanding access to medication-assisted treatment, naloxone distribution, and treatment services in prisons. The report calls for increased monitoring and evaluation to assess progress combating the epidemic.
Antonio Boone of the Office of HIV Planning reviewed major points from the Mayor's Task Force to Combat the Opioid Epidemic in Philadelphia at the June 12, 2017 Positive Committee meeting.
The epidemiology workgroup aims to assess drug abuse patterns, trends, and emerging problems in order to reduce substance abuse and related consequences in communities. The group is charged with four core tasks: identifying drug abuse patterns and changes over time, detecting emerging substances, and communicating findings. The workgroup meets to discuss available data repositories and indicators that can help assess substance abuse issues.
This document discusses plans to integrate primary care and behavioral health care in Eastern Tennessee through strategic guidance, performance improvement solutions, and addressing compatibility issues between clinical documentation systems. It provides demographics on Eastern Tennessee, which has a population of over 2 million people. Top community health needs identified include nutrition/obesity/fitness, after hours access to care, substance abuse, mental illness, diabetes, cancer, tobacco use, and cardiovascular disease. Barriers to healthcare access like lack of insurance, transportation, and provider shortages are also examined.
Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Bu...Center on Addiction
This report summarizes the findings of a study that analyzed spending on substance abuse and addiction by federal, state, and local governments in 2005. The study found that a total of $467.7 billion was spent, accounting for 10.7% of combined spending. Of this, $238.2 billion (9.6% of its budget) was spent by the federal government, $135.8 billion (15.7% of budgets) by state governments, and $93.8 billion (9.0% of budgets) by local governments. Over 95% of federal and state spending went to cope with the public costs of substance abuse through areas like health care, criminal justice, and child welfare, rather than on
Addiction Medicine: Closing the Gap between Science and PracticeCenter on Addiction
These slides accompany CASAColumbia's report, Addiction Medicine: Closing the Gap between Science and Practice, published in June 2012, which found that, despite the prevalence of addiction, the enormity of its consequences, the availability of effective solutions and the evidence that addiction is a disease, both screening and early intervention for risky substance use are rare, and only about 1 in 10 people with addiction involving alcohol or drugs other than nicotine receive any form of treatment.
Pregnancy, Drug Use, and The Law Report and RecommendationsDana Asbury
In October of 2015, more than 250 participants from around the country came together in Nashville, TN for a series of events looking at the legal and medical responses to pregnant women and drug use. Today, we are releasing a report examining pregnancy and drug use and providing a comprehensive set of recommendations in a range of areas including state medical protocols, health coverage and the licensing of treatment facilities.
Ghana has a population of 22 million people and currently has over 14,000 reported cases of HIV/AIDS, with over 10,000 people living with HIV/AIDS, including nearly 8,000 children. Current strategies in Ghana aim to increase access to antiretroviral therapy and medical care to improve life expectancy and quality of life for those infected, while also working to prevent mother-to-child transmission through testing and treatment. Psychological support services play an important role in counseling families and children infected with HIV.
Antonio Boone of the Office of HIV Planning reviewed major points from the Mayor's Task Force to Combat the Opioid Epidemic in Philadelphia at the June 12, 2017 Positive Committee meeting.
The epidemiology workgroup aims to assess drug abuse patterns, trends, and emerging problems in order to reduce substance abuse and related consequences in communities. The group is charged with four core tasks: identifying drug abuse patterns and changes over time, detecting emerging substances, and communicating findings. The workgroup meets to discuss available data repositories and indicators that can help assess substance abuse issues.
This document discusses plans to integrate primary care and behavioral health care in Eastern Tennessee through strategic guidance, performance improvement solutions, and addressing compatibility issues between clinical documentation systems. It provides demographics on Eastern Tennessee, which has a population of over 2 million people. Top community health needs identified include nutrition/obesity/fitness, after hours access to care, substance abuse, mental illness, diabetes, cancer, tobacco use, and cardiovascular disease. Barriers to healthcare access like lack of insurance, transportation, and provider shortages are also examined.
Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Bu...Center on Addiction
This report summarizes the findings of a study that analyzed spending on substance abuse and addiction by federal, state, and local governments in 2005. The study found that a total of $467.7 billion was spent, accounting for 10.7% of combined spending. Of this, $238.2 billion (9.6% of its budget) was spent by the federal government, $135.8 billion (15.7% of budgets) by state governments, and $93.8 billion (9.0% of budgets) by local governments. Over 95% of federal and state spending went to cope with the public costs of substance abuse through areas like health care, criminal justice, and child welfare, rather than on
Addiction Medicine: Closing the Gap between Science and PracticeCenter on Addiction
These slides accompany CASAColumbia's report, Addiction Medicine: Closing the Gap between Science and Practice, published in June 2012, which found that, despite the prevalence of addiction, the enormity of its consequences, the availability of effective solutions and the evidence that addiction is a disease, both screening and early intervention for risky substance use are rare, and only about 1 in 10 people with addiction involving alcohol or drugs other than nicotine receive any form of treatment.
Pregnancy, Drug Use, and The Law Report and RecommendationsDana Asbury
In October of 2015, more than 250 participants from around the country came together in Nashville, TN for a series of events looking at the legal and medical responses to pregnant women and drug use. Today, we are releasing a report examining pregnancy and drug use and providing a comprehensive set of recommendations in a range of areas including state medical protocols, health coverage and the licensing of treatment facilities.
Ghana has a population of 22 million people and currently has over 14,000 reported cases of HIV/AIDS, with over 10,000 people living with HIV/AIDS, including nearly 8,000 children. Current strategies in Ghana aim to increase access to antiretroviral therapy and medical care to improve life expectancy and quality of life for those infected, while also working to prevent mother-to-child transmission through testing and treatment. Psychological support services play an important role in counseling families and children infected with HIV.
The "Fetal Assault Law" is Done: Resources for Treatment ProvidersDana Asbury
In July 2016, Tennessee's "Fetal Assault Law" officially ended. This short resource provides context and explanation for how the law harmed pregnant people and families, a short outline regarding current challenges in treating pregnant individuals and supporting their families, and some recommendations for future action from the Tennessee Association of Alcohol, Drug, and Other Addiction Services (TAADAS).
The National Chlamydia Coalition provided mini-grants of up to $10,000 to 63 state and local organizations across the United States to fund innovative strategies to increase chlamydia screening and treatment. Projects included coalition-building efforts in Minnesota, chlamydia screening programs at universities and in juvenile justice facilities, and community outreach targeting at-risk groups. The programs utilized diverse approaches like provider education, public awareness campaigns, and alternative testing locations. Preliminary results showed increased screening and moderate prevalence of chlamydia infection among young people tested. Evaluation of the projects will provide lessons learned to disseminate.
Welcome to “Pregnancy, Drug Use, and the Law”, a one day public policy conference examining Tennessee law as it relates to pregnant women and new mothers, people who use and are sometimes dependent on drugs, and how we can create fair and effective policies that will support all Tennessee women and families.
First model of one stop service for drug users in drug dependent centers in s...Alexander Decker
This study developed and evaluated a "one stop service" model providing integrated care for drug users at a drug dependence treatment center in southern Thailand. Fifty-six intravenous and other drug users received services including methadone maintenance, HIV/AIDS testing and counseling, health education, tuberculosis screening, antiretroviral therapy, and harm reduction. Most participants were satisfied with the integrated services. The model helped address barriers to care by providing comprehensive services in a single location and establishing a self-help support group. The study concluded the one stop service model should be expanded to improve care for drug users and reduce HIV transmission in Thailand.
This document summarizes the key findings of a study on the effects of drug abuse in Indonesia. The study surveyed 602 individuals across 6 Indonesian provinces and found that:
1) Drug use in Indonesia is typically polydrug use, involving multiple substances, starting at a young age. The most commonly abused drugs are crystal meth, marijuana, and other amphetamine-type stimulants.
2) Drug use poses many health risks, such as driving under the influence, mixing substances, and unprotected sex. It can also lead to physical effects like oral infections, respiratory issues, and overdoses.
3) Long-term drug abuse is linked to mental health issues in 86.4% of respondents as well
Recruiting & Retaining Public Health Workers: Results from the Public Health ...PublicHealthFoundation
The survey of over 11,000 public health workers found differences in factors influencing recruitment and retention across generations:
- Younger workers placed more importance on flexibility, telework options, and career advancement opportunities.
- Older workers were more motivated by mission and helping their communities.
- All groups highly valued job security, benefits, and work-life balance factors like schedule flexibility.
The results suggest tailoring recruitment and retention strategies to different generations' priorities to strengthen the public health workforce.
This document discusses addressing sexual and reproductive health (SRH) and HIV needs among key populations, specifically people who use drugs, in Kenya. It describes a project called "Shadows and Light" implemented by Family Health Options Kenya (FHOK) from 2012-2015, funded by IPPF and the German BACKUP Initiative, that aimed to strengthen SRH-HIV linkages for people who inject drugs. Key activities included training service providers, advocacy, and providing over 50,000 integrated SRH-HIV services to people who use drugs. Successes included higher retention of young people who use drugs in services, improved access to comprehensive care, and increased representation of people who use drugs in national HIV technical working groups. Ch
Changing the Narrative for Women & Girls (Tx, Recovery)Alton King
Innovation. Perseverance. Dedication. Adaptation. These are but a few words that describe behavioral health programs that help clients to be treated for their substance use or co-occurring disorder, obtain and/or sustain their recovery, and enjoy a renewed/reinvigorated life of their choosing. Creative interventions will be discussed that canvas the entire U.S. and several of its dependent areas around the globe.
The document summarizes a presentation about early identification of individuals with HIV/AIDS given to the Philadelphia EMA Ryan White Planning Council. It discusses the national EIIHA initiative goals of increasing awareness of HIV status and linking those with HIV to care. The presentation outlines Philadelphia's EIIHA strategy, logic model, and matrix for targeting different high-risk groups. It also reviews HRSA expectations and policies around testing, outreach, and linkage to care to achieve the goals of diagnosing individuals and linking them quickly to medical care.
1) The document discusses substance use in pregnancy and its effects. It describes several case studies of women (Sandra, Tiffany, Mary, Della) who used various substances like heroin, methadone, cigarettes, alcohol, and marijuana during pregnancy.
2) Prenatal substance use can cause medical complications for both mother and baby, including issues like anemia, infections, preeclampsia, and low birth weight. The most common substance exposed to fetuses is tobacco, followed by alcohol and then illicit drugs.
3) Babies exposed to opioids in utero often experience neonatal abstinence syndrome after birth, with symptoms like tremors, poor sleep, and crying. Treatment can be
This document discusses a smoking cessation program for high-risk patients at Philadelphia FIGHT Dental Services. The program aims to reduce smoking rates among HIV-positive individuals and those at risk for HIV through educational sessions and an evidence-based text messaging program. Literature shows narrative communication and SMS programs can increase quit rates. The goals are to raise awareness of smoking harms, help participants quit, and evaluate the effectiveness of sessions and texts on cessation rates. Activities included grant writing, educational materials, pre/post questionnaires, and signing participants up for the text messaging program. Recommendations include comparing results of sessions with and without texts, providing incentives, improving recruitment, and strengthening provider partnerships.
A bridge too near injecting drug users' sexual behaviourMd. Nakebul Kausar
This document summarizes a study on the personal profiles and health seeking behaviors of injecting drug users (IDUs) in Dhaka, Bangladesh. The study involved interviews with 120 IDUs attending a drug treatment center between March and September 2005. Key findings included: 1) Most respondents (60%) had little knowledge about diseases spread by injecting drugs or needle sharing, with only 17.5% mentioning HIV/AIDS. 2) Regarding protection, 29.2% mentioned not injecting drugs anymore while 34.2% mentioned using sterile needles/syringes. 3) The majority (60%) had never participated in a needle exchange program, with lack of awareness being a key barrier.
Predictors of Smoking Cessation among Pregnant Women in San Bernardino County Temidayo Ogunrinu, MPH
This document summarizes a field practicum report evaluating the predictors of smoking cessation among pregnant women in San Bernardino County who participated in the Comprehensive Tobacco Treatment Program (CTTP). Quantitative analysis found that women in their first and third trimester were less likely to complete the program, as were Whites and Blacks. Qualitative focus groups revealed that incorporating family support and improving transportation assistance could help more women succeed. The program was effective for most, but some barriers prevented full participation.
1) Tobacco smoking remains the leading preventable cause of disease and death worldwide. While smoking rates have decreased in developed countries, certain high risk groups have greater difficulty quitting.
2) Brief advice from doctors and other healthcare professionals on smoking cessation can more than double quit rates compared to no advice. Comprehensive treatment involving both behavioral support and pharmacotherapy is most effective for treating nicotine dependence.
3) Effective cessation medications include nicotine replacement therapy, varenicline, bupropion, and others depending on location. Behavioral support through counseling, telephone quitlines, internet programs, and motivational interviewing can also significantly increase success rates.
The National AIDS Control Programme was launched in 1987 with the aims of preventing further HIV transmission, decreasing morbidity and mortality, and minimizing socio-economic impact. It established the National AIDS Control Organization to implement and monitor the programme. NACP-IV, launched in 2012, aims to halt and reverse the HIV epidemic over five years through prevention services targeting high-risk groups, treatment, care and support for people living with HIV/AIDS.
This document provides information on HIV/AIDS including what HIV/AIDS is, how it progresses, transmission routes, prevention methods, and treatment. It defines AIDS as occurring in people with HIV when the CD4 count is below 200 or they have an opportunistic infection. HIV progressively damages the immune system, making people more susceptible to infections. While there is no cure for AIDS, antiretroviral treatment can slow its progression. The document outlines transmission routes like unprotected sex, contaminated blood, and from mother to child; and prevention methods like condom use, circumcision, antiretroviral treatment, and not sharing needles.
The document discusses the growing heroin addiction epidemic in the United States. It notes that prescription opioid misuse has led many Americans to turn to heroin and that overdose deaths have more than tripled since 2010. It provides information on prevention and treatment efforts, including expanding access to the overdose reversal drug naloxone and increasing medically-assisted treatment programs. The document also discusses Walgreens' efforts to install safe drug disposal kiosks and make naloxone available without a prescription to help address the crisis.
The director of the CDC discussed the prescription drug and opioid overdose epidemic in the United States. He noted that over 145,000 lives have been lost to prescription opioid overdoses in the past decade as opioid prescribing has increased 4-fold since 1999. The CDC is working with multiple states experiencing outbreaks of HIV linked to injection drug use. The director outlined a potential "technical package" of interventions including improving prescribing practices, increasing access to treatment, reducing drug availability, and public awareness campaigns. Progress requires a comprehensive, evidence-based public health approach with law enforcement and community involvement.
The "Fetal Assault Law" is Done: Resources for Treatment ProvidersDana Asbury
In July 2016, Tennessee's "Fetal Assault Law" officially ended. This short resource provides context and explanation for how the law harmed pregnant people and families, a short outline regarding current challenges in treating pregnant individuals and supporting their families, and some recommendations for future action from the Tennessee Association of Alcohol, Drug, and Other Addiction Services (TAADAS).
The National Chlamydia Coalition provided mini-grants of up to $10,000 to 63 state and local organizations across the United States to fund innovative strategies to increase chlamydia screening and treatment. Projects included coalition-building efforts in Minnesota, chlamydia screening programs at universities and in juvenile justice facilities, and community outreach targeting at-risk groups. The programs utilized diverse approaches like provider education, public awareness campaigns, and alternative testing locations. Preliminary results showed increased screening and moderate prevalence of chlamydia infection among young people tested. Evaluation of the projects will provide lessons learned to disseminate.
Welcome to “Pregnancy, Drug Use, and the Law”, a one day public policy conference examining Tennessee law as it relates to pregnant women and new mothers, people who use and are sometimes dependent on drugs, and how we can create fair and effective policies that will support all Tennessee women and families.
First model of one stop service for drug users in drug dependent centers in s...Alexander Decker
This study developed and evaluated a "one stop service" model providing integrated care for drug users at a drug dependence treatment center in southern Thailand. Fifty-six intravenous and other drug users received services including methadone maintenance, HIV/AIDS testing and counseling, health education, tuberculosis screening, antiretroviral therapy, and harm reduction. Most participants were satisfied with the integrated services. The model helped address barriers to care by providing comprehensive services in a single location and establishing a self-help support group. The study concluded the one stop service model should be expanded to improve care for drug users and reduce HIV transmission in Thailand.
This document summarizes the key findings of a study on the effects of drug abuse in Indonesia. The study surveyed 602 individuals across 6 Indonesian provinces and found that:
1) Drug use in Indonesia is typically polydrug use, involving multiple substances, starting at a young age. The most commonly abused drugs are crystal meth, marijuana, and other amphetamine-type stimulants.
2) Drug use poses many health risks, such as driving under the influence, mixing substances, and unprotected sex. It can also lead to physical effects like oral infections, respiratory issues, and overdoses.
3) Long-term drug abuse is linked to mental health issues in 86.4% of respondents as well
Recruiting & Retaining Public Health Workers: Results from the Public Health ...PublicHealthFoundation
The survey of over 11,000 public health workers found differences in factors influencing recruitment and retention across generations:
- Younger workers placed more importance on flexibility, telework options, and career advancement opportunities.
- Older workers were more motivated by mission and helping their communities.
- All groups highly valued job security, benefits, and work-life balance factors like schedule flexibility.
The results suggest tailoring recruitment and retention strategies to different generations' priorities to strengthen the public health workforce.
This document discusses addressing sexual and reproductive health (SRH) and HIV needs among key populations, specifically people who use drugs, in Kenya. It describes a project called "Shadows and Light" implemented by Family Health Options Kenya (FHOK) from 2012-2015, funded by IPPF and the German BACKUP Initiative, that aimed to strengthen SRH-HIV linkages for people who inject drugs. Key activities included training service providers, advocacy, and providing over 50,000 integrated SRH-HIV services to people who use drugs. Successes included higher retention of young people who use drugs in services, improved access to comprehensive care, and increased representation of people who use drugs in national HIV technical working groups. Ch
Changing the Narrative for Women & Girls (Tx, Recovery)Alton King
Innovation. Perseverance. Dedication. Adaptation. These are but a few words that describe behavioral health programs that help clients to be treated for their substance use or co-occurring disorder, obtain and/or sustain their recovery, and enjoy a renewed/reinvigorated life of their choosing. Creative interventions will be discussed that canvas the entire U.S. and several of its dependent areas around the globe.
The document summarizes a presentation about early identification of individuals with HIV/AIDS given to the Philadelphia EMA Ryan White Planning Council. It discusses the national EIIHA initiative goals of increasing awareness of HIV status and linking those with HIV to care. The presentation outlines Philadelphia's EIIHA strategy, logic model, and matrix for targeting different high-risk groups. It also reviews HRSA expectations and policies around testing, outreach, and linkage to care to achieve the goals of diagnosing individuals and linking them quickly to medical care.
1) The document discusses substance use in pregnancy and its effects. It describes several case studies of women (Sandra, Tiffany, Mary, Della) who used various substances like heroin, methadone, cigarettes, alcohol, and marijuana during pregnancy.
2) Prenatal substance use can cause medical complications for both mother and baby, including issues like anemia, infections, preeclampsia, and low birth weight. The most common substance exposed to fetuses is tobacco, followed by alcohol and then illicit drugs.
3) Babies exposed to opioids in utero often experience neonatal abstinence syndrome after birth, with symptoms like tremors, poor sleep, and crying. Treatment can be
This document discusses a smoking cessation program for high-risk patients at Philadelphia FIGHT Dental Services. The program aims to reduce smoking rates among HIV-positive individuals and those at risk for HIV through educational sessions and an evidence-based text messaging program. Literature shows narrative communication and SMS programs can increase quit rates. The goals are to raise awareness of smoking harms, help participants quit, and evaluate the effectiveness of sessions and texts on cessation rates. Activities included grant writing, educational materials, pre/post questionnaires, and signing participants up for the text messaging program. Recommendations include comparing results of sessions with and without texts, providing incentives, improving recruitment, and strengthening provider partnerships.
A bridge too near injecting drug users' sexual behaviourMd. Nakebul Kausar
This document summarizes a study on the personal profiles and health seeking behaviors of injecting drug users (IDUs) in Dhaka, Bangladesh. The study involved interviews with 120 IDUs attending a drug treatment center between March and September 2005. Key findings included: 1) Most respondents (60%) had little knowledge about diseases spread by injecting drugs or needle sharing, with only 17.5% mentioning HIV/AIDS. 2) Regarding protection, 29.2% mentioned not injecting drugs anymore while 34.2% mentioned using sterile needles/syringes. 3) The majority (60%) had never participated in a needle exchange program, with lack of awareness being a key barrier.
Predictors of Smoking Cessation among Pregnant Women in San Bernardino County Temidayo Ogunrinu, MPH
This document summarizes a field practicum report evaluating the predictors of smoking cessation among pregnant women in San Bernardino County who participated in the Comprehensive Tobacco Treatment Program (CTTP). Quantitative analysis found that women in their first and third trimester were less likely to complete the program, as were Whites and Blacks. Qualitative focus groups revealed that incorporating family support and improving transportation assistance could help more women succeed. The program was effective for most, but some barriers prevented full participation.
1) Tobacco smoking remains the leading preventable cause of disease and death worldwide. While smoking rates have decreased in developed countries, certain high risk groups have greater difficulty quitting.
2) Brief advice from doctors and other healthcare professionals on smoking cessation can more than double quit rates compared to no advice. Comprehensive treatment involving both behavioral support and pharmacotherapy is most effective for treating nicotine dependence.
3) Effective cessation medications include nicotine replacement therapy, varenicline, bupropion, and others depending on location. Behavioral support through counseling, telephone quitlines, internet programs, and motivational interviewing can also significantly increase success rates.
The National AIDS Control Programme was launched in 1987 with the aims of preventing further HIV transmission, decreasing morbidity and mortality, and minimizing socio-economic impact. It established the National AIDS Control Organization to implement and monitor the programme. NACP-IV, launched in 2012, aims to halt and reverse the HIV epidemic over five years through prevention services targeting high-risk groups, treatment, care and support for people living with HIV/AIDS.
This document provides information on HIV/AIDS including what HIV/AIDS is, how it progresses, transmission routes, prevention methods, and treatment. It defines AIDS as occurring in people with HIV when the CD4 count is below 200 or they have an opportunistic infection. HIV progressively damages the immune system, making people more susceptible to infections. While there is no cure for AIDS, antiretroviral treatment can slow its progression. The document outlines transmission routes like unprotected sex, contaminated blood, and from mother to child; and prevention methods like condom use, circumcision, antiretroviral treatment, and not sharing needles.
The document discusses the growing heroin addiction epidemic in the United States. It notes that prescription opioid misuse has led many Americans to turn to heroin and that overdose deaths have more than tripled since 2010. It provides information on prevention and treatment efforts, including expanding access to the overdose reversal drug naloxone and increasing medically-assisted treatment programs. The document also discusses Walgreens' efforts to install safe drug disposal kiosks and make naloxone available without a prescription to help address the crisis.
The director of the CDC discussed the prescription drug and opioid overdose epidemic in the United States. He noted that over 145,000 lives have been lost to prescription opioid overdoses in the past decade as opioid prescribing has increased 4-fold since 1999. The CDC is working with multiple states experiencing outbreaks of HIV linked to injection drug use. The director outlined a potential "technical package" of interventions including improving prescribing practices, increasing access to treatment, reducing drug availability, and public awareness campaigns. Progress requires a comprehensive, evidence-based public health approach with law enforcement and community involvement.
ER visits for opioid overdoses is rising in the U.S. Accurate ER reports from medical transcription services and proactive action can help minimize risks.
The document discusses addressing the opioid epidemic through a public health lens. It provides data on the rise in opioid-related deaths in Massachusetts from 2000-2016. It also discusses prevention, intervention, treatment and recovery efforts through Governor Baker's Opioid Working Group. This includes adopting core medical competencies focused on substance use, expanding treatment beds and recovery programs, and the Chapter 55 data initiative to better understand the epidemic through linking multiple health datasets.
The document discusses efforts to address the opioid epidemic in the United States, including:
- Increasing registration and use of prescription drug monitoring programs (PDMPs) to track opioid prescriptions.
- Reducing the stigma around both pain and substance use disorder to increase access to comprehensive treatment.
- Expanding access to naloxone to prevent overdose deaths and "Good Samaritan" legal protections.
- Ongoing education of physicians on safe opioid prescribing and alternative pain management strategies.
Dr. Tom Frieden, Director of the Centers for Disease Control and Prevention, keynote presentation at the National Rx Drug Abuse & Heroin Summit on March 30, 2016.
Web rx16 prev_tues_330_1_lawal_2warren_3huddleston_4pershingOPUNITE
This document discusses the role of health departments in preventing neonatal abstinence syndrome (NAS). It notes that NAS rates have increased significantly in recent years, disproportionately affecting women. Health departments engage in surveillance to monitor NAS trends, partner with other organizations, support treatment and recovery programs, and provide education to prevent NAS, which is entirely preventable. The document outlines specific strategies health departments use across these areas to address the opioid epidemic and protect maternal and infant health.
The document discusses the opioid epidemic in the United States and the role of physicians in addressing it. It notes that opioid overdose deaths have significantly increased since 2012, with over 50,000 deaths in 2015. The American Medical Association (AMA) created an Opioid Task Force to provide recommendations. The AMA is working to increase prescription drug monitoring program usage, safe prescribing practices, and access to treatment for substance use disorders. While physician opioid prescriptions and education efforts have increased to address the epidemic, challenges remain regarding stigma, treatment capacity and access, guideline consistency, and insurance coverage of alternative treatment options.
Kyle molina harm reduction midterm project unm crp 275 community change in a ...Dr. J
Currently our country is experiencing a national health crisis of opiate use and opiate related overdoses, with the corona virus causing these problems to only get worse. In 2019 the number of drug overdoses in the United States rose by 4.6% , for a total of 70,980, with 50,042 involving opioids (American Hospital Association, 2020)
It is estimated around 130 people die each day due to overdose and since 2010 a total of 400,000 deaths have occurred (DrugAbuse.Gov)
Following national trends New Mexico has seen an increase in reported overdoses since the early 2000s and in 2018 63.0% of drug overdose deaths involved opioids with a total of more than 338 fatalities.(DrugAbuse.Gov)
Transmission of bloodborne diseases such as HIV and Hepatitis C is also an issue among the population who use intravenously.
Preventing teen abuse of prescriptions and over theraynaandyailka
This document discusses preventing teen abuse of prescription and over-the-counter medications. It outlines a mission and goals to educate stakeholders on risk factors for teen abuse and significantly reduce abuse among teens aged 13-19. Objectives include better understanding trends in teen medication abuse, increasing parent-teen communication, and reducing unattended medications. Statistics show increasing rates of teen prescription drug abuse. Efforts to address the issue include prescription drug monitoring programs, take-back initiatives, and educating parents, physicians, and communities. Challenges include getting families, physicians, and authorities adequately involved in prevention.
Rx16 federal tues_330_1_spitznas_2baldwin_3welchOPUNITE
This document discusses patient review and restriction programs (PRRs) as tools to help curb prescription drug abuse and coordinate patient care. It describes state Medicaid PRR programs and recent efforts to expand PRR programs to Medicare. It also describes the role of PRR programs in the CDC's Prescription Drug Overdose Prevention for States grant program, the Office of National Drug Control Policy's national strategy, and the federal budget.
This document summarizes an education and advocacy track on parents and naloxone presented at a conference. It introduces Joanne Peterson from Learn to Cope, an organization that provides support and resources to families affected by addiction. It outlines the goals of Learn to Cope, including educating communities about drug dangers and solutions. Data is presented showing the large number of people Learn to Cope has helped and its pilot program training parents to distribute naloxone kits has helped reduce overdose deaths in Massachusetts.
The document provides an overview and training manual for screening and referring women of childbearing age for substance abuse issues, with a focus on reducing rates of Neonatal Abstinence Syndrome in Pasco County, Florida. It describes Neonatal Abstinence Syndrome and risk factors, barriers to screening, benefits of screening, screening tools like CAGE-AID, and community resources for referral. The goal is to identify substance use early to improve maternal and infant outcomes through education, screening, and treatment referral.
EVERFI Webinar: Addressing Prescription Drug Abuse on CampusMichele Collu
This document discusses addressing prescription drug abuse on college campuses. It begins by outlining the scope of the problem, noting that while the US makes up 5% of the world's population, it consumes 75% of the world's prescription drugs. Contributing factors to misuse include easy access to medications, misperceptions about safety, and direct-to-consumer drug advertising. The document then defines misuse and outlines the most commonly abused drug types - opioids, stimulants, and depressants. It presents data on misuse rates among college students and 18-25 year olds. Finally, it discusses prevention strategies including information dissemination, skill building, problem identification and referral services, environmental approaches, and campus-
This document summarizes a presentation on state and federal responses to the opioid epidemic. It discusses innovations from the Kentucky Attorney General including legislative measures targeting pill mills and heroin, programs to expand treatment and recovery, and education initiatives. It also describes the federal response through the Organized Crime Drug Enforcement Task Force (OCDETF), including their national heroin initiative targeting criminal organizations trafficking illegal opioids and heroin, and partnerships with other agencies to address public health and public safety aspects of the epidemic. The presentation outlines strategies at both state and federal levels aimed at improving access to treatment while also enforcing penalties on dealers through investigation and prosecution efforts.
Polypharmacy - What next? (Planning for Wessex) Workshop - Clare Howard's pre...Health Innovation Wessex
Polypharmacy - What next? (planning for Wessex) Conference 30th March 2017
'Polypharmacy Prescribing Comparators' Opening Presentation by Clare Howard, Clinical Lead
1. Co-prescribing opioids and benzodiazepines poses serious health risks like respiratory depression and increased risk of overdose death. Delaware has high rates of prescriptions for these drugs.
2. Delaware's PDMP collects prescription data that can help identify patients and providers with troubling patterns of co-prescribing to reduce risks. Regular screening and urine tests can also help address misuse.
3. PDMP data analysis found that in 2013 over 12% of individuals in Delaware filled prescriptions for both drug classes, putting them at risk. The PDMP is a valuable tool to improve prescribing practices and detect misuse.
Primary medical care settings are ideal for treating chronic illnesses but are underutilized venues for addressing this particular chronic disease. Addiction treatment specialists are too few and many patients find this path to be unacceptable. The question becomes: how to get primary care medical providers to integrate the treatment of patients with opioid use disorders into their practices?
Different ways to accomplish this were the topic of the Louis Kolodner Memorial Lecture at MedChi for the second year in a row. Last year, Dr. Michael Fingerhood described the model that he has developed at Johns Hopkins Medicine. This year, Dr. Richard Schottenfeld, now the Chief of Psychiatry at Howard University, presented research studies done by Yale University and other centers. These studies demonstrated four successful interventions:
Methadone given to already stabilized opioid addiction patients in a primary care setting instead of a specialized opioid treatment program (OTP)
Buprenorphine along with medical counseling given in a primary care setting
An initial dose of buprenorphine given in a hospital emergency department along with a next-day follow up appointment for ongoing treatment
Injectable naltrexone, although more difficult to initiate for patients than was buprenorphine, was effective for those patients who were able to start it
Two barriers that needed to be reduced to achieve these successes were the disinclination of providers to use these medications and general pessimism about the prognosis of opioid use disorders. My hope is that as more successes are demonstrated, these barriers will slowly be lowered. For those interested in more details about these studies, I invite you to access the lecture slides, available here.
Similar to Opioid Awareness - Report Review: The Mayor's Task Force to Combat the Opioid Epidemic in Philadelphia (20)
Overview of the 2018 Update to the Integrated Plan and PrEP Workgroup Draft R...Office of HIV Planning
Mari Ross-Russell (Office of HIV Planning) and Matthew McClain (Public Health Policy & Planning Consultant) presented these slides to the PrEP Workgroup of the Philadelphia EMA HIV Integrated Planning Council on January 16, 2019.
Dr. William R. Short presented this review of PrEP research from the Conference on Retroviruses and Opportunistic Infections to the PrEP Workgroup of the HIPC's Prevention Committee in April 2018.
Sebastian Branca of the AIDS Activities Coordinating Office provided this overview of AACO's quality management program to the HIV Integrated Planning Council on May 10, 2018. This presentation includes discussion of secret shoppers, quality improvement plans, and quality management initiatives.
C-YA! Philadelphia EMA's Plan to Connect our Co-infected Community to a Cure ...Office of HIV Planning
Alex Shirreffs of the Philadelphia Department of Public Health provided this overview of the Philadelphia area's plan to end HIV and Hepatitis C coinfections to the HIV Integrated Planning Council on May 10, 2018.
The document outlines information about the Client Services Unit (CSU) of the AIDS Activities Coordinating Office (AACO) in Philadelphia. It discusses the CSU's mission to help and advocate for people living with HIV/AIDS. It provides data on the 1976 client intakes completed in 2017, including demographics and most common needs. It also describes the transition of AACO's Housing Services Program to the City's Office of Homeless Services and details the consumer feedback process for AACO-funded services.
This presentation was provided to the Philadelphia EMA HIV Integrated Planning Council by Briana Morgan of the Office of HIV Planning. It includes data related to population-level data, race/ethnicity, STIs, risk behaviors, HIV, and more.
This document summarizes disparities in Philadelphia's HIV continuum of care. It identifies several priority populations that experience lower rates of HIV status awareness, retention in medical care, and viral load suppression. These include racial/ethnic minority youth, transgender persons who have sex with men, heterosexual men of color, and persons who inject drugs. The document also finds geographic disparities, with lower continuum measures in collar counties surrounding Philadelphia. It concludes by recommending several areas for action to decrease disparities, such as increasing PrEP access, HIV testing, and linkage to and retention in medical care.
Increasing Treatment Access and Saving Lives in the Dual Opioid and Overdose ...Office of HIV Planning
Silvana Mazzella of Prevention Point Philadelphia gave this presentation on medication assisted treatment to the Philadelphia EMA HIV Integrated Planning Council on March 8, 2018.
Dr. Kathleen Brady of the AIDS Activities Coordinating Office discussed three cycles of the National HIV Behavioral Surveillance in Philadelphia, including cycles with men who have sex with men (MSM), high-risk heterosexuals, and injection drug users. This presentation took place at the Philadelphia EMA HIV Integrated Planning Council meeting on Thursday, January 11, 2018.
Caitlin Conyngham and Erika Aaron of the AIDS Activities Coordinating Office began the initial meeting of the PrEP Working Group with this presentation on November 15, 2017.
Marcy Witherspoon, MSW, LSW of the Health Federation of Philadelphia discussed trauma-informed care with the Philadelphia EMA HIV Integrated Planning Council on November 9, 2018.
OHP's Antonio Boone gave this presentation on different prevention continuum examples at the July meeting of the Prevention Committee of the Philadelphia EMA HIV Integrated Planning Council.
Integrated HIV Surveillance and Prevention Programs for Health Departments - ...Office of HIV Planning
Caitlin Conyngham, Prevention Coordinator at the AIDS Activities Coordinating Office at the Philadelphia Department of Public Health, gave an overview of the new HIV prevention notice of funding opportunity to the HIPC's Prevention Committee on 07-26-2017.
Planning Council Co-Chair and Prevention Committee member Jen Chapman presented on integrated planning and concurrence at the May 2017 meeting of the HIV Integrated Planning Council.
Ryan White HIV AIDS Program (RWHAP) Services and Policy Clarification Notice ...Office of HIV Planning
At the April meeting of the Comprehensive Planning and Needs Assessment Committees, Jessica Brown of AACO presented on Ryan White service categories. She also reviewed changes enacted by PCN 16-02.
At the April meeting of the Comprehensive Planning and Needs Assessment Committees, Jessica Brown of AACO presented on Ryan White service categories. She also reviewed changes enacted by PCN 16-02.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. OPIOID EPIDEMIC REPORT
What is Happening
◼ Prescription Opioid Sales
◼ Opioid Use
◼ Overdoses
Impact
◼ On Families
◼ On the Criminal Justice System
The Mayor's Task Force
◼ Process
◼ Community Input
◼ Monitoring and Evaluation
Recommendations
◼ Overdose Prevention
◼ Treatment
◼ Involvement of the Criminal Justice
System
Act 139
3. WHAT IS HAPPENING
◼ Prescription opioid medications such as: Vicodin,
Percocet, OxyContin have fueled this current crisis.
◼ Nationally 4 out of 5 new heroin users have their first
exposure to opioids via prescription pain medication.
◼ The opioid epidemic in Philadelphia has reached
epidemic levels in recent years due to the rise of
fentanyl, a synthetic opioid that began appearing in
that test results of opioid overdose victims in 2014.
4. PRESCRIPTION OPIOID SALES
◼ Drug Enforcement Agency(DEA) suggests that
opioid sales in Philadelphia doubled between
2000 and 2012.
◼ Healthcare providers continue to prescribe large
quantities of pain medication than medically
appropriate.
◼ Between 100,000 and 200,000 Philadelphians
receive more than one opioid pain medication
prescription each year.
◼ National Survey on Drug Use and Health states
between 50,000 and 60,000 people misused a
prescription opioid pain meds in the last year.
5. OPIOID USE
◼ 90% of people who are prescribed opioids do not
transition to heroin use.
◼ But the large number of people receiving prescription
opioids makes it easier for other individuals to make the
transition.
◼ The transition is likely to occur in Philadelphia-Camden
area due to the high purity and low cost of heroin.
◼ There are an estimated 70,000 heroin users in
Philadelphia.
◼ Likely more, does not include individuals who receive care
in a private treatment system.
◼ 14,000 people were treated for opioid use disorder in
Philadelphia’s system from October 2015 to
September 2016.
By 2016 Fentanyl was found in nearly half of overdose
deaths
6. OVERDOSES
◼ 907 people died from drug overdoses in Philadelphia
during 2016. 702 in 2015 three times the number of
homicides.
◼ Fentanyl is 50 to 100 times stronger than morphine
◼ Found in 412 drug overdose decedents
◼ Fatal overdoses predominantly occur among
Hispanic-white males aged 45-54.
◼ Consequence of older adults becoming dependent on
drugs due to the over-prescribing of opioids.
◼ 2014- PA Physician General Rachel Levine signed a
statewide “standing order” enabling any Pennsylvanian to
obtain naloxone from a pharmacy without an individual
prescription.
7. IMPACT-FAMILIES
Effect of drugs on families includes
◼ Compromised physical and mental health
◼ Increased health care costs
◼ Loss of productivity at school/work
◼ Reduced quality of life
◼ Increased crime and violence
◼ Abuse and neglect.
Neonatal Abstinence Syndrome(NAS) may interfere
with a child’s brain development, mental functioning and
behavior.
▪ NAS increased more than three-fold from 3 per
1,000 births (2002) to 11 per 1,000 live births (2015).
8. IMPACT- FAMILIES
Adverse Childhood Experiences (ACE), stressful or
traumatic events that are strongly related to the
development of a wide range of health problems.
The Philadelphia Urban ACE Study surveyed nearly
2,000 Philadelphians between 2012-2013. Data
showed
◼ 40% of respondents experienced greater than or
equal to four ACEs.
◼ Approximately 35% grew up with substance abuse in
their household.
◼ Substance use becomes increasingly likely across
adolescence, rates peaking among people in their
20’s.
◼ 74% of adults 18-30 years old admitted to
substance use disorder treatment programs began
using at the age of 17 or younger.
9. IMPACT- CRIMINAL JUSTICE SYSTEM
◼ Incarceration itself is a risk factor for developing substance use disorder.
◼ Philadelphia Department of Prison processes 30,000 individuals for intake each year, averaging over 6,000
people per day.
◼ 40% participate in behavioral health treatment (primarily pharmacological care)
◼ 17% who are mentally ill
◼ 14% living with Hepatitis C
◼ 3% living with HIV
◼ 14% tested positive for opioids (15% of females tested and 12% of males tested)
◼ Pregnant women with opioid use disorder receive methadone for the duration of the pregnancy.
◼ 300 inmates receive methadone annually.
10. IMPACT- CRIMINAL JUSTICE SYSTEM
◼ Opportunities for Prevention and Treatment Interventions for Offenders Needing Support (OPTIONS)
◼ A cognitive behavioral treatment program that is offered withdrawal management support(detox)
◼ 1,500 people also participate in substance use disorder counseling through the OPTIONS program.
◼ Inmates who participate in withdrawal management will experience reduced tolerance to opioids and are at greater risk
for overdose.
◼ Dept. of Prisons provides withdrawal management 8,000 times annually
◼ Of the 3,172 people who died of unintentional drug overdose from 2010-15, 782 (25%) were incarcerated in
Philadelphia Department of Prisons.
11. PHILADELPHIA TREATMENT COURT
The court is determined to treat substance use disorder as a root cause of criminal activity, providing an alternative or
supplement to normal proceedings.
◼ Treatment Court can offer post-plea deals that deliver a network of treatment and supportive services:
◼ Recovery housing
◼ Vocational training
◼ Employment placement
◼ Enrolled more than 4,800 participants and graduated more than 3,100 participants.
◼ In the past five years 890 participants have accepted to Treatment Court representing 74% of all referrals.
◼ Self reported opioid use increased from 22% in 2015 to 37% in March 2017.
◼ 78% of participants successfully completed Treatment Court in 2016.
◼ Shown reduced recidivism when compared to drug offenders, reducing rates of rearrest and reconviction from 6% to
26%.
12. THE MAYOR’S TASK FORCE- PROCESS
◼ Taskforce composed of over 100 experts, stakeholders and community members.
◼ Arthur C. Evans, Commissioner, Department of Behavioral Health and Intellectual disability Services
◼ Thomas D. Farley, Health Commissioner, Philadelphia Department of Public Health
◼ Formed 5 subcommittees
1. Public Education and Prevention Strategies
2. Service Access, Best Practices, and Treatment Providers
3. Overdose Prevention and Harm Reduction
4. Justice System, Law Enforcement, and First Responders
5. Data Analysis and Sharing
◼ Each subcommittee was lead by two co-chairs and met five times for two hours from January 18, 2017 to March 20,
2017.
13. THE MAYOR'S TASK FORCE- COMMUNITY INPUT
The task force organized four community listening sessions over a two week period between January and
February 2017.
◼ Sessions were held in the Northwest, North, South/West, Northeast areas of Philadelphia.
◼ Total attendance for all four sessions was 463 community members. 116 people attended each session.
◼ 42 of Philadelphia’s 47 populated zip codes were represented.
◼ 86% of attendees have been directly impacted themselves or know someone directly impacted by the opioid
epidemic.
◼ 84% reported that they felt seriously listened to by city officials and task force members on possible
solutions.
14. THE MAYOR’S TASK FORCE- COMMUNITY INPUT
Common themes expressed at the four Community Listening Sessions:
◼ Opioid Prescribing
◼ Impose harsher restrictions on doctors illegally prescribing opioids
◼ Improve monitoring of doctors distributing and prescribing opioids.
◼ Public Education
◼ Increase early intervention and education opportunities for at-risk children and populations
◼ Increasing Treatment Access and Availability
◼ Increase medication-assisted treatment (MAT) for opioid use disorder
◼ Increase the length of time that individuals remain engaged in treatment.
◼ Make available innovative alternative treatments for pain management, such as acupuncture and EEG biofeedback.
◼ Public Safety
◼ Establish drug-free communities so persons in recovery do not have to be tempted by drug dealers while participating in or after returning from
treatment.
◼ Government Coordination and Communication
◼ Facilitate partnerships between the city and communities in fighting the epidemic
◼ Increase understanding and partnership between DHS and recovering mothers.
15. THE MAYOR’S TASK FORCE- MONITORING AND EVALUATION
Task Force recommended that the City establish high-level substance use surveillance program that would:
◼ Develop an opioid epidemic data report to establish a baseline and monitor the epidemic.
◼ Establish use of real time data to support a rapid response plan
◼ Use data matched across departments to identify barriers and opportunities for optimal systems interactions with individuals.
◼ Develop an evaluation plan to assess the progress and impact of the actions taken as a result of the Mayor's Opioid Task Force
Report.
◼ Developed a set of core metrics to monitor progress on the opioid epidemic:
◼ Opioid prescription rate per 1,000 population*
◼ Buprenorphine prescription rate per 1,000 population*
◼ Behavioral health treatment rate for patients with a primary diagnosis of opioid use disorder*
◼ Medication-assisted treatment rate for patients with a primary diagnosis of opioid disorder*.
◼ Fatal overdoses
◼ Nonfatal overdoses
16. RECOMMENDATIONS- PREVENTION AND EDUCATION
4. Improve health care professional education
◼ Healthcare professional school and provider organizations should require and have standard for broad,
competency-based training for all levels of healthcare professionals(dentists, pharmacists, physical therapists,
counselors and social workers).
◼ Focusing on pain, pain management and substance abuse disorder.
◼ The city should continue to encourage professional schools and organizations to share their curricula on pain
management and addiction.
◼ National survey data shows that half of PCP are “very” concerned about the risk of substance use disorder or death
related to opioid use, fewer are concerned about tolerance, impaired cognition and sedation.
◼ “In order to reduce the liberal prescribing of opioid pain medication, the city should support evidence-based
approaches to changing prescribing behavior.
Monitoring Metric: number of opioid pills sold
17. RECOMMENDATIONS- TREATMENT
6. Increase the provision of medicated assisted treatment(MAT)
◼ MAT is considered as a vital evidence-based treatment by numerous national professional organizations.
◼ Integrating MAT into treatment settings will ease patients burden of navigating the complex treatment system.
◼ All barriers to MAT should be identified and reduced.
Monitoring Metric: Publicly insured opioid use disorder clients participating in MAT.
10. Provide safe housing, recovery, and vocational supports
The city should work with other systems and elected officials to:
◼ increase safe permanent supporting housing, recovery houses, vocational support and recovery support services.
◼ Eliminate barriers to longer retention at treatment facilities
◼ End housing discrimination against individuals enrolled in MAT
◼ NIMBY(Not In My Backyard) is a major barrier to new treatment programs and engagement of elected officials is necessary.
◼ There is a shortage of safe housing and vocational supports.
◼ Not having affordable housing makes it more difficult to achieve good health.
Monitoring Method: Number of individuals housed that have opioid use disorder.
18. RECOMMENDATIONS- TREATMENT
7. Expand treatment access and capacity
◼ The Drug Enforcement Agency and National Survey on Drug Use and Health estimate that 122,000 and 150,000 Philadelphians
are in need of substance use disorder treatment.
1. Increase the number of sites in the city offering addiction treatment services.
2. Expand weekend and evening operations for facilities at multiple levels of care.
3. Identify gaps in substance use disorder treatment capacity for special populations and increase capacity of treatment slots and
providers to engage these populations at all levels of care.
4. Partner with the state to resolve identification issues
5. Create a web-based database for the general public and provider access to identify available treatment slots in real time.
6. Integrate information on how to access treatment into public education campaigns
7. Expand the capacity of crisis centers and emergency departments. In Philadelphia to assess and treat individuals with opioid use
disorder.
8. Improve the quality of assessments for individuals entering treatment by adopting ASAM(American Society of Addiction
Medicine) criteria.
9. Increase use of peer recovery specialist to support individuals in their recovery throughout behavioral health and medical settings.
Monitoring Method: People treated for opioid use disorder in the public behavioral health system.
19. RECOMMENDATIONS- OVERDOSE PREVENTION
12. Expand naloxone availability
◼ Engage with government agencies, community based organizations, health care providers, and private citizens.
◼ The use of naloxone by laypeople has been linked to reductions in overdose death rate.
◼ Should be available to persons at risk of overdose through 4 main areas:
1. Governmental and quasi-governmental agencies such as fire, police, homeless outreach agencies
2. Harm reduction programs
3. Take-home programs from hospital emergency department, prisons discharge and opioid treatment programs
4. Direct request at pharmacies
◼ Distribution centers should include training on:
◼ Recognition of overdose
◼ Administration of naloxone
◼ Treatment service ability
◼ Harm reduction messages
Monitoring Metrics: doses of naloxone distributed/administered, by agency/ Nonfatal drug overdoses treated in hospital emergency depts./ Fatal
drug overdoses
20. RECOMMENDATIONS- OVERDOSE PREVENTION
13. Further explore comprehensive user engagement sites(CUES)
Walk-in setting locations in which central services are provided to reduce substance use and fatal overdoses
◼ Referral to treatment and social services
◼ Wound care
◼ Medically supervised drug consumption
◼ Access to sterile injection equipment and naloxone
Safe Consumption Facilities(SCF) have been operating in Europe, Australia and Canada since 1988 and have been shown to:
◼ Reduce overdose death, disease transmission (including HIV, Hepatitis C and B) injection related infections and other adverse health
outcomes.
◼ Serve as an access point for D&A treatment, medical services and housing services, reducing the burden on Emergency depts., Police, and
Fire.
◼ Improve public order and neighborhood safety by reducing public drug consumption and improper disposal of drug use equipment.
The pilot program should be rigorously evaluated for health and community outcomes to guide future decisions.
Monitoring Metrics: Community impact assessment
21. RECOMMENDATIONS- OVERDOSE PREVENTION
15. Address homelessness among opioid users
The city should expand outreach and specialized programs to meet the needs of individuals with opioid use
disorder who are homeless such as City’s Safe Heaven, Journey of Hope and Housing First programs.
◼ Housing first provides access to housing for homeless individuals without restriction for those suffering from
substance use disorder.
◼ This strategy has been proven to reduce homelessness, shelter costs and health care costs
◼ Shown to increase substance use disorder and mental health treatment among its participants.
◼ Successfully implemented in Canada and many United States cities including Philadelphia.
Monitoring Metric: Individuals with opioid use disorder placed in Safe Heavens and Housing First programs
22. RECOMMENDATIONS- INVOLVEMENT OF THE CRIMINAL JUSTICE
SYSTEM
18. Provide Substance abuse disorder assessment and treatment in the Philadelphia Department of Prisons
◼ PDP should provide substance abuse treatment to all inmates upon entry and comprehensive treatment during
incarceration with continuum of care plan upon release.
◼ Should include a plan to obtain an identification card to facilitate treatment.
◼ Treatment during incarceration increases:
◼ Likelihood of engagement in treatment post-incarceration
◼ Reduced recidivism
◼ Increase abstinence
◼ Decreased overdose morbidity.
◼ Inmates who participated in MAT were twice as likely to engage in treatment upon re-entry.
Monitoring Metric: Inmates for opioid use disorder while incarcerated/ Inmates with opioid use disorder released with
continuum of care plan.
23. ACT 139
◼ Act 139 provides limited immunity from charge and prosecution for possession of drugs and drug
paraphernalia for individuals who experience drug overdose and are in need of medical care and for those
who seek medical care in good faith for a person experiencing an overdose so long as certain conditions are
met.
◼ Provides limited immunity from charge and prosecution for certain drug crimes for both a person acting in good faith
who seek medical assistance for someone having a drug overdose and the person suffering from one.
◼ Overdose rates in Pennsylvania have increased by 89% since 1999. In 2011 it had the 14th
highest overdose
mortality rate in the country.
◼ In 2014 Senate Bill 1164 was passed unanimously in the summer of 2014, signed by Governor Wolf on
September 30th
, when it be came Act 139.
◼ Dr. Rachel Levine , Pennsylvania Physician General signed standing order enabling any Pennsylvanian to
obtain Naloxone from a pharmacy with an individual prescription.
24. ACT 139
Immunity only applies to the following crimes
◼ Unlawful possession of a controlled substance or counterfeit substance
◼ Unlawful purchase or receipt of a controlled substance
◼ The possession or non-sale distribution of 30 grams or less of marijuana or 8 grams or less of hashish
◼ The use of, or possession with intent to use drug paraphernalia
◼ The delivery of, possession with intent to deliver or manufacture with intent to deliver, drug paraphernalia
◼ The unlawful possession of more than thirty doses as a dispensed prescription of more than three trade
packages of anabolic steroids.
25. WHAT CAN BE DONE
City Agencies are:
◼ Providing naloxone to EMS staff and police officers.
◼ Funding and supporting drug treatment providers to offer treatment for people addicted to opioids.
◼ Working to disrupt criminal networks that are distributing fentanyl
Health care providers can:
◼ Reduce their prescribing of opioids
◼ Obtain naloxone and learn how to use it.
◼ Register for and use prescription drugs monitoring program database when prescribing opioids.
PDPH is:
◼ Working with the Mayor's Task Force to combat the opioid epidemic to develop a plan to better prevent prescription opioid addiction, increase
treatment for those who are dependent and treat drug overdoses.
◼ Distributing guidelines to physicians and other prescribers on reducing inappropriate prescribing of opioids.
◼ Developing a media campaign warning consumers about the inherent risks of prescription opioids.