The document summarizes a presentation on collaboration, coordination, and data to address prescription drug abuse at the state level. It discusses Tennessee's Prescription for Success initiative, which brought together multiple state agencies under the Public Safety Subcabinet to develop a coordinated action plan. The plan focused on three key initiatives: reducing violent crime, addressing repeat offenders, and creating an environment for job growth. One outcome was a law requiring prescribers and dispensers to use the state's prescription drug monitoring program to curb doctor shopping and misuse. The initiative emphasizes cross-agency collaboration and using data to develop tailored community responses and mobilize resources to combat prescription drug abuse.
This document summarizes a presentation on building local capacity to prevent prescription drug abuse. It discusses three panelists who will speak on approaches to prevent Rx drug misuse, abuse, and diversion. These include Terry Cline, Commissioner of Health for Oklahoma; Gregg Raduka, Director of Prevention/Intervention for The Council on Alcohol and Drugs; and Christopher Wood from the Georgia Department of Behavioral Health and Developmental Disabilities. The moderator will be Regina LaBelle from the White House Office of National Drug Control Policy. The panelists will discuss policy and program approaches, the role of state health agencies in collaborating with partners, and how to form and engage statewide Rx prevention collaboratives.
1. Two states, South Carolina and Wisconsin, improved integration of PDMP data into electronic health systems by establishing connections between their PDMPs and various health IT platforms like EMR systems and pharmacy dispensing software.
2. States face challenges with PDMP integration like legal definitions of access, costs of integration projects, and establishing necessary agreements and user authorizations.
3. Florida operates drug surveillance systems through a medical examiners commission and PDMP. Analysis found declines in prescription opioid overdoses after implementation of legislative and regulatory interventions including a PDMP in 2011. However, heroin overdose deaths increased as some shifted to heroin.
Linking and mapping PDMP data can provide several benefits but also faces challenges. Linking PDMP and clinical data allows for evaluating the impact of PDMP interventions on outcomes and prescribing decisions. However, obtaining permissions and data is difficult due to legal and resource barriers. Mapping PDMP data using GIS tools in Washington identified areas for targeting overdose prevention efforts by visualizing patterns in prescribing risks, treatment availability, and overdoses. Stakeholders used these maps to guide education and funding decisions. Sustaining these tools requires ongoing funding and expanding included data sources.
Rx16 federal wed_1230_1_kelly_2bohn-killorinOPUNITE
1) The National HIDTA Program provides assistance to law enforcement agencies in critical drug trafficking regions through 28 regional HIDTA programs. It facilitates cooperation among federal, state, local, and tribal law enforcement.
2) Each HIDTA program has an executive board that identifies threats, develops strategies, and requests funding for initiatives. It brings together over 7,400 federal agents, 15,700 state and local officers, and 500 agencies across the country.
3) In response to the opioid epidemic, HIDTA employs law enforcement targeting of heroin and fentanyl trafficking, public health prevention efforts, and training on investigating heroin organizations. It has committed additional funds to enhance intelligence sharing and public health partnerships.
This document summarizes a presentation on engaging physicians in prevention efforts to address the opioid epidemic. It was presented by Yngvild Olsen and included the following key points:
1. Multiple policies like PDMPs, medication-assisted treatment, and naloxone access need to work together to reduce opioid misuse and overdoses.
2. Programs that educate physicians about prescription drug abuse and its link to heroin, and engage them in prevention, screening, and treatment can help address the epidemic.
3. Expanding access to evidence-based treatment with medications like buprenorphine and naloxone, combined with behavioral therapies, can help manage opioid addiction as a chronic disease
This document discusses recovery ready ecosystems and recovery community organizations. It introduces presenters from Young People in Recovery and Hope House Treatment Track who will discuss interventions, prevention, and recovery programs. Examples of Young People in Recovery chapters, programs, and services are provided, including employment workshops, education workshops, housing workshops, and recovery support services. The document also discusses recovery community organizations and initiatives in Texas and Georgia, such as the Association of Persons Affected by Addiction in Dallas and the Georgia Council on Substance Abuse.
Revised order rx16 pdmp wed_1115_1_eadie_2reilly_3hallvik_4hildebranOPUNITE
This document summarizes a presentation on a study examining how prescriber registration and use of a prescription drug monitoring program (PDMP) in Oregon impacted opioid prescribing patterns and patient outcomes. The study found that statewide opioid prescribing generally decreased over time, but prescribers who registered for the PDMP prescribed more after registering, especially those who used the PDMP most frequently. In contrast, prescribers who did not register prescribed less. Patients whose providers were all registered had lower overdose rates than those with some registered and some non-registered providers. The conclusions were that PDMPs may need refinements like mandatory use to optimize their impact on prescribing and outcomes.
This document summarizes a presentation on youth performance-enhancing drugs and ADHD medication. It discusses trends in misuse of these substances among young people. The presentation is given by representatives from various organizations focused on prevention, health promotion, and substance abuse issues among youth and college students. The presentation covers types of performance-enhancing drugs and their potential side effects. It also discusses trends in attitudes towards these substances and risks of misuse. Strategies are presented for helping adolescents pursue their goals without these drugs. The document concludes by outlining plans for addressing misuse of ADHD medication among college students through education and collaboration between various stakeholder groups.
This document summarizes a presentation on building local capacity to prevent prescription drug abuse. It discusses three panelists who will speak on approaches to prevent Rx drug misuse, abuse, and diversion. These include Terry Cline, Commissioner of Health for Oklahoma; Gregg Raduka, Director of Prevention/Intervention for The Council on Alcohol and Drugs; and Christopher Wood from the Georgia Department of Behavioral Health and Developmental Disabilities. The moderator will be Regina LaBelle from the White House Office of National Drug Control Policy. The panelists will discuss policy and program approaches, the role of state health agencies in collaborating with partners, and how to form and engage statewide Rx prevention collaboratives.
1. Two states, South Carolina and Wisconsin, improved integration of PDMP data into electronic health systems by establishing connections between their PDMPs and various health IT platforms like EMR systems and pharmacy dispensing software.
2. States face challenges with PDMP integration like legal definitions of access, costs of integration projects, and establishing necessary agreements and user authorizations.
3. Florida operates drug surveillance systems through a medical examiners commission and PDMP. Analysis found declines in prescription opioid overdoses after implementation of legislative and regulatory interventions including a PDMP in 2011. However, heroin overdose deaths increased as some shifted to heroin.
Linking and mapping PDMP data can provide several benefits but also faces challenges. Linking PDMP and clinical data allows for evaluating the impact of PDMP interventions on outcomes and prescribing decisions. However, obtaining permissions and data is difficult due to legal and resource barriers. Mapping PDMP data using GIS tools in Washington identified areas for targeting overdose prevention efforts by visualizing patterns in prescribing risks, treatment availability, and overdoses. Stakeholders used these maps to guide education and funding decisions. Sustaining these tools requires ongoing funding and expanding included data sources.
Rx16 federal wed_1230_1_kelly_2bohn-killorinOPUNITE
1) The National HIDTA Program provides assistance to law enforcement agencies in critical drug trafficking regions through 28 regional HIDTA programs. It facilitates cooperation among federal, state, local, and tribal law enforcement.
2) Each HIDTA program has an executive board that identifies threats, develops strategies, and requests funding for initiatives. It brings together over 7,400 federal agents, 15,700 state and local officers, and 500 agencies across the country.
3) In response to the opioid epidemic, HIDTA employs law enforcement targeting of heroin and fentanyl trafficking, public health prevention efforts, and training on investigating heroin organizations. It has committed additional funds to enhance intelligence sharing and public health partnerships.
This document summarizes a presentation on engaging physicians in prevention efforts to address the opioid epidemic. It was presented by Yngvild Olsen and included the following key points:
1. Multiple policies like PDMPs, medication-assisted treatment, and naloxone access need to work together to reduce opioid misuse and overdoses.
2. Programs that educate physicians about prescription drug abuse and its link to heroin, and engage them in prevention, screening, and treatment can help address the epidemic.
3. Expanding access to evidence-based treatment with medications like buprenorphine and naloxone, combined with behavioral therapies, can help manage opioid addiction as a chronic disease
This document discusses recovery ready ecosystems and recovery community organizations. It introduces presenters from Young People in Recovery and Hope House Treatment Track who will discuss interventions, prevention, and recovery programs. Examples of Young People in Recovery chapters, programs, and services are provided, including employment workshops, education workshops, housing workshops, and recovery support services. The document also discusses recovery community organizations and initiatives in Texas and Georgia, such as the Association of Persons Affected by Addiction in Dallas and the Georgia Council on Substance Abuse.
Revised order rx16 pdmp wed_1115_1_eadie_2reilly_3hallvik_4hildebranOPUNITE
This document summarizes a presentation on a study examining how prescriber registration and use of a prescription drug monitoring program (PDMP) in Oregon impacted opioid prescribing patterns and patient outcomes. The study found that statewide opioid prescribing generally decreased over time, but prescribers who registered for the PDMP prescribed more after registering, especially those who used the PDMP most frequently. In contrast, prescribers who did not register prescribed less. Patients whose providers were all registered had lower overdose rates than those with some registered and some non-registered providers. The conclusions were that PDMPs may need refinements like mandatory use to optimize their impact on prescribing and outcomes.
This document summarizes a presentation on youth performance-enhancing drugs and ADHD medication. It discusses trends in misuse of these substances among young people. The presentation is given by representatives from various organizations focused on prevention, health promotion, and substance abuse issues among youth and college students. The presentation covers types of performance-enhancing drugs and their potential side effects. It also discusses trends in attitudes towards these substances and risks of misuse. Strategies are presented for helping adolescents pursue their goals without these drugs. The document concludes by outlining plans for addressing misuse of ADHD medication among college students through education and collaboration between various stakeholder groups.
This document discusses ensuring access to quality substance use disorder (SUD) treatment. It outlines federal laws like the Mental Health Parity and Addiction Equity Act and Affordable Care Act that are intended to improve access to SUD treatment. It also discusses some state parity laws. While progress has been made in expanding coverage for SUD treatment, barriers still exist like limits on services and lack of providers. Enforcement of these laws is needed to fully achieve parity and reduce denials of medically necessary care.
This document summarizes a presentation on technologies to reduce prescription drug diversion, fraud, and abuse through electronic prescribing and drug deactivation systems. It discusses Delaware's pilot program with an at-home drug deactivation system. The presentation describes how electronic prescribing of controlled substances can reduce diversion and fraud while improving patient satisfaction. It also outlines DEA requirements for electronic prescribing and discusses Cambridge Health Alliance's experience implementing electronic prescribing of controlled substances with Epic and Imprivata. Finally, it summarizes the results of Delaware's pilot program, which provided at-home drug deactivation systems to specific pharmacies to promote safe disposal of unused prescription drugs.
Rx16 prev wed_330_workplace issues and strategiesOPUNITE
This document discusses workplace issues related to prescription drug abuse and strategies for prevention. It begins with introductions of the presenters and moderators. The learning objectives are then outlined as understanding challenges of prescription drug abuse in the workplace, identifying prevention strategies, and describing programs available through SAMHSA. The document then covers topics such as the scope of prescription drug misuse among workers, risks to the workplace, prevention strategies employers can consider, and available resources from SAMHSA.
The panel discussed two youth prevention programs - the Give Me a Reason voluntary drug testing program for parents and the This Is (Not) about Drugs prevention program implemented in schools. The Give Me a Reason program provides free at-home drug testing kits for parents to help prevent drug use among youth. The This Is (Not) about Drugs program uses a film and lesson plan to educate students about the risks of prescription opioid and heroin use with the goal of preventing first-time drug use.
This document summarizes the opioid crisis in the United States from 2000 to 2014. It shows that the number of opioid-related overdose deaths more than tripled during this period, increasing from about 8,000 to over 28,000. Additionally, 7.9 million Americans aged 12 or older met the criteria for an illicit drug use disorder in 2013-2014 but only 20% received treatment. The document outlines actions by the Obama administration to address the crisis and increase funding for treatment. It emphasizes that stories can help reduce stigma and that recovery is possible through working together.
This document provides information about an advocacy track presentation on advocating for change related to addiction issues. The presentation features Gary Mendell, founder and CEO of Shatterproof, and Kim Manlove from the Indiana Addictions Issues Coalition. They will discuss strategies for influencing legislation and how people in recovery can become advocates. The learning objectives focus on advocating for state laws on PDMP usage, explaining strategies to influence legislation, describing how people in recovery can advocate, and providing counsel as part of a treatment team. The presentation then provides details on Shatterproof's story, the overdose epidemic, solutions for different populations, and legislative accomplishments in various states related to expanding access to naloxone and mandating PDMP usage.
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.
Web only rx16 pharma-wed_330_1_shelley_2atwood-harlessOPUNITE
This document discusses a presentation on pharmacy burglary, robbery, and diversion of prescription drugs. The presentation covers trends in prescription drug diversion, particularly those involving robbery and burglary of pharmacies. It identifies preventative measures to enhance pharmacy security and safety. Strategies to reduce pharmacy crimes are outlined. The offender perspective is examined based on interviews with convicted offenders. Routine activities theory is discussed as relating to suitable targets, capable guardians, and motivated offenders. Partnerships between regulatory agencies and law enforcement are emphasized as key to prevention efforts.
Web rx16 prev_tues_200_1_bretthaude-mueller_2scott_3debenedittis_4cairnes copyOPUNITE
This presentation covered multi-media prevention strategies for issues like prescription drug overdoses. It discussed the CDC's digital Rx drug prevention campaign, best practices for digital messaging, and programs using expectancy challenge theory and media literacy education in schools. Presenters included representatives from the CDC, Media Literacy for Prevention, and the Hanley Center Foundation who discussed their work developing and implementing digital communications and single-session prevention programs.
This document summarizes a panel discussion on improving utilization of prescription drug monitoring programs (PDMPs). The panel will discuss current practices for interstate sharing of PDMP data, strategies for integrating PDMP data into healthcare records, and lessons from Washington state's program providing organizations access to PDMP data. The goal is to identify best practices that can be implemented in other states to increase interoperability and utilization of PDMP data.
The document outlines state responses to prescription drug and heroin abuse presented at an advocacy track session. It includes presentations from officials in Arizona, Virginia, and New Mexico on their state's strategies. Arizona's presentation focuses on the state's prescriber report cards. Virginia's presentation discusses the governor's task force recommendations and a new health and criminal justice data committee. New Mexico's presentation describes the state's high overdose rates and model of stakeholder collaboration to reduce overdose deaths.
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 presentations from public health officials in North Carolina and Northern Kentucky on community responses to the heroin epidemic. Key points include:
- Officials from North Carolina and Northern Kentucky outlined programs and partnerships implemented in their regions to address rising rates of opioid and heroin abuse, including treatment programs, harm reduction strategies, legislation, and education initiatives.
- Data presented showed increasing rates of overdose deaths, neonatal abstinence syndrome, and infectious diseases associated with intravenous drug use such as hepatitis C in Northern Kentucky.
- Community leaders and advocates in Northern Kentucky have worked to raise awareness, pass legislation to expand access to treatment, and establish prevention and support networks to address the heroin epidemic impacting the region.
This document summarizes a presentation given by Demetra Ashley of the DEA about regulations and efforts to address the prescription drug abuse epidemic. It discusses how most prescription drug abuse involves obtaining medications from friends and family, not through criminal means. The DEA works with various groups to educate on responsible prescribing and dispensing through initiatives like take-back events and conferences. The goal is to curb abuse while ensuring access to needed medications through enforcement as well as prevention and treatment efforts.
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 Health Home project is evaluating a new program that is part of healthcare reform in New York State. The program identifies individuals with substance use disorders who have other medical and psychiatric problems and offers them a new form of integrated care. The evaluation will study whether this program results in better quality of care and a reduction in health care costs for this vulnerable and chronically ill population.
Office-Based Opioid Treatment: What You Need to Know: Trends in Behavioral He...Epstein Becker Green
Presented by David Shillcutt (Associate, Epstein Becker Green) and Kristina Sherry (Attorney, Nelson Hardiman) on April 4, 2019.
Office-based opioid treatment providers are on the front lines of the response to the opioid epidemic, but recent developments in federal and state legislation have significant implications for provider business models and service delivery strategies.
This webinar will examine provider capacity issues for medication assisted treatment, the opportunities and challenges of telemedicine for addiction services, and the expansion of innovative service delivery networks including the “Hub and Spoke” system and related models.
Part of a "first Thursdays" webinar series hosted by Behavioral Health Association of Providers, Epstein Becker & Green, P.C., and Nelson Hardiman, LLP.
More info: https://www.ebglaw.com/events/office-based-opioid-treatment-what-you-need-to-know-trends-in-behavioral-health-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
This document provides a summary of a presentation on the risks of medical marijuana and marijuana legalization. It begins with disclosures from the presenters and outlines six learning objectives. It then discusses concerns that marijuana is addictive, especially for those who start using it early, and impacts adolescent brain development. The document notes the lack of evidence that marijuana is effective for the conditions it is claimed to treat. It also discusses the risks of increased diversion of marijuana to youth and greater social acceptance of marijuana use negatively impacting public health. The document concludes with messages on how to discuss these issues with the public.
The document summarizes a vision session on prescription opioid overdose that included presentations from the Oklahoma Commissioner of Health and the president of ASTHO. Key points discussed include:
- The growing epidemic of prescription opioid overdose deaths and costs to the healthcare system.
- ASTHO's Prescription Drug Overdose Prevention Challenge which aims to reduce overdose rates and engages state health officials and partners across sectors.
- Strategies discussed to address the epidemic through prevention, monitoring, enforcement, treatment and recovery efforts.
8 pharmacy track pharmacists working with local coalitions and pdm psOPUNITE
This document summarizes a presentation on pharmacists working with local coalitions and prescription drug monitoring programs (PDMPs). It discusses Nicole O'Kane presenting on how pharmacists can utilize PDMPs to screen for safety concerns and optimize patient care. It also discusses Kristina Clark and Christina Merino presenting on how a local coalition in Coffee County, TN engaged pharmacists and other stakeholders to reduce prescription drug abuse through education, monitoring, and evaluation.
This document discusses ensuring access to quality substance use disorder (SUD) treatment. It outlines federal laws like the Mental Health Parity and Addiction Equity Act and Affordable Care Act that are intended to improve access to SUD treatment. It also discusses some state parity laws. While progress has been made in expanding coverage for SUD treatment, barriers still exist like limits on services and lack of providers. Enforcement of these laws is needed to fully achieve parity and reduce denials of medically necessary care.
This document summarizes a presentation on technologies to reduce prescription drug diversion, fraud, and abuse through electronic prescribing and drug deactivation systems. It discusses Delaware's pilot program with an at-home drug deactivation system. The presentation describes how electronic prescribing of controlled substances can reduce diversion and fraud while improving patient satisfaction. It also outlines DEA requirements for electronic prescribing and discusses Cambridge Health Alliance's experience implementing electronic prescribing of controlled substances with Epic and Imprivata. Finally, it summarizes the results of Delaware's pilot program, which provided at-home drug deactivation systems to specific pharmacies to promote safe disposal of unused prescription drugs.
Rx16 prev wed_330_workplace issues and strategiesOPUNITE
This document discusses workplace issues related to prescription drug abuse and strategies for prevention. It begins with introductions of the presenters and moderators. The learning objectives are then outlined as understanding challenges of prescription drug abuse in the workplace, identifying prevention strategies, and describing programs available through SAMHSA. The document then covers topics such as the scope of prescription drug misuse among workers, risks to the workplace, prevention strategies employers can consider, and available resources from SAMHSA.
The panel discussed two youth prevention programs - the Give Me a Reason voluntary drug testing program for parents and the This Is (Not) about Drugs prevention program implemented in schools. The Give Me a Reason program provides free at-home drug testing kits for parents to help prevent drug use among youth. The This Is (Not) about Drugs program uses a film and lesson plan to educate students about the risks of prescription opioid and heroin use with the goal of preventing first-time drug use.
This document summarizes the opioid crisis in the United States from 2000 to 2014. It shows that the number of opioid-related overdose deaths more than tripled during this period, increasing from about 8,000 to over 28,000. Additionally, 7.9 million Americans aged 12 or older met the criteria for an illicit drug use disorder in 2013-2014 but only 20% received treatment. The document outlines actions by the Obama administration to address the crisis and increase funding for treatment. It emphasizes that stories can help reduce stigma and that recovery is possible through working together.
This document provides information about an advocacy track presentation on advocating for change related to addiction issues. The presentation features Gary Mendell, founder and CEO of Shatterproof, and Kim Manlove from the Indiana Addictions Issues Coalition. They will discuss strategies for influencing legislation and how people in recovery can become advocates. The learning objectives focus on advocating for state laws on PDMP usage, explaining strategies to influence legislation, describing how people in recovery can advocate, and providing counsel as part of a treatment team. The presentation then provides details on Shatterproof's story, the overdose epidemic, solutions for different populations, and legislative accomplishments in various states related to expanding access to naloxone and mandating PDMP usage.
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.
Web only rx16 pharma-wed_330_1_shelley_2atwood-harlessOPUNITE
This document discusses a presentation on pharmacy burglary, robbery, and diversion of prescription drugs. The presentation covers trends in prescription drug diversion, particularly those involving robbery and burglary of pharmacies. It identifies preventative measures to enhance pharmacy security and safety. Strategies to reduce pharmacy crimes are outlined. The offender perspective is examined based on interviews with convicted offenders. Routine activities theory is discussed as relating to suitable targets, capable guardians, and motivated offenders. Partnerships between regulatory agencies and law enforcement are emphasized as key to prevention efforts.
Web rx16 prev_tues_200_1_bretthaude-mueller_2scott_3debenedittis_4cairnes copyOPUNITE
This presentation covered multi-media prevention strategies for issues like prescription drug overdoses. It discussed the CDC's digital Rx drug prevention campaign, best practices for digital messaging, and programs using expectancy challenge theory and media literacy education in schools. Presenters included representatives from the CDC, Media Literacy for Prevention, and the Hanley Center Foundation who discussed their work developing and implementing digital communications and single-session prevention programs.
This document summarizes a panel discussion on improving utilization of prescription drug monitoring programs (PDMPs). The panel will discuss current practices for interstate sharing of PDMP data, strategies for integrating PDMP data into healthcare records, and lessons from Washington state's program providing organizations access to PDMP data. The goal is to identify best practices that can be implemented in other states to increase interoperability and utilization of PDMP data.
The document outlines state responses to prescription drug and heroin abuse presented at an advocacy track session. It includes presentations from officials in Arizona, Virginia, and New Mexico on their state's strategies. Arizona's presentation focuses on the state's prescriber report cards. Virginia's presentation discusses the governor's task force recommendations and a new health and criminal justice data committee. New Mexico's presentation describes the state's high overdose rates and model of stakeholder collaboration to reduce overdose deaths.
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 presentations from public health officials in North Carolina and Northern Kentucky on community responses to the heroin epidemic. Key points include:
- Officials from North Carolina and Northern Kentucky outlined programs and partnerships implemented in their regions to address rising rates of opioid and heroin abuse, including treatment programs, harm reduction strategies, legislation, and education initiatives.
- Data presented showed increasing rates of overdose deaths, neonatal abstinence syndrome, and infectious diseases associated with intravenous drug use such as hepatitis C in Northern Kentucky.
- Community leaders and advocates in Northern Kentucky have worked to raise awareness, pass legislation to expand access to treatment, and establish prevention and support networks to address the heroin epidemic impacting the region.
This document summarizes a presentation given by Demetra Ashley of the DEA about regulations and efforts to address the prescription drug abuse epidemic. It discusses how most prescription drug abuse involves obtaining medications from friends and family, not through criminal means. The DEA works with various groups to educate on responsible prescribing and dispensing through initiatives like take-back events and conferences. The goal is to curb abuse while ensuring access to needed medications through enforcement as well as prevention and treatment efforts.
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 Health Home project is evaluating a new program that is part of healthcare reform in New York State. The program identifies individuals with substance use disorders who have other medical and psychiatric problems and offers them a new form of integrated care. The evaluation will study whether this program results in better quality of care and a reduction in health care costs for this vulnerable and chronically ill population.
Office-Based Opioid Treatment: What You Need to Know: Trends in Behavioral He...Epstein Becker Green
Presented by David Shillcutt (Associate, Epstein Becker Green) and Kristina Sherry (Attorney, Nelson Hardiman) on April 4, 2019.
Office-based opioid treatment providers are on the front lines of the response to the opioid epidemic, but recent developments in federal and state legislation have significant implications for provider business models and service delivery strategies.
This webinar will examine provider capacity issues for medication assisted treatment, the opportunities and challenges of telemedicine for addiction services, and the expansion of innovative service delivery networks including the “Hub and Spoke” system and related models.
Part of a "first Thursdays" webinar series hosted by Behavioral Health Association of Providers, Epstein Becker & Green, P.C., and Nelson Hardiman, LLP.
More info: https://www.ebglaw.com/events/office-based-opioid-treatment-what-you-need-to-know-trends-in-behavioral-health-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
This document provides a summary of a presentation on the risks of medical marijuana and marijuana legalization. It begins with disclosures from the presenters and outlines six learning objectives. It then discusses concerns that marijuana is addictive, especially for those who start using it early, and impacts adolescent brain development. The document notes the lack of evidence that marijuana is effective for the conditions it is claimed to treat. It also discusses the risks of increased diversion of marijuana to youth and greater social acceptance of marijuana use negatively impacting public health. The document concludes with messages on how to discuss these issues with the public.
The document summarizes a vision session on prescription opioid overdose that included presentations from the Oklahoma Commissioner of Health and the president of ASTHO. Key points discussed include:
- The growing epidemic of prescription opioid overdose deaths and costs to the healthcare system.
- ASTHO's Prescription Drug Overdose Prevention Challenge which aims to reduce overdose rates and engages state health officials and partners across sectors.
- Strategies discussed to address the epidemic through prevention, monitoring, enforcement, treatment and recovery efforts.
8 pharmacy track pharmacists working with local coalitions and pdm psOPUNITE
This document summarizes a presentation on pharmacists working with local coalitions and prescription drug monitoring programs (PDMPs). It discusses Nicole O'Kane presenting on how pharmacists can utilize PDMPs to screen for safety concerns and optimize patient care. It also discusses Kristina Clark and Christina Merino presenting on how a local coalition in Coffee County, TN engaged pharmacists and other stakeholders to reduce prescription drug abuse through education, monitoring, and evaluation.
E-Prescribing Controlled Substances: Opportunities and Experiences - May 2014...Forward360 LLC
Electronic prescribing of controlled substances (EPCS) provides opportunities to improve safety and reduce fraud compared to paper prescriptions. EPCS is now legal in all but two states, though adoption has been limited due to lack of awareness, competing IT priorities, and geographic disparities between enabled pharmacies and providers. Experiences from providers and pharmacies already using EPCS show benefits like increased accountability, accuracy, and reduced costs. Widespread adoption could save up to $700 million annually through improved medication management.
This document summarizes a presentation on prescriber attitudes and education regarding prescription drug misuse. The presentation features speakers from the Substance Abuse and Mental Health Services Administration, Centers for Disease Control and Prevention, and Canadian Centre on Substance Abuse. It discusses perceptions of prescription drug misuse among healthcare professionals in Canada, including challenges in identifying misuse, inadequate training and resources to address the problem, and questionable prescribing practices encountered by pharmacists. The goal is to inform physicians and providers of education tools being developed by CDC/SAMHSA to help them play a critical role in responding to prescription drug abuse.
This document summarizes presentations from two communities - Huntington, WV and Camden County, NJ - on their responses to heroin crises. It outlines programs implemented in Huntington, including a harm reduction program, centralized information system, and drug court expansion. It also discusses the region's history with prescription drug abuse and rise in heroin and associated issues like hepatitis and neonatal abstinence syndrome. Long-term strategies proposed include expanding treatment services, promoting career opportunities for those in recovery, and preventing relapse through environmental design changes.
This document summarizes a presentation on health plan involvement in safe prescribing. It includes:
1) Presentations from medical experts on prescription drug abuse trends from medical examiner data and a tribal health system's safe prescribing program.
2) A discussion of health plan policies to reduce "red flag" medication combinations like opioids plus benzodiazepines through prior authorization, formulary changes, and provider restrictions.
3) Examples of one health plan's implementation of policies like restricting methadone prescriptions to pain specialists and removing carisoprodol from its formulary.
Intro to Prevention: Psychopharmacology Guest LectureJulie Hynes
Current A&D Conditions in lane County: And why we need prevention. Guest lecturer: Julie Hynes, MA, RD, CPS - PreventionLane at Lane County Public Health
This resume is for Dr. Joan Sullivan, who has over 25 years of leadership experience in non-profit organizations and healthcare. She is currently the Foundress and Chief Director of Pharmacy Services at Mission of Mercy, Inc., a non-profit that provides free healthcare to those in need. Prior to this role, she held several director and VP roles at hospitals and healthcare companies. She demonstrates strong leadership, strategic planning, and program development skills. Her experience includes launching new programs, managing pharmacy operations, and developing clinical services.
This document provides an overview of a presentation on preventing opioid overdose deaths. The presentation features four speakers and focuses on explaining the opioid overdose crisis epidemiology, describing treatment options to reduce overdose deaths, and advocating for advancing research and clinical practice. The learning objectives are listed as explaining the overdose epidemic, describing treatment options for clinicians, and advocating for research and practice directions. Brief biographies and disclosures are provided for each speaker.
Web only rx16-adv_tues_330_1_elliott_2brunson_3willis_4deanOPUNITE
This document outlines an advocacy track presentation on activating communities to address prescription drug abuse. It provides biographies of the presenters and moderators and discloses any conflicts of interest. The learning objectives are to identify best practices for implementing CADCA's seven strategies for community change to impact prescription drug issues. It then provides examples of how various coalitions across the country are utilizing each of the seven strategies, such as providing education, enhancing skills, supporting communities, and changing policies.
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.
WHAT is the Ottawa County Community Health Improvement Plan?
A plan that focuses on the greatest health needs in Ottawa County. Community members, including people from health care and human service agencies, identified three priority health areas based on data from the Community Health Needs Assessment (CHNA).
WHY a CHIP?
Public health challenges are too great for a single person, organization or sector to solve alone. The CHIP is a guide for the community to work together and meet its health needs.
The document discusses new developments in prescription drug monitoring programs (PDMPs) in California, Colorado, and Minnesota. It provides an overview of presentations given on upgrades to the PDMP systems in each state. Key points include: Colorado's PDMP has enhanced data reporting requirements and streamlined data retrieval; Minnesota's PDMP has focused on improving data quality and compliance; and California's upgraded PDMP (CURES 2.0) features automated registration, delegation of authority, patient flagging, peer-to-peer communication on patient safety, and de-identified data sets.
This document summarizes a presentation on closing treatment gaps in the health care and criminal justice systems for opioid use disorders. It introduces the presenters and moderator and provides learning objectives focused on improving identification and treatment of opioid use disorders in health care settings and strategies for improving outcomes for frequently incarcerated individuals. Disclosures are provided for the presenters stating that they have no relevant financial relationships.
This document discusses prescriber viewpoints on how mandating prescription drug monitoring program (PDMP) compliance is working. It provides an overview of presentations from three physicians on their experiences with PDMP mandates in Kentucky, West Virginia, and New York. The physicians evaluate the impact of mandates requiring prescribers to check the PDMP before prescribing opioids. They describe changes in prescribing patterns, attitudes towards the mandates, and recommendations for other states.
Similar to Rx15 ea tues_330_1_lovedale_2holton_3varney-edwards (20)
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.
Kana Enomoto, Acting Administrator, Substance Abuse and Mental Health Services Administration, keynote presentation at the National Rx Drug Abuse & Heroin Summit March 29, 2016
This document summarizes a presentation on managing morphine equivalent dose (MED) and identifying high-risk opioid use through "red flagging." It discusses how calculating MED at the point of sale can help identify unsafe dosages and decrease opioid prescriptions. It also evaluates different methods to screen for overdose risk, finding that simple opioid use thresholds to flag patients may not accurately target those most likely to experience preventable overdoses. The presentation aims to explain MED management, describe payer solutions that reduced opioid use, and identify more precise ways to intervene with highest-risk patients.
The document discusses the opioid crisis in the United States, including rising rates of prescription opioid misuse and abuse, as well as heroin use and overdose deaths. It outlines how research can help address this crisis through developing less abusable analgesics, expanding access to treatment medications like naloxone and buprenorphine, and exploring new treatment approaches such as immunotherapies and precision medicine targeting genetic factors. The National Institute on Drug Abuse is supporting these research efforts and working to disseminate findings to improve prevention and intervention programs.
This document discusses strategies for reducing buprenorphine diversion and pill mills while improving access to treatment. It notes that limiting access to buprenorphine treatment is associated with increased diversion, while expanded access to quality treatment decreases diversion and overdose deaths. The document recommends educating prescribers, using medically-derived prescribing standards, ensuring adequate insurance coverage of safe prescribing practices, and addressing diversion risks for other controlled medications. It argues against onerous new regulations that could limit treatment access. The goal is to identify and support high-quality treatment while prosecuting criminal operations.
This document summarizes a presentation on linking and mapping prescription drug monitoring program (PDMP) data. It discusses the benefits of linking PDMP data to clinical data, including improving patient safety, evaluating prescribing decisions, and assessing the impact of PDMP interventions. It describes challenges with linking data, such as obtaining consent and negotiating data use agreements. It also discusses Washington State's MAPPING OPIOID AND OTHER DRUG ISSUES (MOODI) tool, which integrates PDMP data with other databases to map and target treatment and overdose prevention efforts at the community level.
This document discusses drug court models and the role of law enforcement in drug courts. It begins with introductions from presenters and outlines learning objectives about explaining drug court operations and benefits, how law enforcement can utilize drug courts, and identifying best practices. The following sections provide details on drug court models, including how they integrate treatment into the justice system using a non-adversarial approach. Key components of drug courts are outlined, and presenters discuss issues like prescription drug and heroin abuse as well as outcomes from drug courts in reducing recidivism and saving money. Law enforcement can play roles in prevention, addressing domestic violence, and targeting the right populations for drug court involvement through assessment.
This document discusses neonatal abstinence syndrome (NAS) and universal maternal drug testing. It provides background information on NAS including trends showing large increases in incidence and costs associated with NAS. It outlines objectives related to describing NAS trends, identifying legislative activities impacting NAS, describing family planning for women in substance abuse treatment, and explaining a hospital program using universal drug testing. The document then covers topics including NAS symptoms, incidence and geographic trends, costs of NAS, opioid use in women of childbearing age, unintended pregnancy rates, contraceptive use among opioid users, and maternal drug exposure sources.
Web only rx16 pharma wed_200_1_hagemeier_2fleming_3vernachioOPUNITE
Community pharmacists are well positioned to help address the growing problem of opioid and benzodiazepine addiction but face challenges. Early identification of at-risk patients, supportive benefit structures, and intervention training could empower pharmacists. While many recognize their responsibility, behavioral engagement in prevention is often lacking due to practice barriers, lack of patient information, and fear of responses. Standardizing communication expectations and screening tools could help pharmacists better fulfill their role on the treatment team.
Web only rx16 len wed_200_1_augustine_2napier_3darr - copyOPUNITE
This document summarizes a presentation about the Handle with Care program, which aims to help children who have been exposed to trauma. The presentation discusses how drug abuse and violence impact children, showing statistics on drug seizures and crimes in certain areas. It then describes the Handle with Care program, where law enforcement notifies schools of children who were exposed to a traumatic event so the school can provide trauma-informed support. School interventions discussed include therapy dogs, academic accommodations, and on-site therapy. The presenters emphasize that Handle with Care aims to help children succeed in school by providing trauma-sensitive support.
The document summarizes a Heroin Response Strategy presented by experts from various High Intensity Drug Trafficking Areas. The strategy involves 3 components: 1) Establishing a regional public health and public safety information sharing network through "Points of Light" teams in each state. 2) Implementing community education and prevention programs. 3) Creating a platform for regional public health and public safety partnerships through annual symposiums. The goal is to reduce drug overdoses through enhanced collaboration between law enforcement and health agencies.
This document summarizes findings from interviews conducted as part of a study evaluating a chronic pain management pilot program for Medicaid patients in Rhode Island. Key findings include:
1) Patients reported that complementary and alternative therapies like acupuncture, massage and chiropractic care helped them better understand the relationship between stress and pain and provided an opportunity to build trusting relationships with providers.
2) Providers noted that the program allowed patients to receive hands-on care and personal connections that they may not receive otherwise due to lack of trust in the medical system and limited therapeutic relationships.
3) The program addressed transportation barriers by having some providers conduct home visits, improving access to care for patients with mobility issues.
4)
Web only rx16 len wed_1230_1_daugherty_2baier-haasOPUNITE
This document summarizes a presentation on investigating and prosecuting drug-related homicides. It discusses signs that can indicate an overdose death, such as the presence of drugs, track marks, and foam coming from the mouth. It emphasizes treating the death scene like a homicide scene by thoroughly photographing and collecting all potential evidence. This includes searching for drug packaging, needles, phones and surveillance footage. The document also outlines interviewing witnesses to build a timeline and identify the victim's source of drugs. It suggests attempting a controlled buy from suspects to obtain contemporaneous drug samples and strengthen cases.
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
Rx15 ea tues_330_1_lovedale_2holton_3varney-edwards
1. Education and Advocacy Track
Collaboration, Coordination & Data:
Three Keys for State Progress
Presenters:
• Laurie Lovedale, MPH, CPS II, Manager, Prescription Drug Abuse
Prevention Program, Peer Assistance Services, Inc.
• Dwight Holton, JD, CEO, Lines for Life
• E. Douglas Varney, Commissioner, Tennessee Department of
Mental Health and Substance Abuse Services
• Karen Edwards, PhD, Research Director, Tennessee Department
of Mental Health and Substance Abuse Services
Moderator: Regina M. LaBelle, JD, Chief of Staff, White House Office
of National Drug Control Policy (ONDCP), and Member, Rx Summit
National Advisory Board
2. Disclosures
• Laurie Lovedale, MPH, CPS II; Dwight Holton, JD; E. Douglas
Varney; Karen Edwards, PhD; and Regina M. LaBelle, JD, have
disclosed no relevant, real or apparent personal or
professional financial relationships with proprietary entities
that produce health care goods and services.
3. Disclosures
• All planners/managers hereby state that they or their
spouse/life partner do not have any financial
relationships or relationships to products or devices
with any commercial interest related to the content of
this activity of any amount during the past 12 months.
• The following planners/managers have the following to
disclose:
– Kelly Clark – Employment: Publicis Touchpoint Solutions;
Consultant: Grunenthal US
– Robert DuPont – Employment: Bensinger, DuPont &
Associates-Prescription Drug Research Center
– Carla Saunders – Speaker’s bureau: Abbott Nutrition
4. Learning Objectives
1. Specify benefits of collaboration and
coordination among entities engaged in Rx
drug abuse.
2. Describe a method for empowering
communities to tailor an effective local
response to Rx drug abuse.
3. Explain how data can be used to mobilize the
resources needed to combat Rx drug abuse.
5. Collaboration, Coordination and
Data: Three Keys for State Progress
Laurie Lovedale, MPH, CPS II
Manager, Prescription Drug Abuse
Prevention Program
Peer Assistance Services
6. Disclosure Statement
• Laurie Lovedale, MPH, CPS II has disclosed no
relevant, real or apparent personal or
professional financial relationships with
proprietary entities that produce health care
goods and services
7. Session Objectives
• Specify benefits of collaboration and
coordination among entities engaged in Rx
drug abuse.
• Describe a method for empowering
communities to tailor an effective local
response to Rx drug abuse.
• Explain how data can be used to mobilize the
resources needed to combat Rx drug abuse.
8.
9.
10. Strategic Planning Process in Colorado
1st NGA Policy Academy
CO Team includes representation
from CDHS, CDPHE, DPS, DORA, HCPF,
AG’s Office and Governor’s Office
CO Team identifies focus areas
for state strategic plan
CO Roundtables
185 experts and stakeholders
convene including state health
officials, health professionals,
academics, professional membership
organizations, law enforcement
representatives and policymakers
Draft of initial recommendations,
expanding on major focus areas
CO In-State Policy Academy
40 decision-makers and
stakeholders reconvene
Initial recommendations finalized
and timeline established
through May 2014
2nd NGA Policy Academy
CO Team shares action plan and
lessons learned with the six other
states participating in the
NGA Policy Academy
CU School of Pharmacy
recommendation to coordinate
consortium, house strategic plan,
make and track progress
13. Prescriber
and Provider
Education
Workgroup
Agency Co-Chair:
Cathy Traugott, HCPF
Univ Co-Chair:
Lee Newman, MD
PDMP
Workgroup
Agency Co-Chair:
Chris Gassen, DORA
Univ Co-Chair:
Jason Hoppe, DO
Safe Disposal
Workgroup
Agency Co-Chair:
Shannon Breitzman,
CDPHE
Univ Co-Chair:
Sunny Linnebur,
PharmD
Public
Awareness
Workgroup
Agency Co-Chair:
Stan Paprocki, OBH
Univ Co-Chair:
Carol Runyan, PhD
Treatment
Workgroup
Agency Co-Chair:
Denise Vincioni, OBH
Univ Co-Chair:
Paula Riggs, MD
Data/Analysis
Workgroup
Agency Co-Chair:
Barbara Gabella,
CDPHE
Univ Co-Chair:
Ingrid Binswanger, MD
Coordinating Center
CU School of Pharmacy
+Coordinating Committee
Governor
Policy
Lead
CO Attorney
General
Substance Abuse
Trend & Response
Task Force
CO
Legislature
Colorado Consortium for Prescription Drug Abuse Prevention
A coordinated, statewide, interuniversity/interagency network
LEGEND
= New
= Existing
Subcommittee
14. Prescription Drug Abuse Prevention
Program
• A State Priority Initiative funded by the
Colorado Office of Behavioral Health
• 5-year funding cycle
• Funded for over 20 years
15. 2010-2015 Program Objectives
• Increase awareness of the problem
• Increase availability of medication disposal
programs statewide
• Encourage responsible prescribing practices
• Encourage patient responsibility
• Track data and trends
16.
17.
18.
19.
20. Accomplishments of the Colorado
Consortium for Prescription Drug
Abuse Prevention
1st Year
21. PDMP Work Group
• HB14‐1283: PDMP Enhancement Bill
• Mandatory PDMP registration for all CO DEA registered
prescribing practitioners & all CO licensed pharmacists
• Allows PDMP‐registered prescribing practitioners &
pharmacists to delegate access
• Allows the PDMP to send Unsolicited Reports (“Push
Notices”) to affected prescribing practitioners and
pharmacies
• As with out‐of‐state prescribing practitioners in the
past, it now allows out‐of‐state pharmacists to obtain
patient information from the PDMP;
22. • Provides Colorado Department of Public
Health and Environment access to the PDMP
for public health purposes
• Creates of a PDMP Taskforce – to further study
the effectiveness of the PDMP.
23. Public Awareness Work Group
• Statewide social
marketing campaign
• All adult Coloradoans
18+
• Pre/post survey
– Safe Use
– Safe Storage
– Safe Disposal
– Advocacy
24.
25. Safe Disposal Work Group
• Developed guidelines for safe disposal in
Colorado
• Developed brochure to convey guidelines to
public
• Distributed brochure to major pharmacy chains in
Colorado and at multiple community events
• CDPHE expanded number of safe disposal sites
through grant‐funded provision of lock boxes to
law enforcement agencies
• Created map of disposal sites
26.
27.
28.
29. Providers Education Work Group
Online Training & Education
for Providers
• Developed at the Colorado School
of Public Health in the Center for
Worker Health & Environment
• Launched in Fall 2012
• Supported by an unrestricted
educational grant from Pinnacol
Assurance
WWW.PAINMANAGEMENTCME.ORG
30. Providers Education Work Group
New Prescriber
Education
• Dentists
• Veterinarians
• Physicians
Dr. Brett Kessler, President, Colorado Dental
Association
31. DORA Boards
• Nursing
• Medical
• Pharmacy
• Dental
• Nurse Physician
Advisory Taskforce
(NPATCH)
32. Data Analysis Work Group
• Created a data inventory
• Prioritized five indicators from the inventory
– to track over time
• Specified a data dashboard
33.
34.
35. • Naloxone Work Group – Standing Orders Bill
• Explore integrating EHR with PDMP
• Expanding public awareness campaign to
target certain populations
36. National Rx Drug Abuse Summit:
Oregon’s Regional Summit Agenda to
Reduce Abuse, Misuse and Overdose
Dwight Holton Chief Executive Officer Lines for Life
37. • Dwight Holton has disclosed no relevant, real
or apparent personal or professional financial
relationships with proprietary entities that
produce health care goods and services
38. Lines for Life Team
• 14 Masters Level Counselors
• 120 Highly Trained Volunteers
• 20 Teens on YouthLine
• Nationally Accredited Suicide Line
• De-Escalate 98% of calls on LifeLine
• Trainers of Trainers
40. The Oregon Epidemic
• Oregon ranks #1 In Non-Medical Use of
Opioids (2010-2011, SAMSHA NSDUH)
• Over 3 million opioid prescriptions in 2013
(54% of all Rx) (OHA Injury and Violence Prevention Fact Sheet)
– 1.88 M hydrocodone
– 1.15 M oxycodone
• Over 100 million opioid pills every year
– Population: 3.9 million
– 25 pills for every man, woman and child
41. Opioid Deaths
• 46 people die every day (Centers for Disease Control)
• ~110 Oregonians in 2014
– 150 Oregonians in 2013
– 193 in 2011
– 170 in 2012
42.
43. Source: SAMHSA Treatment Episode Data Set
(TEDS), 2000-2010
28,326
37,649
45,882
52,664
60,824
71,048
82,359
98,386
122,185
142,124
157,171
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
20002001200220032004200520062007200820092010
More Than 5-Fold Increase
In Treatment Admissions For
Prescription Painkillers
In the Past Decade
12
10
8
6
4
2
0 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008
*Deaths are those for which poisoning by drugs (illicit, prescription, and
over-the-counter) was the underlying cause.
Drug OD in the US Have More
Than Tripled since 1990 and INCREASES Greater for
Women (Five-FOLD)
National Vital Statistics System. Drug Overdose Death Rates by State 2008.
100 people die from drug
overdoses every day in the US
CDC Vital Signs, July 2013.
Slide from Presentation of Dr. Nora Volkow, Director, Natl Institute of
Drug Abuse, April 22, 2014 National Rx Summit
44.
45.
46. Regional Summit Objectives
1. Decrease pills in circulation
2. Promote PDMP
3. Patient education
4. Change attitudes & perceptions
5. Reduce the volume of unwanted pills
6. Improve & expand access to
treatment services
47. Core Strategy
• Regional summits to develop regional action plans to
reduce abuse
• Include all relevant stakeholders
• CCO
• Third party payers
• Hospitals/systems
• Treatment providers
• Prescribers
• Prevention
• Public health
• Law enforcement
49. Regional Summit Agenda
• State of the state
• State of the region
• PDMP data and survey data
• Highlight Key Initiatives in Oregon
• Identify barriers to reducing abuse:
• Better Prescribing
• Reducing Volume of Unwanted Pills
• Improving and Expanding Treatment
• Expanded & Better Use of the PDMP
50. Regional Summit Outcomes
• Regional Plans to Reduce Misuse, Abuse
and Overdose
• Policy Recommendations to Governor
and Legislature
• Improved patient, provider and system education
51. Regional Survey Instrument
• Goals
– Identify existing regional strategies that should be supported
– Establish a baseline regarding use of evidenced based practices
and standards to reduce abuse, misuse and overdose
– Identify and understand unique regional opportunities
– Identify and understand unique regional challenges
• Participants
– Systems
– Clinics
– Public Health Officials
– Providers
52. Reducing the Pills in Circulation
for each: Identify Barriers and Solutions
• Prescribing Practices
– Rx Guidelines
• Expanding use of guidelines
• Baseline components of effective guidelines
– Use of the PDMP
• Expanding use
• Standard of Care?
– Other?
• Reimbursement Strategies/Incentives
– Rx bias in reimbursement?
– Reimbursement cap?
– Other?
53. Reducing the Pills in Circulation (2 of 2)
for each: Identify Barriers and Solutions
• Expanding Use of Non-Opioid Therapies
– Non-opioid Therapies (movement, yoga,
acupuncture)
• Primary Care Provider education
– In practice today
– In medical education
• Access/availability of providers
• Reimbursement incentives
– Moving non-opioid therapies above the line
– Addressing any reimbursement bias
– Alternative Pain Clinic Model
54. Improving Treatment and
Access to Treatment
• Improving access to medication assisted therapies
– Suboxone
• Reimbursement strategies
• Improving provider access
– Expanded certification
– Hub model
– Naloxone
• Co-prescription strategies
• Law enforcement / first responder access
• Post Naloxone intervention strategies
56. Collaboration, Coordination and
Data: Three Keys for State Progress
Doug Varney, Commissioner
Karen Edwards, Ph.D., Research Director
Tennessee Department of Mental Health
and Substance Abuse Services
Tennessee Department of Mental Health
and Substance Abuse Services
Varney & Edwards, 2/24/2015
57. Disclosure Statements
• Doug Varney, Commissioner, has disclosed no
relevant, real or apparent personal or professional
financial relationships with proprietary entities that
produce health care goods and services.
• Karen Edwards, Ph.D., has disclosed no relevant, real
or apparent personal or professional financial
relationships with proprietary entities that produce
health care goods or services.
Tennessee Department of Mental Health
and Substance Abuse Services 2
Varney & Edwards, 2/24/2015
58. Learning Objectives
1. Specify benefits of collaboration and coordination
among entities addressing Rx drug abuse.
2. Describe a method for empowering communities to
tailor an effective local response to Rx drug abuse.
3. Explain how data can be used to mobilize the
resources needed to combat Rx drug abuse.
Tennessee Department of Mental Health
and Substance Abuse Services 3
Varney & Edwards, 2/24/2015
59. Gov. Haslam announces Prescription for Success
Varney & Edwards, 2/24/2015
Tennessee Department of Mental Health
and Substance Abuse Services 4
60. Building an initiative:
Prescription for Success
Governor
focus on
collaboration
Public Safety
Subcabinet
Prescription
for Success
Varney & Edwards, 2/24/2015
Tennessee Department of Mental Health
and Substance Abuse Services 5
61. Department of Safety and Homeland Security
Department of Mental Health and Substance Abuse Services
Department of Children’s Services
Tennessee Bureau of Investigation
Department of Correction
Board of Probation and Parole
Military Department
Department of Health
Governor’s Highway Safety Office
(Department of Transportation)
Office of Criminal Justice Programs
(Department of Finance & Administration)
Law Enforcement Training Academy
(Department of Commerce & Insurance)
Additional Staff Support:
Tennessee Criminal Justice Coordinating Council
National Governors Association Center for Best Practices
The Center for Non-Profit Management
PUBLIC SAFETY SUBCABINET WORKING GROUP
Varney & Edwards, 2/24/2015
Tennessee Department of Mental Health
and Substance Abuse Services 6
62. PUBLIC SAFETY ACTION PLAN
Contains Three Key Initiatives/Focus Areas to Curb Crime and
Help Create a Climate for Job Growth in Tennessee
Communities.
Violent Crimes Repeat Offenders
An Atmosphere that
Encourages
Investment
And Job Growth
Tennessee Department of Mental Health
and Substance Abuse Services 7
Varney & Edwards, 2/24/2015
63. o All prescribers must access the controlled substance
database prior to prescribing an opioid or benzodiazepine
o Dispensers must check the database if a person tries to
obtain a prescription for a controlled substance for
fraudulent, illegal, or medically inappropriate purposes
o Increases penalties for doctor shopping from a Class A
misdemeanor to a Class E felony
o Allows data sharing from the prescription monitoring
database
Prescription Drug Safety Act of 2012
Tennessee Department of Mental Health
and Substance Abuse Services 8
Varney & Edwards, 2/24/2015
64. o Neonatal Abstinence Syndrome Working Group
o Substance Abuse Data Task Force
Agreement to share data
Standard definitions
Footnote data source
Review by data “owner” before sharing
Safety Subcabinet Working Groups
Tennessee Department of Mental Health
and Substance Abuse Services 9
Varney & Edwards, 2/24/2015
65. Prescription for Success
Statewide Strategies to Prevent and Treat
the Prescription Drug Abuse Epidemic
in Tennessee
Prescription For Success Partners
• Tennessee Department of Health
• Tennessee Department of Children’s
Services
• Tennessee Department of Correction
• Tennessee Department of Safety &
Homeland Security
• Tennessee Department of Health Care
Finance Administration (TennCare)
• Tennessee Bureau of Investigation
• U.S. Department of Justice Drug
Enforcement Administration
Tennessee Department of Mental Health
and Substance Abuse Services 10
Varney & Edwards, 2/24/2015
66. PRESCRIPTION FOR SUCCESS
Tennessee Department of Mental Health
and Substance Abuse Services 11
7
Goals
1. Decrease the number of
Tennesseans that abuse controlled
substances.
2. Decrease the number of
Tennesseans who overdose on
controlled substances.
3. Decrease the amount of
controlled substances
dispensed in Tennessee.
4. Increase access to drug
disposal outlets in Tennessee.
5. Increase access and quality of
early intervention, treatment
and recovery services.
6. Expand collaborations
and coordination among
state agencies.
7. Expand collaboration
and coordination with
other states.
33 Strategies
Measures of Success
Varney & Edwards, 2/24/2015
67. TELL THE STORY OF PRESCRIPTION
DRUG ABUSE IN TENNESSEE
Using data to:
Varney & Edwards, 2/24/2015
Tennessee Department of Mental Health
and Substance Abuse Services 12
68. Telling the Story of Prescription Drug
Abuse in Tennessee
• Identify the problem
• Answer questions
• Track success
Tennessee Department of Mental Health
and Substance Abuse Services 13
Varney & Edwards, 2/24/2015
69. IDENTIFY THE PROBLEM
Use data to:
Varney & Edwards, 2/24/2015
Tennessee Department of Mental Health
and Substance Abuse Services 14
70. Drug Overdose
342
391
422
484
660
753
868
963 972
924 929
1,059 1,062
1,094
0
200
400
600
800
1,000
1,200
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Drug overdose deaths in Tennessee: 1999-2012
(Source: Office of Policy, Planning and Assessment,
Tennessee Department of Health - Death Certificates)
Tennessee Department of Mental Health
and Substance Abuse Services 15
Varney & Edwards, 2/24/2015
71. Admissions to Publicly Funded Substance Abuse Treatment
TN: Opioids
TN: Alcohol
US: Opioids
Tennessee Department of Mental Health
and Substance Abuse Services 16
Varney & Edwards, 2/24/2015
73. ANSWER QUESTIONS
Use data to:
Varney & Edwards, 2/24/2015
Tennessee Department of Mental Health
and Substance Abuse Services 18
74. How does substance abuse for young adults change over time?
How does Tennessee compare to the United States?
United States Tennessee
*NOTE: Tennessee began disaggregating heroin admissions from prescription opioids in July 2009.
Substance abuse treatment admissions among young adults, ages 18-24,
by primary substance of abuse: Tennessee and the United States from 2002 to 2011
(Data source: TEDS-A)
28.5%
15.3%
16.8%
4.4%
24.7%
25.8%
0.0%
2.3%*
15.5%
41.4%
14.5% 10.9%
0%
25%
50%
75%
100%
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
34.6%
26.0%
7.4%
3.2%
30.3%
29.7%
13.5%
17.6%
2.4%
14.6%
11.9% 8.9%
0%
25%
50%
75%
100%
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Tennessee Department of Mental Health
and Substance Abuse Services 19
Varney & Edwards, 2/24/2015
75. Where in Tennessee is prescription drug abuse a problem?
Percent of TDMHSAS funded treatment admissions by county when prescription opioids are named as a substance of abuse
(Data Source: TDMHSAS, 2011-2014)
Tennessee Department of Mental Health
and Substance Abuse Services 20
Varney & Edwards, 2/24/2015
FY 2011
FY 2014
76. TRACK SUCCESS
Use data to:
Varney & Edwards, 2/24/2015
Tennessee Department of Mental Health
and Substance Abuse Services 21
77. Cumulative number of high utilization patients* by quarter in the
Controlled Substances Monitoring Database (CSMD): CY 2011 to 2014
1,950 2,246
1,785 1,374
2,413 2,218
1,533
1,404
2,515 2,261
1,533
1,278
2,352
1,940
1,335
1,307
0
2,000
4,000
6,000
8,000
10,000
CY2011 CY2012 CY2013 CY2014
CountofHighUtilizationPatients
Q1 Q2 Q3 Q4
*Note: Patients filled prescriptions from 5 or more prescribers at 5 or more
dispensers within 90 days.
Source: Tennessee Department of Health
Decrease Doctor Shopping
Tennessee Department of Mental Health
and Substance Abuse Services 22
Varney & Edwards, 2/24/2015
78. Increase Disposal Boxes
Tennessee Department of Mental Health
and Substance Abuse Services 23
Varney & Edwards, 2/24/2015
Source: Tennessee Department of Mental Health and Substance Abuse Services
January 2012 to December 2014
79. Increase Safe Housing Options for Individuals in Recovery
61
163
0
40
80
120
160
200
Jul-13 Oct-13 Jan-14 Apr-14 Jul-14 Oct-14
Capacity(beds)
Monthly capacity of Oxford Houses in Tennessee:
July 2013 to December 2014
Tennessee Department of Mental Health
and Substance Abuse Services 24
Varney & Edwards, 2/24/2015
Source: Tennessee Department of Mental Health and Substance
Abuse Services
80. Increase Access to Recovery Courts
Varney & Edwards, 2/24/2015
Tennessee Department of Mental Health
and Substance Abuse Services 25
1,284
1,612
2,057
2,267 2,267
2,542 2,542
-
500
1,000
1,500
2,000
2,500
3,000
Q2 Q3 Q4 Q1 Q2 Q3 Q4
CY2013 CY2014
Capacity
Capacity of adult recovery (drug) courts:
Q2 CY 2013 to Q4 CY 2014
Source: Tennessee Department of Mental Health and Substance
Abuse Services
81. Questions?
• Prescription for Success:
http://tn.gov/mental/prescriptionforsuccess/
• For more information contact:
Karen Edwards, Ph.D.
Karen.Edwards@tn.gov
615-532-3648
Varney & Edwards, 2/24/2015
Tennessee Department of Mental Health
and Substance Abuse Services 26
82. Education and Advocacy Track
Collaboration, Coordination & Data:
Three Keys for State Progress
Presenters:
• Laurie Lovedale, MPH, CPS II, Manager, Prescription Drug Abuse
Prevention Program, Peer Assistance Services, Inc.
• Dwight Holton, JD, CEO, Lines for Life
• E. Douglas Varney, Commissioner, Tennessee Department of
Mental Health and Substance Abuse Services
• Karen Edwards, PhD, Research Director, Tennessee Department
of Mental Health and Substance Abuse Services
Moderator: Regina M. LaBelle, JD, Chief of Staff, White House Office
of National Drug Control Policy (ONDCP), and Member, Rx Summit
National Advisory Board
Editor's Notes
36% is 2011 death data from CDPHE
NSDUH data is 2010 - 2011
Governor Hickenlooper co-chaired the NGA Rx Drug Abuse Reduction Policy Academy
7 states – 1year effort
Focus Areas – Provider education, PDMP, Public awareness, safe disposal, data/analysis – Attendees split into focus areas to discuss recommendations
University of Colorado – School of Pharmacy proposed the idea of a Consortium to house the plan. As we know, everyone gets very excited and engaged in the process, but they everyone goes back to their jobs and the momentum gets lost.
Each of the working groups are co-chaired by a designee from a state department (state health dept., OBH, DORA) and a representative from a school at the University of Colorado – Anschutz Medical Campus (School of Public Health, School of Pharmacy). Each co-chair sits on the Coordinating committee along with Dr. Valuck, myself, and a policy lead from the Governor’s Office. Stakeholders that make up the working groups and do the work. Meet once a month. The Consortium is also a sub-committee of the Substance Abuse Trends and Response Task Force which is chaired by the Attorney General.
Healthcare professionals resource cards for patients
Focused on assessment and monitoring of patients with the prescribing of opioids, creation of a treatment plan, how to discontinue opioid treatment if the patient isn’t responding, intervening is misuse or abuse is suspected.
Consortium made the PDMP enhancement recommendations to DORA, worked with DORA to discuss the recommendations with stakeholders so would be less resistance during session, created a panel of witnesses to testify
Active: 18 states currently - Arizona, Arkansas, Connecticut, Delaware, Illinois, Indiana, Idaho, Kansas, Michigan, Minnesota, Nevada, New Mexico, North Dakota, Ohio, South Carolina, South Dakota, Wisconsin, Utah, In Progress: Kentucky, Alabama, Louisiana, Maine, Mississippi, Tennessee (As of Feb. 4, 2015)
Consortium teamed up with DORA and the Board of Pharmacy to discuss enhancements, get a bill written, talk with stakeholders about the enhancements and any concerns they may have. Rounded up people to testify in favor of the bill. Organized a bill signing with the Governor at Children’s Hospital and got the media there.
PDMP video and Hayes Vreeman
Governor kicked off campaign and his office created their own PSA’s and TV spots, in addition to the earned media efforts through Webb Strategic.
Submitted proposals which were included in the Attorney General’s report to the legislature. Requested money to fund statewide disposal.
REMS - Risk Evaluation and Mitigation Strategy - The Extended-Release (ER) and Long-Acting (LA) Opioid Analgesics REMS was designed to ensure that the benefits of ER/LA opioid analgesics outweigh the risks. Manufacturers create education for providers following a blueprint of what needs to be included.
Also working on a curriculum scan in the Schools of Medicine, Dentistry, Nursing and Pharmacy
The Nurse Physician Advisory Taskforce for Colorado Healthcare (NPATCH) is a healthcare policy taskforce. NPATCH improves healthcare in Colorado by facilitating communication between the practices of nursing and medicine, and addressing areas of mutual concern. The taskforce is made up of 12 members, comprised of five physicians, five nurses and two consumer representatives. One physician is a representative from the Colorado Medical Board, and one nurse is a representative from the Board of Nursing.