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Us response thomas_frieden
The document discusses the public health epidemic of prescription opioid abuse in the U.S., noting that over 16,500 deaths annually result from opioid-related overdoses. It emphasizes the rising trend in overdose deaths and suggests a multipronged public health approach involving better monitoring, support for states, improved clinical practices, and laws/regulations to combat the crisis. Successful state-level interventions, such as real-time prescription drug monitoring, are highlighted as effective measures in reducing overdose incidents.
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Us response thomas_frieden
- 1. Stopping the Epidemicof Prescription Opioid Abuse National Prescription Drug Abuse Summit Orlando, FL April 2, 2013 Thomas R. Frieden, MD, MPH Director Centers for Disease Control and Prevention
- 2. Prescription drug abuse isa public health epidemic Every year more than 16,500 people in the US die from prescription opioid-related drug overdose, more than from heroin and cocaine combined
- 3. Drug overdose deathsinvolving opioids are rising rapidly US, 1999-2010 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 NumberofDeaths Opioids Heroin Cocaine Benzodiazepines CDC/NCHS National Vital Statistics System, CDC Wonder. Updated with 2010 mortality.
- 4. Drug overdose nowkills more people than motor vehicle crashes US, 1980-2010 NCHS Data Brief, December, 2011, updated with 2009 and 2010 mortality data. 0 5 10 15 20 25 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 Deathsper100,000population Motor Vehicle Traffic Drug Poisoning (Overdose)
- 5. Opioid overdose deaths,sales, and treatment admissions rise in parallel US, 1999-2010 National Vital Statistics System, DEA’s Automation of Reports and Consolidated Orders System, SAMHSA’s TEDS 0 1 2 3 4 5 6 7 8 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Rate Opioid Sales KG/10,000 Opioid Deaths/100,000 Opioid Treatment Admissions/10,000 Opioid Sales Kg/10,000
- 6. Large burden ofoverdose deaths
- 7. CDC strategic focusareas • Better monitoring to better understand epidemic and what works to stop it • Support States • Improve clinical practice
- 8. Public health approach • Prescription Drug Monitoring Programs (PDMPs) • Patient review & restriction Programs • Laws/regulations/strategies • Insurers & Pharmacy Benefit Managers (PBM) mechanisms • Clinical guidelines • Substance abuse treatment
- 9. Real-time Prescription DrugMonitoring Program reporting, Oklahoma 0 50,000 100,000 150,000 200,000 250,000 300,000 350,000 3Q2010 4Q2010 1Q2011 2Q2011 3Q2011 4Q2011 1Q2012 2Q2012 3Q2012 4Q2012 NumberofPDMPreportsrequested Prescriber Dispenser LE/Regulatory Information provided by Don Vogt, OK PDMP, 2013. 24 hour reporting 5 minute reporting
- 10. As PDMP useincreased in Oklahoma, doctor shopping decreased 564 417 306 0 100 200 300 400 500 600 2010 2011 2012 Numberofdoctorshoppersidentified Information provided by Don Vogt, OK PDMP, 2013.
- 11. After sharp increases,oxycodone- related deaths decreased in Florida 0 200 400 600 800 1000 1200 1400 1600 2007 2008 2009 2010 2011 Numberofdeaths Oxycodone Alprazolam Methadone Hydrocodone Fentanyl Source: Florida Medical Examiners Commission Annual Reports.
- 12. Washington State isreversing the epidemic of Rx opioid overdose 0 2000 4000 6000 8000 10000 12000 14000 16000 18000 0 100 200 300 400 500 600 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 NumberofDeaths NumberofDeaths WA State US Source: CDC/NCHS and Washington State Department of Health, Death Certificates. Note for WA State: * Tramadol only deaths included in 2009, but not in prior years. 300 or more deaths prevented
- 13. Deaths from allopioid types are declining Washington State, 1995-2011 0 50 100 150 200 250 300 350 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 NumberofDeaths Fentanyl Hydrocodone Methadone Oxycodone Source: Washington State Department of Health, Death Certificates
- 14. Both health andlaw enforcement are essential to reverse the epidemic of opiate abuse
- 15. Four components ofthe opioid overdose problem – each needs specific approach
- 16. Centers for DiseaseControl and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Phone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: www.cdc.gov