PRESCRIPTION FOR AN EPIDEMIC

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1 PRESCRIPTION FOR AN EPIDEMIC David J. Hickton United States Attorney Western District of Pennsylvania Magellan Healthcare Conference Camp Hill, Pennsylvania June 9, 2016

2 Opioids Made from opium poppy or artificially produced Used to treat pain in individuals 11 and older Million prescriptions written More dangerous when consumed with alcohol, stimulants or sedatives Rapidly addictive depending on DNA

3 Heroin 4 out of 5 users started by abusing Rx painkillers Use serious and increasing Used by more people/all demographics Available in larger quantities/higher quality Causing increasing number of overdose deaths

4 Statistics 2014 drug overdose deaths: 47, opioid overdose deaths: 28, overdose deaths per day: ,000 OD deaths since 1999 more than World War II, the Korean War & Vietnam War

5 In 1999, there was one drug overdose death every 30 minutes In 2014, there was one drug overdose death every 12 minutes

6 Data from the National Heroin Threat Assessment

7 Data from the National Heroin Threat Assessment

8 Source: National Institutes of Health

9 Source: National Institutes of Health

10 Headlines Show Pennsylvania Hard Hit

11 Allegheny County: April 2014 Problem demanded a comprehensive solution Supply side Increased focus on large-scale drug trafficking organizations Community Impact Prosecutions Demand side Created U.S. Attorney s Working Group on Addiction: Prevention, Intervention, Treatment and Recovery

12 Working Group on Addition: Prevention, Intervention, Treatment and Recovery Co-Chairs Neil A. Capretto, D.O. F.A.S.A.M., Medical Director-Gateway Rehab Michael Flaherty, Ph.D., Clinical Psychologist Participants Citizens, family members of users and individuals in recovery Specialists in Public Health, Law Enforcement, Human Services, Education, Medicine, Pharmacology, Treatment and Recovery

13 Allegheny County: September 2014 Action Plan Recommendation Highlights Increased distribution of naloxone One-stop shop website: Continuing education for prescribers, pharmacists, medical students Passage of statewide Prescription Drug Monitoring Program and Good Samaritan Laws (Now passed and enacted) Overdose prevention and treatment programs for incarcerated individuals Support and promote Take Back initiatives

14 Washington, DC: March 2015 National Heroin Task Force Announced Co-Chairs: U.S. Attorney David J. Hickton, WDPA Mary Lou Leary, Office of National Drug Control Policy Strong PA participation: Donald S. Burke, MD, Dean of the University of Pittsburgh Graduate School of Public Health Gene Vittone, Washington County District Attorney Dr. Melinda Campopiano, Medical Officer, SAMHSA Addiction Specialists Dr. Neil Capretto and Dr. Mike Flaherty

15 Participating Federal Agencies Office of National Drug Control Policy Department of Justice Drug Enforcement Administration Federal Bureau of Investigation United States Attorney s Offices Bureau of Prisons Office of the Deputy Attorney General Organized Crime/Drug Enforcement Task Forces Community Oriented Policing Services Criminal Division Bureau of Justice Assistance Department of Health & Human Services Substance Abuse and Mental Health Services Office of Intergovernmental and External Affairs Centers for Medicare and Medicaid Services Health Resources and Services Administration Indian Health Service Department of Homeland Security Headquarters Immigration and Customs Enforcement Customs and Border Protection Department of Education Department of Veterans Affairs Centers for Disease Control National Institutes of Health National Institute on Drug Abuse Food and Drug Administration Office of Justice Programs Department of Interior

16 Nat l Heroin Task Force Findings Public health and public safety opioid response strategies must be integrated Policies must be grounded in scientific understanding that substance use disorders are a chronic brain disease Visible community-based recovery supports must be available, affordable and accessible

17 Opioid Response Strategy: 2016 Confronting the threat from every direction Fully-functioning Fusion Center Enhanced coordination with 25 County District Attorneys Education for prescribers, pharmacists, med students, first responders and public Prevention aimed at middle school and high school students Increased availability and use of naloxone Additional Take Back programs/drop box locations

18 Opioid Response Progress $1.1 Billion in New Funding in President Obama s Proposed FY2017 Budget $920 Million to allow States to expand access to Medication Assisted Treatment for opioid use disorders $50 Million in National Health Service Corps to expand access to substance use treatment providers (rural focus) $30 Million to evaluate effectiveness of treatment programs using Medication Assisted Treatment

19 Opioid Response Progress $500 Million in Continued Funding to DOJ and HHS in President Obama s Proposed FY2017 Budget Expand State-level prescription drug overdose prevention strategies Increase the availability of Medication Assisted Treatment programs Improve access to the overdose reversal drug naloxone Support targeted enforcement activities

20 Opioid Response Progress Centers for Disease Control releases Rx Painkiller Guidelines March 2016 First national standards Recommends doctors first try ibuprofen and aspirin to treat pain Recommends opioid treatment for 3 to 7 days only Recommends urine testing of patients and prescriber use of PDMPs before prescribing Does not apply to cancer patients, end-of-life treatment or surgery patients

21 Sources National Institutes of Health: National Heroin Threat Assessment: hreat_assessment_summary.pdf Opioid Overdose Reduction Action Plan: National Heroin Task Force Report: publicationsalphabetical-list-h

22 Questions?

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