A Review of the Impacts of Opiate Use in Ontario: Summary Report

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "A Review of the Impacts of Opiate Use in Ontario: Summary Report"

Transcription

1 A Review of the Impacts of Opiate Use in Ontario: Summary Report A Provincial Summary Report of the Impacts of the Discontinuation of Oxycontin in Ontario: January to August 2013 December 2013

2 This report has been prepared by the Public Health Division of the Ministry of Health and Long-Term Care, in collaboration with Public Health Ontario Infectious Diseases Policy and Programs Section Public Health Policy and Programs Branch Public Health Division Ministry of Health and Long-Term Care

3 Table of Contents Executive Summary... 4 Introduction... 5 Methods... 6 Results... 7 Discussion and Limitations Summary References... 14

4 Executive Summary Introduction: The Public Health Policy and Programs Branch, Public Health Division and the Provincial Programs Branch, Negotiations and Accountability Management Division of the Ministry of Health and Long-Term Care (the Ministry) provide funding, policy directions and monitoring for harm reduction programming and services in Ontario. The public health units and their respective harm reduction partners implement and maintain the programs. The Local Health Integrated Networks provide funding to addiction treatment programs including withdrawal management services. In response to the discontinuation of Oxycontin (Oxycontin) in Ontario on February 27, 2012, the Ministry developed a plan to assist clients who use or abuse oxycodone drugs and may be affected by the changes. This plan included the collection, review and analysis of the available information about the impacts on affected populations, clinical outcomes and the health care system. This is the second report produced by the Ministry in collaboration with Public Health Ontario (PHO) and summarizes data from January 1 to August 31, Subsequent reports will be provided quarterly. Methods: Aggregate, non-identifiable data related to opioid use from the following sources were collected and reported to PHO and the Ministry: Ontario s public health unit harm reduction programs; ConnexOntario (provincial hotline for information on drug, gambling and mental health); Drug and Alcohol Treatment Information System (DATIS); Acute Care Enhanced Surveillance (ACES) (Emergency Department visits and hospital admissions); The Opioid Agonist Maintenance Program (OAMP); The Office of the Chief Coroner of Ontario (OCC). Results: Qualitative reports indicate that there are increases in the availability of opiates and that generic Oxycontin is circulating. The number of new admissions to treatment agencies, calls to telephone help lines and individuals registered through the methadone maintenance program have remained consistent. On average, 802 new patients received treatment for addiction through the OAMP each month. Emergency department visits and hospital admissions associated with opiate withdrawal or overdose have been consistent with a slight increase noted beginning in the summer months. Of the drugs resulting in death due to opiate toxicity, oxycodone was the most prevalent. Discussion and limitations: On the basis of this report, there have been no substantial changes in seeking access to health care services as a result of the discontinuation of Oxycontin. Despite no significant changes to population health or health system utilization as a result of the discontinuation of Oxycontin, both qualitative and quantitative data indicate that Oxycontin and generic versions of it are still circulating and are the leading cause of deaths attributed to opiate use. Access to emergency departments, addiction treatment centres, methadone maintenance programs and telephone help lines are all being utilized and will be important indicators to continue monitoring changes of opiate use in Ontario. There are, however, a number of limitations that must be considered when interpreting these results. Available data are limited in terms of geographic representation, and there is an identified need for more information, particularly from First Nations communities. Conclusions: The Ministry, in collaboration with PHO maintains a commitment to monitor the effects of the discontinuation in availability of Oxycontin in Ontario and will use findings from this and future summary reports to strengthen the monitoring and process of opiate use focusing on the negative effects on the population and health care system in Ontario. Future consideration of opiate surveillance and research should also include stratification of data at a local level. This may facilitate the development of more targeted harm reduction policies and public health interventions. The Ministry and PHO would like to thank all harm reduction partners for their collaboration and look forward to the continuation of this work. 4

5 Introduction The misuse of prescription drugs has been an issue of growing concern in Ontario. Between 1991 and 2007, the number of prescriptions in Ontario for oxycodone drugs increased by 850%, to the highest provincial rate of narcotics use in Canada 1. Between 1991 and 2004, the Office of the Chief Coroner of Ontario classified 7353 deaths linked to the involvement of alcohol, drugs or both. Among those deaths, 3406 involved opioid use and were listed as the main cause of death 1. In particular, the use and misuse of drugs such as OxyContin (Oxycontin), an extended release opioid medication prescribed to manage pain, has grown significantly in recent years. A review conducted by the Ministry of Health and Long-Term Care (the Ministry) on the prescribing and utilization of oxycodone controlled release tablets through the Ontario Drug Benefit program 2 found that the majority of use of Oxycontin is outside the current Limited Use criteria. This included: excessive prescribing, escalating misuse, increased diversion from the drugs intended use, increased addiction and increased opioid-related overdoses and deaths. The addition of long-acting oxycodone in Ontario led to a fivefold increase in deaths related to its use from 1999 to 2004, as well as an increase in the overall opioid-related mortality 1. As a result, the availability of Oxycontin in Ontario was discontinued on February 27, The Public Health Policy and Programs Branch, Public Health Division and the Provincial Programs Branch, Negotiations and Accountability Management Division of the Ministry provide funding, policy direction and monitoring for harm reduction programming and services in Ontario. The public health units and their respective harm reduction partners implement and maintain the programs. The Local Health Integrated Networks (LHIN) provides funding to addiction treatment programs including withdrawal management services. The goals of these programs are to respond to the needs of individuals who use substances in order to prevent the transmission of infectious diseases and to facilitate access to care and treatment services. As a result of the discontinuation of Oxycontin, an Expert Group on Narcotics Addictions was established by the Ministry in March The purpose of this group was to provide advice on short, medium and long-term recommendations to support clients who use or abuse oxycodone drugs and may be affected by the changes in the Oxycontin supply. One aspect of the strategy was to collect, review and analyze the impacts the discontinuation of Oxycontin had on: affected populations; clinical outcomes; and the health care system. The discontinuation in the availability of Oxycontin is part of the larger Narcotics Strategy 3, launched on August 27, 2010, that the Ministry supports in order to address issues around prescription opioids. Since March 2012, the Ministry, in collaboration with Public Health Ontario (PHO) has been collecting data from a variety of stakeholders in order to review the impacts of the discontinuation of oxycontin. A report entitled A Review of the Impacts of Opiate Use in Ontario: Interim Summary Report presented the data collected from March 1 to December In February 2013, a review of the surveillance approach was conducted to assess if the original objectives and data sources were still applicable to the evolving opiate use and priorities in Ontario. As a result, an updated surveillance approach was developed which included revised data sources with the intention of better capturing the negative health impacts related to opiate use. Subsequent summary surveillance reports reviewing this data will be provided on a quarterly basis. The purpose of this report is to describe the health impacts associated with opiate use on an individual and health care system levels from January 1 to August 31, A Review of the Impacts of Opiate Use in Ontario: Summary Report December

6 Methods Data from six sources have been collected from January 1 to August Information is collected by either PHO or the Ministry in aggregate format either on a monthly or quarterly basis. Analysis is conducted by both PHO and the ministry then collated for interpretation. Data Sources I. Ontario s Public Health Units (PHUs), including their respective harm reduction partners provide to the Ministry qualitative information regarding observed and client reported changes in user demographics and frequency in drugs of choice. In addition, education and/or training materials developed by PHUs are also reported. II. III. IV. ConnexOntario is a government funded provincial hotline which provides free and confidential health service information regarding drug, alcohol, problem gambling and mental health services. ConnexOntario reports to PHO the number of calls regarding drug use. The Drug and Alcohol Treatment Information System (DATIS) is a comprehensive, province-wide client information system that reports from Ontario addiction agencies. DATIS reports to PHO the number of new admissions to treatment agencies where clients specified prescription opioids as a problem substance. The Opioid Agonist Maintenance Program (OAMP) collects the number of Ontario Health Insurance Plan (OHIP) fee schedule codes that are billed by physicians for the management and supervision of a patient receiving treatment for addiction in an OAMP. Definitions of categories reported are listed below: a. Number of patients: the number of unique health numbers (OHIP) that had one or more OAMP fee codes during the month; b. New patients: number of unique health numbers (OHIP) that had one or more OAMP fee codes during the month, but did not have any in the previous 12 months; c. Number of physicians: number of unique physician billing numbers that submitted one or more OAMP fee codes during the month. V. The Acute Care Enhanced Surveillance (ACES/EDSS), formally known as Emergency Department Syndromic Surveillance (EDSS) is a syndromic surveillance system that reports to PHO the number of emergency department visits, as well as the number of hospital admissions related to opioid use. Cases are identified from a computerized system using a syndromic filter consisting of key words including: overdose, withdrawal, substance abuse and opiates. The filter excludes: alcohol, acetaminophen and other common non-narcotic drug overdoses. VI. The Office of the Chief Coroner of Ontario (OCC) collects data regarding fatalities in Ontario. The numbers of deaths due to acute drug toxicity involving opiates under surveillance (codeine, Fentanyl, heroin, hydromorphone, methadone, morphine or oxycodone) are collected. Deaths by age and month are provided to the Ministry. A Review of the Impacts of Opiate Use in Ontario: Summary Report December

7 Results Ontario s Public Health Units (PHUs) Qualitative observations from PHUs were collected from June to August, Changes in user s drug of choice varied with at least 50% of PHUs noting a slight or major change. For those that reported changes in user s drug of choice, decreases and increases were noted for specific opiates and are presented in Table 1. Overall, more increases were observed, especially pertaining to increases in heroin and hydromorphone. Generic Oxycontin was noted as circulating in some jurisdictions, as was fake oxycontin laced with Fentanyl. The category for Other noted increases in the availability of cocaine, crack cocaine, Wellbutrin and Epsom salts sold as crystal meth (methamphetamine). The use of levamisole in crack cocaine was also reported. Finally, Krokodile and the Party Powder also known as Benzylpiperazine were noted during this surveillance period. Table 1: The number of PHUs that reported decreases and increases by drug, June to August, Ontario 2013 Drug June (n=18) Decrease July (n=22) August (n=18) June (n=18) Increase July (n=22) Fentanyl Heroin Hydromorphone Methadone Morphine Oxycodone Other August (n=18) The majority (76% to 93%) of PHUs that responded indicated that for each month, no changes in the demographics of users were observed. For the few that did report either a slight or major change, the observations noted were regarding an increase in youth drug rates and users requesting to go on methadone. Informative training materials and sessions were developed by a number of PHUs and their harm reduction partners during this three month period. These topics and materials included: Sharps handling training; Information and warning packages; Opiate Outreach Treatment training; Harm reduction, overdose training and education; Peer outreach; Presentations to the Ontario Provincial Police and Emergency Medical Services on harm reduction programs/services provided and; Community forums. A Review of the Impacts of Opiate Use in Ontario: Summary Report December

8 Counts ConnexOntario The number of telephone calls to ConnexOntario help line regarding drug use from January to August is presented in Figure 1. Overall, the number of calls ranged between 200 and 350. From January to June, the number of calls and two month moving average was on the decline; however, in June and July an increase of calls was noted. The twomonth standard deviation (SD), which represents the upper limit of expected activity based on moving averages was not exceeded in any period indicating no unexpected sudden surges in activity. Figure 1: Number of calls to ConnexOntario regarding opiate use by month in Ontario from January to August Number of calls to ConnexOntario regarding opiate use by month in Ontario, January to August Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Total Distinct counts 2 Months Moving Average 2 Month Moving Average + 2SD A Review of the Impacts of Opiate Use in Ontario: Summary Report December

9 The Drug and Alcohol Treatment Information System (DATIS) The numbers of new admissions to treatment agencies where clients specified prescription opioids as a problem substance are presented in Figure 2. From January to August, the number and two-month moving average of assessments fluctuated from approximately 1400 to 1650 per month. The number and two-month moving average of assessments since May has remained steady, around 1500 per month; however, the two-month standard deviation was similar to monthly numbers in July and August steady and consistent activity. Figure 2: Number and moving average of monthly in-take assessments related to prescription opioids in Ontario, January to August 2013 The Opioid Agonist Maintenance Program (OAMP) The number of patients, new patients and unique physician billing codes that are billed through OHIP for the management and supervision of a patient receiving treatment for addiction in an OAMP from January to June 2013 are presented in Table 2. An average and median of 34,703 and 34,696 patients had one or more OAMP fee codes reported through OHIP during this time period. The number of unique health numbers (OHIP) who had one or more OAMP fee code registered in the month, but did not have any in the previous 12 months, ranged from 699 in March to 918 in June. Overall, an average of 802 new patients each month was registered for methadone management and supervision. The number of unique physician billing numbers that submitted one or more OAMP fee codes during the month was consistent, ranging from 246 in May to 253 in January. A Review of the Impacts of Opiate Use in Ontario: Summary Report December

10 Table 2: Number of Opioid Agonist Maintenance Program (OAMP) Patients and Physicians from January to June 2013 Month Number of OAMP Patients Number of New OAMP Patients Number of OAMP Physicians January 34, February 34, March 34, April 34, May 34, June 34, Data for all categories extracted September The Acute Care Enhanced Surveillance (ACES/EDSS) Opiate related emergency department (ED) visits in the ACES/EDSS syndromic surveillance system from January to August 2013 are presented in Figure 3. The number of weekly ED visits fluctuated between four and 16; however, the four-week moving average has remained consistent, averaging 10. Figure 3: Emergency department visits meeting syndromic criteria, by week, from January to August 2013 in Ontario The numbers of weekly hospital admissions related to opiate use captured in ACES/EDSS from January to August 2013 are presented in Figure 4. The number of weekly admissions ranged from 4 to 16. The four-week moving average of hospital admissions during this same time period was slightly more stable; however, a continuous increase beginning June is noted. A Review of the Impacts of Opiate Use in Ontario: Summary Report December

11 Figure 4: Hospital admissions meeting syndromic criteria, by week, from January to August 2013 in Ontario It should be noted that due to small numbers even small fluctuations can appear significant; however bi-weekly numbers do not exceed the two standard deviation upper limit of expected number of ED visits and hospital admissions respectively. The Office of the Chief Coroner of Ontario (OCC) The numbers of deaths reported from January to August 2013 as a result of acute drug toxicity involving opiates are presented in Table 3. Of the drugs resulting in death due to opiate toxicity, oxycodone was the most prevalent, followed by Fentanyl, methadone, hydromorphone, morphine, codeine and heroin. In some instances, more than one opiate was identified through toxicology analysis. The age ranges of deaths are similar across all opiates. Fentanyl and heroin contributed to more deaths in the younger age groups whereas codeine contributed to deaths in the older age group. Table 3: Number of deaths reported related to opiates in Ontario from January 1 to August 31, 2013 Opiate Number of deaths* Mean Age Median Age Age Range Codeine Fentanyl Heroin Hydromorphone Methadone Morphine Oxycodone *Where an opiate was indicated to result in death. Data extracted September 2013 is preliminary and subject to change. A Review of the Impacts of Opiate Use in Ontario: Summary Report December

12 Discussion and Limitations From January 1 to August 31, 2013, a variety of data sources were utilized to provide an overview of the negative health impacts to an individual and the health care system as a result of opioid use. There are many data limitations which need to be considered when interpreting the results and are included. The observations collected from PHUs and their harm reduction partners indicated that there were increases in the availability of drugs, especially pertaining to heroin and hydromorphone. In addition, generic oxycontin was noted as circulating in some jurisdictions, as was fake oxycontin laced with Fentanyl. Increases in the availability of nonopiates were also noted. Minimal changes in the demographics of users were reported but when noted; a decreasing age in users was observed. Many informative materials and training programs were developed, indicating a greater knowledge transfer of harm reduction practices and services offered. Modifications in the survey tool used to collect information by the PHUs and harm reduction programs commenced in June 2013 and therefore, only review a threemonth surveillance period. These reports are based on observation and direct client accounts and have monthly response rates that vary between 33% and 67%. Access to treatment agencies by where opiate use is specified as the problem substance and calls to telephone help lines have both remained consistent through this surveillance period. This may be as a result of the increase in availability of opiates widely circulating in Ontario. The number of new people accessing treatment and those continuing to access treatment for addiction through the methadone maintenance program have remained consistent from January to June The fee schedule codes are billed by physicians for the management and supervision of a patient receiving treatment for addiction in an OAMP and can include services such as: a consultation, assessment or visit; medication reviews; adjusting the dose of the opioid agonist therapy; prescribing additional therapy; discussions with pharmacists; and discussions with the patient, relative, representative or other caregivers. At this time we are not able to differentiate between patients who are on methadone and suboxone (buprenorphine). As we continue to monitor opiate surveillance in Ontario, the OAMP billing will be an important data source utilized to determine if there is an increase of drug users seeking assistance and what, if any, resources are facing challenges meeting user needs. The fee codes processed are done on a monthly basis and may be delayed. As a result, only data between January and June 2013 were included in this analysis. ED visits and hospital admissions have remained consistent through this surveillance period with a slight increase beginning in the summer months. The continued monitoring of emergency visits and admissions will be important to determine the negative outcomes related to opiate use. Data captured in ACES/EDSS are not representative of the province as a whole as approximately half the Emergency departments in Ontario are captured. Specifically, few hospitals in the southwest, Ottawa and Greater Toronto Area are included. The Ministry is committed to continue to support the expansion of this syndromic surveillance system to all hospitals in Ontario. Finally, the key words included to form the syndromic criteria were modified during this surveillance review to be more specific to opiate use, withdrawal and overdose. As a result, the data presented in this summary report cannot be compared to the previous opiate summary report from March 2012 to December Other health consequences of opioid use such as accidental injury and chronic disease including cardiovascular disease, liver damage and mental health disorders are not included in this summary report. Further research on these aspects may provide more detailed information on the long-term impacts of opioid use on individuals and the health care system. Reported deaths from the OCC indicate that acute drug toxicity as a result of oxycodone is the most predominant compared to all other opiates under surveillance; however, this information was preliminary at the time of analysis and subject to change. Due to small cell sizes, data could not be presented by month. Not all deaths are investigated by the OCC; therefore, this is an underestimate of the true number of fatal outcomes as a result of opiate use. A Review of the Impacts of Opiate Use in Ontario: Summary Report December

13 At this time data is presented at a provincial level and has not been further stratified by LHINs, PHUs or First Nation communities. Previous research 4 has indicated that statistically significant associations between prescribed opioids and related deaths were observed at a public health level. Future surveillance reports should take into consideration analyzing data by local level communities as understanding the differences within Ontario may influence specific policies and allow for more targeted harm reduction interventions. Summary In March 2012, the Ministry in collaboration with PHO committed to collect and review available data related to overdose, withdrawal and mortality associated with the discontinuation in availability of Oxycontin in Ontario. In February 2013, a surveillance review was conducted and modifications with regards to the data sources included were made. This is the second summary report developed since March 2012; however, due to data modifications, comparisons to the first report entitled A Review of the Impacts of Opiate Use in Ontario: Interim Summary Report should not be conducted. Based on available data from January 1 to August 31, 2013, and included in this report, no significant change in population health or access to the health care system related to prescription opioid use was noted. Qualitative reports indicate that there are increases in the availability of opiates and that generic Oxycontin is again available. Of the drugs resulting in death due to opiate toxicity, oxycodone was the most prevalent. Access to emergency departments, treatment centres, maintenance programs and telephone help lines are all being utilized and will be important indicators to monitor changes in opiate use in Ontario. Future consideration of opiate use surveillance and research should also include stratification and inclusion of data to determine harm reduction program activity, drug use and impacts to the health care system at a variety of local levels. This may facilitate the development of more targeted policies and public health interventions. The Ministry, in collaboration with PHO maintains a commitment to monitor the discontinuation in availability of Oxycontin in Ontario and will use findings from this and future summary reports to strengthen the monitoring of opiate use and the negative effects on the population and health care system in Ontario. A Review of the Impacts of Opiate Use in Ontario: Summary Report December

14 References 1. Dhalla, I., Mamdani, M., Sivilotti, M., Kopp, A., Qureshi, O., and Juurlink, D. (2009). Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone. Canadian Medical Association Journal, 181 (12), pp Ontario Drug Benefit program Ontario s Narcotics Strategy Gomes, T. Juurlink, D. N. Moineddin, R. Gozdyra, P. Dhalla, I. et al. Geographical variation in opioid prescribing and opioid-related mortality in Ontario. ICES Report, Healthcare Quarterly Vol. 14, No A Review of the Impacts of Opiate Use in Ontario: Summary Report December

15

FINAL REPORT JULY 2015. Opioid Prescribing and Opioid-Related Hospital Visits in Ontario

FINAL REPORT JULY 2015. Opioid Prescribing and Opioid-Related Hospital Visits in Ontario FINAL REPORT JULY 2015 Opioid Prescribing and Opioid-Related Hospital Visits in Ontario 2 The (ODPRN) is funded to conduct pharmacoepidemiology and drug policy research as part of an initiative to provide

More information

Treatment System 101

Treatment System 101 Treatment System 101 A brief overview for courtroom decision-makers and people working in criminal justice sectors March 11, 2015 West Toronto Human Services & Justice Coordinating Cttee. Agenda Introduction

More information

TRENDS IN HEROIN USE IN THE UNITED STATES: 2002 TO 2013

TRENDS IN HEROIN USE IN THE UNITED STATES: 2002 TO 2013 2013 to 2002 States: United the in Use Heroin in Trends National Survey on Drug Use and Health Short Report April 23, 2015 TRENDS IN HEROIN USE IN THE UNITED STATES: 2002 TO 2013 AUTHORS Rachel N. Lipari,

More information

Table of Contents. I. Introduction... 2. II. Summary... 3. A. Total Drug Intoxication Deaths... 5. B. Opioid-Related Deaths... 9

Table of Contents. I. Introduction... 2. II. Summary... 3. A. Total Drug Intoxication Deaths... 5. B. Opioid-Related Deaths... 9 Table of Contents I. Introduction... 2 II. Summary... 3 III. Charts A. Total Drug Intoxication Deaths... 5 B. Opioid-Related Deaths... 9 C. Heroin-Related Deaths... 11 D. Prescription Opioid-Related Deaths...

More information

Treatment of Opioid Dependence: A Randomized Controlled Trial. Karen L. Sees, DO, Kevin L. Delucchi, PhD, Carmen Masson, PhD, Amy

Treatment of Opioid Dependence: A Randomized Controlled Trial. Karen L. Sees, DO, Kevin L. Delucchi, PhD, Carmen Masson, PhD, Amy Category: Heroin Title: Methadone Maintenance vs 180-Day psychosocially Enriched Detoxification for Treatment of Opioid Dependence: A Randomized Controlled Trial Authors: Karen L. Sees, DO, Kevin L. Delucchi,

More information

Populations at risk for opioid overdose

Populations at risk for opioid overdose Populations at risk for opioid overdose Len Paulozzi, MD, MPH Division of Unintentional Injury Prevention National Center for Injury Prevention and Control Centers for Disease Control and Prevention April

More information

Massachusetts Substance Abuse Policy and Practices. Senator Jennifer L. Flanagan Massachusetts Worcester and Middlesex District

Massachusetts Substance Abuse Policy and Practices. Senator Jennifer L. Flanagan Massachusetts Worcester and Middlesex District Massachusetts Substance Abuse Policy and Practices Senator Jennifer L. Flanagan Massachusetts Worcester and Middlesex District November 2014 Substance Abuse and Addiction National and State opioid abuse

More information

Visit www.takebackmylife.org to hear more of my story or call 211 for help and treatment options

Visit www.takebackmylife.org to hear more of my story or call 211 for help and treatment options In high school, I experimented with alcohol and pot. Then I moved on to narcotics and cocaine, which landed me in jail several times. By 25, I was a daily heroin user with a long-term prison sentence.

More information

Northwestern Ontario Prescription Drug Abuse Treatment Program. Dr. Sharon Cirone Dr. Ashok Krishnamurthy

Northwestern Ontario Prescription Drug Abuse Treatment Program. Dr. Sharon Cirone Dr. Ashok Krishnamurthy Northwestern Ontario Prescription Drug Abuse Treatment Program Dr. Sharon Cirone Dr. Ashok Krishnamurthy DISCLOSURE OF COMMERCIAL SUPPORT This program has received NO financial support This program has

More information

Death in the Suburbs: How Prescription Painkillers and Heroin Have Changed Treatment and Recovery

Death in the Suburbs: How Prescription Painkillers and Heroin Have Changed Treatment and Recovery Death in the Suburbs: How Prescription Painkillers and Heroin Have Changed Treatment and Recovery Marvin D. Seppala, MD Chief Medical Officer Hazelden Betty Ford Foundation This product is supported by

More information

Magee-Womens Hospital

Magee-Womens Hospital Magee-Womens Hospital Magee Pregnancy Recovery Program: History Pregnancy Recovery Center A Medical Home Model Approach to Strengthen Families Bawn Maguire, MSN, RN Programmatic Nurse Specialist Stephanie

More information

Urine Drug Testing Methadone 101 Methadone for hospitalists

Urine Drug Testing Methadone 101 Methadone for hospitalists Urine Drug Testing Methadone 101 Methadone for hospitalists Dr. Patricia Mark MB, BCh LEARNING OBJECTIVES Clarify the purpose of urine drug testing Distinguish between UDT for detection of illicit drug

More information

Strategic Plan for Alcohol and Drug Abuse

Strategic Plan for Alcohol and Drug Abuse Strategic Plan for Alcohol and Drug Abuse Fiscal Years 2016-2017 1 GARRETT COUNTY, MARYLAND STRATEGIC PLAN FOR ALCOHOL AND DRUG ABUSE Vision: Mission: A safe and drug free Garrett County To assist in promoting

More information

Presentation to Senate Health and Human Services Committee: Prescription Drug Abuse in Texas

Presentation to Senate Health and Human Services Committee: Prescription Drug Abuse in Texas Presentation to Senate Health and Human Services Committee: Prescription Drug Abuse in Texas David Lakey, MD Commissioner, Department of State Health Services Lauren Lacefield Lewis Assistant Commissioner,

More information

Prescription drug abuse trends. Minnesota s Prescription Monitoring Program. Minnesota Rural Health Conference June 25, 2013 Duluth

Prescription drug abuse trends. Minnesota s Prescription Monitoring Program. Minnesota Rural Health Conference June 25, 2013 Duluth Prescription drug abuse trends Minnesota s Prescription Monitoring Program Carol Falkowski Drug Abuse Dialogues www.drugabusedialogues.com Barbara Carter, Manager MN Board of Pharmacy www.pmp.pharmacy.state.mn.us

More information

The Opioid Addiction Epidemic: How marketing and regulatory failure led to a public health crisis

The Opioid Addiction Epidemic: How marketing and regulatory failure led to a public health crisis The Opioid Addiction Epidemic: How marketing and regulatory failure led to a public health crisis Andrew Kolodny, M.D. Chief Medical Officer, Phoenix House Foundation Inc. Executive Director, Physicians

More information

CCENDU Bulletin. Deaths Involving Fentanyl in Canada, 2009 2014

CCENDU Bulletin. Deaths Involving Fentanyl in Canada, 2009 2014 www.ccsa.ca www.cclt.ca CCENDU Bulletin, August 215 ummary CCENDU Bulletin Deaths Involving Fentanyl in Canada, 29 214 Between 29 and 214, there were at least 655 deaths in Canada where fentanyl was determined

More information

Opioid Addiction and Methadone: Myths and Misconceptions. Nicole Nakatsu WRHA Practice Development Pharmacist

Opioid Addiction and Methadone: Myths and Misconceptions. Nicole Nakatsu WRHA Practice Development Pharmacist Opioid Addiction and Methadone: Myths and Misconceptions Nicole Nakatsu WRHA Practice Development Pharmacist Learning Objectives By the end of this presentation you should be able to: Understand how opioids

More information

An integrated approach to addressing opiate abuse in Maine. Debra L. Brucker, MPA, PhD State of Maine Office of Substance Abuse October 2009

An integrated approach to addressing opiate abuse in Maine. Debra L. Brucker, MPA, PhD State of Maine Office of Substance Abuse October 2009 An integrated approach to addressing opiate abuse in Maine Debra L. Brucker, MPA, PhD State of Maine Office of Substance Abuse October 2009 Background Defining the problem: Opiates pain relievers (OxyContin,

More information

Drug Abuse Trends in the Seattle-King County Area: 2014

Drug Abuse Trends in the Seattle-King County Area: 2014 Drug Abuse Trends in the Seattle-King County Area: 2014 June 12, 2015 Caleb Banta-Green 1, T. Ron Jackson 2, Steve Freng 3, Michael Hanrahan 4, Cynthia Graff 5, John Ohta 6, Mary Taylor 7, Richard Harruff

More information

RULES AND REGULATIONS PERTAINING TO OPIOID OVERDOSE REPORTING

RULES AND REGULATIONS PERTAINING TO OPIOID OVERDOSE REPORTING RULES AND REGULATIONS PERTAINING TO OPIOID OVERDOSE REPORTING [R23-1-OPOIDR] STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DEPARTMENT OF HEALTH April 2014 (E) COMPILER S NOTES: Proposed Additions: The

More information

2015 OPSC Annual Convention. syllabus. February 4-8, 2015 Hyatt Regency Mission Bay San Diego, California

2015 OPSC Annual Convention. syllabus. February 4-8, 2015 Hyatt Regency Mission Bay San Diego, California 2015 OPSC Annual Convention syllabus February 4-8, 2015 Hyatt Regency Mission Bay San Diego, California FRIDAY, FEBRUARY 6, 2015: 9:30am - 10:30am Opioid Addiction and Buprenorphine Use * Presented by

More information

Arkansas Emergency Department Opioid Prescribing Guidelines

Arkansas Emergency Department Opioid Prescribing Guidelines Arkansas Emergency Department Opioid Prescribing Guidelines 1. One medical provider should provide all opioids to treat a patient s chronic pain. 2. The administration of intravenous and intramuscular

More information

EMERGENCY DEPARTMENT VISITS INVOLVING NARCOTIC PAIN RELIEVERS

EMERGENCY DEPARTMENT VISITS INVOLVING NARCOTIC PAIN RELIEVERS Relievers Pain Narcotic Involving Visits Department Emergency Drug Abuse Warning Network Short Report November 05, 2015 EMERGENCY DEPARTMENT VISITS INVOLVING NARCOTIC PAIN RELIEVERS AUTHORS Elizabeth H.

More information

Overdose in Toronto: Trends, Prevention and Response

Overdose in Toronto: Trends, Prevention and Response HL6.4 STAFF REPORT ACTION REQUIRED Overdose in Toronto: Trends, Prevention and Response Date: September 1, 2015 To: From: Wards: Board of Health Medical Officer of Health All Reference Number: SUMMARY

More information

A Local Multifaceted, Multidisciplinary Approach to Opiate Overdose & Death

A Local Multifaceted, Multidisciplinary Approach to Opiate Overdose & Death A Local Multifaceted, Multidisciplinary Approach to Opiate Overdose & Death 2013 WPHA-WALHDAB Annual Conference Wednesday, May 22: 2:00-2:35 pm Lisa Bullard-Cawthorne, MS, MPH OPIATE PREVALENCE IN DANE

More information

Testimony Engrossed House Bill 1101 Department of Human Services Senate Human Services Committee Senator Judy Lee, Chairman February 19, 2013

Testimony Engrossed House Bill 1101 Department of Human Services Senate Human Services Committee Senator Judy Lee, Chairman February 19, 2013 Testimony Engrossed House Bill 1101 Department of Human Services Senate Human Services Committee Senator Judy Lee, Chairman February 19, 2013 Chairman Lee, members of the Senate Human Services Committee,

More information

Avoiding Abuse, Achieving a Balance:

Avoiding Abuse, Achieving a Balance: Avoiding Abuse, Achieving a Balance: Tackling the Opioid Public Health Crisis College of Physicians and Surgeons of Ontario Table of Contents EXECUTIVE SUMMARY...5 Summary of Recommendations...6 INTRODUCTION...12

More information

Prior Authorization Guideline

Prior Authorization Guideline Prior Authorization Guideline Guideline: CSD - Suboxone Therapeutic Class: Central Nervous System Agents Therapeutic Sub-Class: Analgesics and Antipyretics (Opiate Partial Agonists) Client: County of San

More information

Drug-related hospital stays in Australia 1993 2009

Drug-related hospital stays in Australia 1993 2009 in Australia 1993 29 Prepared by Funded by Amanda Roxburgh and Lucy Burns, National Drug and Alcohol Research Centre the Australian Government Department of Health and Ageing Recommended Roxburgh, A.,

More information

Drug- and Alcohol-Related Intoxication Deaths in Maryland, 2014

Drug- and Alcohol-Related Intoxication Deaths in Maryland, 2014 Maryland Department of Health and Mental Hygiene Larry Hogan, Governor Boyd Rutherford, Lt. Governor Van Mitchell, Secretary May, 215 Drug- and Alcohol-Related Intoxication Deaths in Maryland, 214 Table

More information

opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 Ranked #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380

opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 Ranked #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380 opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 ed #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380 effects of alcohol in the brain 100 Top 30 698 heroin addiction 100

More information

Strong States, Strong Nation POLICY OPTIONS TO DECREASE RISKS FROM THE USE OF METHADONE AS A PAIN RELIEVER

Strong States, Strong Nation POLICY OPTIONS TO DECREASE RISKS FROM THE USE OF METHADONE AS A PAIN RELIEVER Strong States, Strong Nation POLICY OPTIONS TO DECREASE RISKS FROM THE USE OF METHADONE AS A PAIN RELIEVER November 17, 2015 Today s Speakers Karmen Hanson, Program Manager, NCSL Cynthia Reilly, Director,

More information

Harnessing National Data Sets to Measure Safety of Opioid Treatment: National Survey on Drug Use and Health (NSDUH) and VA Data

Harnessing National Data Sets to Measure Safety of Opioid Treatment: National Survey on Drug Use and Health (NSDUH) and VA Data Harnessing National Data Sets to Measure Safety of Opioid Treatment: National Survey on Drug Use and Health (NSDUH) and VA Data William C. Becker, MD Assistant Professor, General Internal Medicine VA Connecticut

More information

Trends of Opioid Misuse and Diversion: Lessons from the United States

Trends of Opioid Misuse and Diversion: Lessons from the United States Trends of Opioid Misuse and Diversion: Lessons from the United States 31 October 2012 Richard C. Dart, MD, PhD Director Rocky Mountain Poison and Drug Center Professor - University of Colorado, Department

More information

CDC s Prevention Efforts to Address Prescription Opioid Epidemic

CDC s Prevention Efforts to Address Prescription Opioid Epidemic CDC s Prevention Efforts to Address Prescription Opioid Epidemic Jan Losby, PhD, MSW Lead, Prescription Drug Overdose Health Systems and State Support Team Division of Unintentional Injury Prevention NASBO

More information

Drug Testing to Support Pain Management

Drug Testing to Support Pain Management NATIONAL REFERENCE LABORATORY Drug Testing to Support Pain Management 500 Chipeta Way, Salt Lake City, UT 84108 (800) 522-2787 (801) 583-2787 www.aruplab.com www.arupconsult.com ARUP is an enterprise of

More information

Opiate Addiction in Ohio: An Update on Scope of Problem Ashland Ohio

Opiate Addiction in Ohio: An Update on Scope of Problem Ashland Ohio Governor s Cabinet Opiate Action Team Promoting Wellness and Recovery John R. Kasich, Governor Tracy J. Plouck, Director Opiate Addiction in Ohio: An Update on Scope of Problem Ashland Ohio November 14,

More information

The ABCs of Medication Assisted Treatment

The ABCs of Medication Assisted Treatment The ABCs of Medication Assisted Treatment J E F F R E Y Q U A M M E, E X E C U T I V E D I R E C T O R C O N N E C T I C U T C E R T I F I C A T I O N B O A R D The ABCs of Medication Assisted Treatment

More information

The Determinations Report: A Report On the Physician Waiver Program Established by the. Drug Addiction Treatment Act of 2000 ( DATA )

The Determinations Report: A Report On the Physician Waiver Program Established by the. Drug Addiction Treatment Act of 2000 ( DATA ) The Determinations Report: A Report On the Physician Waiver Program Established by the Drug Addiction Treatment Act of 2000 ( DATA ) Submitted by the Center for Substance Abuse Treatment, Substance Abuse

More information

Opioids and the Injured Worker Tools for Successful Outcomes

Opioids and the Injured Worker Tools for Successful Outcomes Opioids and the Injured Worker Tools for Successful Outcomes Tim Pokorney, RPh Director, Clinical Express Scripts Workers' Compensation Division Goals and Objectives Alarming statistics for narcotic utilization,

More information

Resources for the Prevention and Treatment of Substance Use Disorders

Resources for the Prevention and Treatment of Substance Use Disorders Resources for the Prevention and Treatment of Substance Use Disorders Table of Contents Age-standardized DALYs, alcohol and drug use disorders, per 100 000 Age-standardized death rates, alcohol and drug

More information

Improving Outcomes in Patients Who are Prescribed Alprazolam with Concurrent Use of Opioids

Improving Outcomes in Patients Who are Prescribed Alprazolam with Concurrent Use of Opioids Improving Outcomes in Patients Who are Prescribed Alprazolam with Concurrent Use of Opioids Pik-Sai Yung, M.D. Staff Psychiatrist Center for Counseling at Walton Background and Rationale Alprazolam is

More information

SAMHSA Initiatives to Educate Prescribers and Consumers and Treatment Resources

SAMHSA Initiatives to Educate Prescribers and Consumers and Treatment Resources SAMHSA Initiatives to Educate Prescribers and Consumers and Treatment Resources Nick Reuter Division of Pharmacologic Therapy Substance Abuse and Mental Health Services Administration 1 Overview National

More information

PARTNERSHIP HEALTHPLAN RECOMMENDATIONS For Safe Use of Opioid Medications

PARTNERSHIP HEALTHPLAN RECOMMENDATIONS For Safe Use of Opioid Medications PARTNERSHIP HEALTHPLAN RECOMMENDATIONS For Safe Use of Opioid Medications Primary Care & Specialist Prescribing Guidelines Introduction Partnership HealthPlan is a County Organized Health System covering

More information

Substance Abuse Treatment Admissions Involving Abuse of Pain Relievers: 1998 and 2008

Substance Abuse Treatment Admissions Involving Abuse of Pain Relievers: 1998 and 2008 Treatment Episode Data Set The TEDS Report July 15, 010 Substance Abuse Treatment Admissions Involving Abuse of Pain Relievers: 1998 and 008 In Brief The proportion of all substance abuse treatment admissions

More information

The Prescription Opioid and Heroin Crisis: An Epidemic of Addiction

The Prescription Opioid and Heroin Crisis: An Epidemic of Addiction The Prescription Opioid and Heroin Crisis: An Epidemic of Addiction Andrew Kolodny, M.D. Chief Medical Officer, Phoenix House Foundation Inc. Executive Director, Physicians for Responsible Opioid Prescribing

More information

WHAT WE KNOW. Collective Action Issue Brief #2 Updated June 2014 PRESCRIPTION PAIN MEDICATION MISUSE

WHAT WE KNOW. Collective Action Issue Brief #2 Updated June 2014 PRESCRIPTION PAIN MEDICATION MISUSE Collective Action Issue Brief #2 Updated June 2014 PRESCRIPTION PAIN MEDICATION MISUSE WHAT WE KNOW The misuse and abuse of prescription drugs has become a leading cause of harm among New Hampshire adults,

More information

ARCHIVED BULLETIN. Product No. 2004-L0424-013 SEPTEMBER 2004 U. S. D E P A R T M E N T O F J U S T I C E

ARCHIVED BULLETIN. Product No. 2004-L0424-013 SEPTEMBER 2004 U. S. D E P A R T M E N T O F J U S T I C E BULLETIN INTELLIGENCE Product No. 2004-L0424-013 SEPTEMBER 2004 U. S. D E P A R T M E N T O F J U S T I C E NDIC Within the past 2 years buprenorphine a Schedule III drug has been made available for use

More information

John R. Kasich, Governor Orman Hall, Director

John R. Kasich, Governor Orman Hall, Director John R. Kasich, Governor Orman Hall, Director 2 3 Epidemics of unintentional drug overdoses in Ohio, 1979-2011 1,2,3 1800 1600 1400 1200 1000 800 Prescription drugs are causing a larger overdose epidemic

More information

PRESCRIPTION DRUG ABUSE: THE NATIONAL PERSPECTIVE

PRESCRIPTION DRUG ABUSE: THE NATIONAL PERSPECTIVE PRESCRIPTION DRUG ABUSE: THE NATIONAL PERSPECTIVE May 19, 2012 National Association Boards of Pharmacy Annual Meeting Gil Kerlikowske, Director White House Office of National Drug Control Policy ONDCP

More information

Heroin Addiction. Kim A. Drury RN, MSN

Heroin Addiction. Kim A. Drury RN, MSN Heroin Addiction Kim A. Drury RN, MSN Heroin use is on the rise in our area. Nearly every day the news media reports situations involving Heroin. According to the Substance Abuse and Mental Health Services

More information

DRUG AND ALCOHOL-ASSOCIATED INTOXICATION DEATHS BALTIMORE CITY

DRUG AND ALCOHOL-ASSOCIATED INTOXICATION DEATHS BALTIMORE CITY 2007-2012 DRUG AND ALCOHOL-ASSOCIATED INTOXICATION DEATHS BALTIMORE CITY Lead Authors: Aruna Chandran, Chief of Epidemiologic Services, Baltimore City Health Department Elizabeth Salisbury-Afshar, Medical

More information

Substance Abuse 2014-2015. Chapter 10: Substance Abuse

Substance Abuse 2014-2015. Chapter 10: Substance Abuse Substance Abuse 214-215 Chapter 1: Substance Abuse 265 214-215 Health of Boston Substance Abuse Substance abuse involves the excessive use of alcohol or illicit substances (e.g., marijuana, cocaine, heroin,

More information

Implementing Prescribing Guidelines in the Emergency Department. April 16, 2013

Implementing Prescribing Guidelines in the Emergency Department. April 16, 2013 Implementing Prescribing Guidelines in the Emergency Department April 16, 2013 Housekeeping Note: Today s presentation is being recorded and will be provided within 48 hours. Two ways to ask questions

More information

Blueprint for Prescriber Continuing Education Program

Blueprint for Prescriber Continuing Education Program CDER Final 10/25/11 Blueprint for Prescriber Continuing Education Program I. Introduction: Why Prescriber Education is Important Health care professionals who prescribe extended-release (ER) and long-acting

More information

Module 6 Alcoholism, Drug Abuse and Corruption

Module 6 Alcoholism, Drug Abuse and Corruption Module 6 Alcoholism, Drug Abuse and Corruption Lecture 36 Drug Abuse: Concept, Extent and Nature Concept Any substance (usually chemical) which influences our bodies or emotions when consumed may be called

More information

Drug Abuse Patterns and Trends in the San Francisco Bay Area Update: June 2014

Drug Abuse Patterns and Trends in the San Francisco Bay Area Update: June 2014 Drug Abuse Patterns and Trends in the San Francisco Bay Area Update: June 24 Alice A. Gleghorn, Ph.D. ABSTRACT In San Francisco, increases in heroin consequence indicators (treatment admissions and Drug

More information

Issue Brief Prescription Drug Misuse in Vermont

Issue Brief Prescription Drug Misuse in Vermont Issue Brief Prescription Drug Misuse in Vermont STATE EPIDEMIOLOGICAL OUTCOMES WORKGROUP - JUNE, 214 Summary Discrepancies between the perceived problem of prescription drug misuse in Vermont and several

More information

Discontinuation: Involuntary Discharge

Discontinuation: Involuntary Discharge Discontinuation: Involuntary Discharge TYPICALLY A PROCESS NOT AN EVENT Objectives 2 Review indications for discharge. Develop a therapeutic approach, in the context of the nature of Substance Use Disorders.

More information

This is the written version of our Hot Topic video presentation available at: MayoMedicalLaboratories.com/hot-topics

This is the written version of our Hot Topic video presentation available at: MayoMedicalLaboratories.com/hot-topics This is the written version of our Hot Topic video presentation available at: MayoMedicalLaboratories.com/hot-topics Welcome to Mayo Medical Laboratories Hot Topics. These presentations provide short discussion

More information

Narcotic drugs used for pain treatment Version 4.3

Narcotic drugs used for pain treatment Version 4.3 Narcotic drugs used for pain treatment Version 4.3 Strategy to restrict the pack sizes or the type of packaging available in public pharmacies. 1. Introduction The document describing the strategy of the

More information

TESTIMONY. March 17, 2014. Rutland, VT

TESTIMONY. March 17, 2014. Rutland, VT Community Solutions to Breaking the Cycle of Heroin & Opioid Addiction TESTIMONY Harry Chen, MD, Commissioner of Health March 17, 2014 Senate Committee on the Judiciary Franklin Conference Center at the

More information

Non medical use of prescription medicines existing WHO advice

Non medical use of prescription medicines existing WHO advice Non medical use of prescription medicines existing WHO advice Nicolas Clark Management of Substance Abuse Team WHO, Geneva Vienna, June 2010 clarkn@who.int Medical and Pharmaceutical role Recommendations

More information

INFO Brief. Prescription Opioid Use: Pain Management and Drug Abuse In King County and Washington State

INFO Brief. Prescription Opioid Use: Pain Management and Drug Abuse In King County and Washington State ADAI-IB 23-3 INFO Brief Prescription Opioid Use: Pain Management and Drug Abuse In King County and Washington State O ctober 23 Caleb Banta-Green (Alcohol and Drug Abuse Institute, University of Washington),

More information

Strategic Plan for Alcohol and Drug Abuse. 2014-2016 December 2013 Update. 6 Month Update 1 Approved: 1/8/14

Strategic Plan for Alcohol and Drug Abuse. 2014-2016 December 2013 Update. 6 Month Update 1 Approved: 1/8/14 Strategic Plan for Alcohol and Drug Abuse 2014-2016 December 2013 Update 6 Month Update 1 Approved: 1/8/14 GARRETT COUNTY, MARYLAND STRATEGIC PLAN FOR ALCOHOL AND DRUG ABUSE Vision: Mission: A safe and

More information

Opioid/Opiate Dependent Pregnant Women

Opioid/Opiate Dependent Pregnant Women Opioid/Opiate Dependent Pregnant Women The epidemic, safety, stigma, and how to help. Presented by Lisa Ramirez MA,LCDC & Kerby Stewart MD The prescription painkiller epidemic is killing more women than

More information

Wheeling Ohio County Health Department Emergency Department Opioid Prescribing Guidelines

Wheeling Ohio County Health Department Emergency Department Opioid Prescribing Guidelines In collaboration with medical professionals and community leaders in Ohio County, West Virginia, the Wheeling-Ohio County Health Department has developed the following recommended guidelines and best practices

More information

Frequently asked questions

Frequently asked questions Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction Frequently asked questions What is Naltrexone? Naltrexone is a prescription drug that completely blocks the effects of all opioid drugs

More information

The TIRF REMS Access program is a Food and Drug Administration (FDA) required risk management program

The TIRF REMS Access program is a Food and Drug Administration (FDA) required risk management program Subject: Important Drug Warning Announcement of a single shared REMS (Risk Evaluation and Mitigation Strategy) program for all Transmucosal Immediate Release Fentanyl (TIRF) products due to the potential

More information

Ever wish you could... Quit using heroin? Protect yourself from HIV infection? Get healthier?

Ever wish you could... Quit using heroin? Protect yourself from HIV infection? Get healthier? Ever wish you could... Quit using heroin? Protect yourself from HIV infection? Get healthier? Good News: Medical treatments called opioid (oh-pee-oyd) maintenance can help you! Injecting heroin puts you

More information

MEDICATION ABUSE IN OLDER ADULTS

MEDICATION ABUSE IN OLDER ADULTS MEDICATION ABUSE IN OLDER ADULTS Clifford Milo Singer, MD Adjunct Professor, University of Maine, Orono ME Chief, Division of Geriatric Mental Health and Neuropsychiatry The Acadia Hospital and Eastern

More information

Opioid Prescribing for Chronic Pain: Guidelines for Marin County Clinicians

Opioid Prescribing for Chronic Pain: Guidelines for Marin County Clinicians Opioid Prescribing for Chronic Pain: Guidelines for Marin County Clinicians Although prescription pain medications are intended to improve the lives of people with pain, their increased use and misuse

More information

Neurobiology and Treatment of Opioid Dependence. Nebraska MAT Training September 29, 2011

Neurobiology and Treatment of Opioid Dependence. Nebraska MAT Training September 29, 2011 Neurobiology and Treatment of Opioid Dependence Nebraska MAT Training September 29, 2011 Top 5 primary illegal drugs for persons age 18 29 entering treatment, % 30 25 20 15 10 Heroin or Prescription Opioids

More information

Drug Use and Abuse in San Diego County, California: 2013

Drug Use and Abuse in San Diego County, California: 2013 Drug Use and Abuse in San Diego County, California: 213 Karla D. Wagner, Ph.D. 1 ABSTRACT The most significant change observed in drug use/abuse indicators in San Diego County in 213 was an increase in

More information

Macomb County Office of Substance Abuse MCOSA. Executive Summary

Macomb County Office of Substance Abuse MCOSA. Executive Summary Macomb County Office of Substance Abuse MCOSA Executive Summary This report marks the second data profile of alcohol and illicit drugs burden in Macomb County. The first report produced in 2007 detailed

More information

+ + + + + ECSTASY. Trends in Drug Use and Related Harms in Australia, 2001 to 2013. National Drug and Alcohol Research Centre

+ + + + + ECSTASY. Trends in Drug Use and Related Harms in Australia, 2001 to 2013. National Drug and Alcohol Research Centre ALCOHOL PHARMACEUTICAL OPIOIDS HEROIN 21-212 COCAINE DRUG TRENDS CANNABIS + + + + + + ECSTASY Trends in Drug Use and Related Harms in Australia, 21 to 213 Medicine APC POP- UP STAND National Drug and Alcohol

More information

Information for Pharmacists

Information for Pharmacists Page 43 by 42 CFR part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. Information for Pharmacists SUBOXONE (buprenorphine HCl/naloxone HCl

More information

Appendix 14: Obtaining Data on Opioid Poisoning

Appendix 14: Obtaining Data on Opioid Poisoning : Obtaining Data on Opioid Poisoning Obtaining Hospital Data on Nonfatal Opioid Poisoning Data on the number of nonfatal opioid overdoses can often be obtained from hospitals serving your community. Forming

More information

Testimony of. Daliah Heller, PhD, MPH Assistant Commissioner Bureau of Alcohol and Drug Use Prevention, Care and Treatment

Testimony of. Daliah Heller, PhD, MPH Assistant Commissioner Bureau of Alcohol and Drug Use Prevention, Care and Treatment Testimony of Daliah Heller, PhD, MPH Assistant Commissioner Bureau of Alcohol and Drug Use Prevention, Care and Treatment New York City Department of Health and Mental Hygiene before the New York City

More information

The Heroin and Prescription Drug Abuse Prevention and Reduction Act Section by Section

The Heroin and Prescription Drug Abuse Prevention and Reduction Act Section by Section The Heroin and Prescription Drug Abuse Prevention and Reduction Act Section by Section TITLE I: PREVENTION SUBTITLE A- PRESCRIBER EDUCATION PRACTITIONER EDUCATION This subtitle requires practitioners who

More information

SUPPORTING WOMEN USING OPIATES IN PREGNANCY: A Guideline for Primary Care Providers May, 2011

SUPPORTING WOMEN USING OPIATES IN PREGNANCY: A Guideline for Primary Care Providers May, 2011 INTRODUCTION SUPPORTING WOMEN USING OPIATES IN PREGNANCY: A Guideline for Primary Care Providers May, 2011 Prevalence of Opiate Use and Impact on Maternal, Fetal, and Neonatal Health: The prevalence of

More information

The Opiate Epidemic. Laura Suminski, MSE, NCC, LPC-IT, SAC-IT Krystle Gutting, MS, LPC-IT, SAC-IT

The Opiate Epidemic. Laura Suminski, MSE, NCC, LPC-IT, SAC-IT Krystle Gutting, MS, LPC-IT, SAC-IT The Opiate Epidemic Laura Suminski, MSE, NCC, LPC-IT, SAC-IT Krystle Gutting, MS, LPC-IT, SAC-IT Connections Counseling Madison, WI www.connectionscounseling.com The Opiate Epidemic Opioid-related Facts

More information

Opiate Treatment for Aboriginal High School Students in Ontario

Opiate Treatment for Aboriginal High School Students in Ontario Opiate Treatment for Aboriginal High School Students in Ontario January 2014 1 CHALLENGE About 40% of the students at an Aboriginal high school in Thunder Bay Ontario (Canada) are known to be addicted

More information

Prescriber Behavior, Pain Treatment and Addiction Treatment

Prescriber Behavior, Pain Treatment and Addiction Treatment Prescriber Behavior, Pain Treatment and Addiction Treatment Mary Fleming, M.S. Director, Office of Policy, Planning, and Innovation Substance Abuse and Mental Health Services Administration NGA Policy

More information

Broward Barometer of Adult Drug Abuse Indicators Summer 2008

Broward Barometer of Adult Drug Abuse Indicators Summer 2008 Adult Summer 8 The chart below summarizes the severity and trends for indicators of drug use and abuse in Broward County, Florida. The Severity Index is based on the number of drug-related deaths, emergency

More information

Considerations when Using Controlled Substances to Treat Chronic Pain

Considerations when Using Controlled Substances to Treat Chronic Pain Considerations when Using Controlled Substances to Treat Chronic Pain By Mary-Beth F. Plum, Pharm.D. Impact of Chronic Pain Acute pain is the body s response to environmental dangers, and it helps protect

More information

Orange County Heroin Task Force Recommendations

Orange County Heroin Task Force Recommendations Orange County Heroin Task Force Recommendations Law Enforcement Subcommittee 1) Continue Joint Enforcement Details with the Orange County Sheriff s Office, the Orlando Police Department and state and federal

More information

Lazarus Recovery Services

Lazarus Recovery Services Lazarus Recovery Services Overdose Survivors Group Family Addiction Support Family Peer Specialist Support Housing Family Overdose Support Biological Psychological Parent/ Family Empowerment Faith Individual

More information

Abstral Prescriber and Pharmacist Guide

Abstral Prescriber and Pharmacist Guide Abstral Prescriber and Pharmacist Guide fentanyl citrate sublingual tablets Introduction The Abstral Prescriber and Pharmacist Guide is designed to support healthcare professionals in the diagnosis of

More information

Iowa Governor s Office of Drug Control Policy

Iowa Governor s Office of Drug Control Policy Iowa Governor s Office of Drug Control Policy medicines or take them in a manner not prescribed, we increase the risk of negative effects. It is estimated that over 35 million Americans are ages 65 and

More information

Opioids for Pain Treatment. Opioids for Chronic Pain and Addiction Treatment. Outline for Today. Opioids for pain treatment

Opioids for Pain Treatment. Opioids for Chronic Pain and Addiction Treatment. Outline for Today. Opioids for pain treatment Opioids for Chronic Pain and Addiction Treatment Joseph Merrill M.D., M.P.H. University of Washington February 24, 2012 Outline for Today Opioids for pain treatment Trends Problems High dose prescribing

More information

The Changing Face of Opioid Addiction:

The Changing Face of Opioid Addiction: 9th Annual Training and Educational Symposium September 6, 2012 The Changing Face of Opioid Addiction: A Review of the Research and Considerations for Care Mark Stanford, Ph.D. Santa Clara County Dept

More information

Treatment Approaches for Drug Addiction

Treatment Approaches for Drug Addiction Treatment Approaches for Drug Addiction NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call 1-800-662-HELP(4357)

More information

Testimony of The New York City Department of Health and Mental Hygiene. before the

Testimony of The New York City Department of Health and Mental Hygiene. before the Testimony of The New York City Department of Health and Mental Hygiene before the New York City State Assembly Committee on Alcoholism and Drug Abuse on Programs and Services for the Treatment of Opioid

More information

Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction. Frequently Asked Questions

Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction. Frequently Asked Questions Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction Frequently Asked Questions What is Naltrexone? Naltrexone is a prescription drug that effectively blocks the effects of heroin, alcohol,

More information

Opiate Abuse and Mental Illness

Opiate Abuse and Mental Illness visited on Page 1 of 5 LEARN MORE (HTTP://WWW.NAMI.ORG/LEARN-MORE) FIND SUPPORT (HTTP://WWW.NAMI.ORG/FIND-SUPPORT) GET INVOLVED (HTTP://WWW.NAMI.ORG/GET-INVOLVED) DONATE (HTTPS://NAMI360.NAMI.ORG/EWEB/DYNAMICPAGE.ASPX?

More information

Southlake Psychiatry. Suboxone Contract

Southlake Psychiatry. Suboxone Contract Suboxone Contract Thank you for considering Southlake Psychiatry for your Suboxone treatment. Opiate Addiction is a serious condition for which you may find relief with Suboxone treatment. In order to

More information

CDC Initiatives & Priorities to Address the Prescription Drug Overdose Crisis

CDC Initiatives & Priorities to Address the Prescription Drug Overdose Crisis CDC Initiatives & Priorities to Address the Prescription Drug Overdose Crisis Grant Baldwin, PhD, MPH February 2, 2016 National Center for Injury Prevention and Control Division of Unintentional Injury

More information

August 2011. A. Introduction

August 2011. A. Introduction Recommendations of the Expert Group on the Regulatory Framework for products containing buprenorphine / naloxone and buprenorphine-only for the treatment of opioid dependence August 2011 A. Introduction

More information