10/12/2016 Required Disclosure Opioids and Maine: the state of the - - PDF document

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Opioids and Maine: the state of the state

Christopher Pezzullo, DO State Health Officer Maine DHHS|Maine CDC October 16, 2016

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Required Disclosure

2 Department of Health and Human Services

Number of drug deaths involving specific drug types*: 2014**

3

70 57 43 42 30 24

*Some deaths may be caused by more than one key drug. **2014 results are preliminary ***Deaths caused by known pharmaceutical morphine removed from total.

More than one in three

• verdose deaths involved

benzodiazepines.

More than one in four

• verdose deaths involved

heroin/morphine.

Source: Marci Sorg, Margaret Chase Smith Policy Center at University of Maine, Office of the Chief Medical Examiner

Unintentional Injury Deaths in Maine, by type: 2009‐2014

4 2009 2010 2011 2012 2013 2014 Motor vehicle‐related injury deaths 159 161 136 164 145 131 Drug‐related overdose deaths 179 167 155 163 176 208 50 100 150 200 250 Source: Office of the Chief Medical Examiner, Maine Bureau of Highway Safety/Maine Department of Transportation

In 2014, there were 208

drug related overdose

deaths compared to 131

motor vehicle related

deaths.

208 131

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Source, National Data: USCDC; Multiple Cause of Death Files from the National Vital Statistics System, 2002‐2013.

Heroin related death overdoses, Maine vs. Nation: 2002‐2013

5 Source, Maine Data: Maine Department of Health and Human Services, Office od Research, Data and Vital Statistics 2.2 2.8 1.8

3.3

2.4 1.9 1.5 1.0 0.5 0.7 2.1

4.3

0.7 0.7 0.6 0.7 0.7 0.8 1.0 1.1 1.0 1.4 1.9

2.7

0.0 1.0 2.0 3.0 4.0 5.0 Maine Nation Rates/100,000

Number of drug affected baby notifications*: 2005‐2014

6 165 201 274 343 451 572 667 779 927 200 400 600 800 1000 976 Source: Office of Child and Family Services (OCFS), Maine Automated Child Welfare Information System (MACWIS).

From 2005 to 2014, the number of drug affected baby notifications increased by 480%.

In 2014, there were a total of 976 reports of drug affected babies and 995 in 2015.

*This measure reflects the number of infants born in Maine where a healthcare provider reported to OCFS that there was reasonable cause to suspect the baby may be affected by illegal substance abuse or demonstrating withdrawal symptoms resulting from prenatal drug exposure (illicit or prescribed appropriately under a physician’s care for the mother’s substance abuse treatment) or who have fetal alcohol spectrum disorders.

Additional Maine facts…..

• Maine #1 state per capita long acting

extended release opioids (USCDC 2102)

• 80 million discrete opioid pills rx’d per

year

Implementation Timeline for 488 (PMP Legislation)

8 Department of Health and Human Services

August 1, 2016

• 100 MME limit for new Rxs
• Exempted: ED/inpatient

LTCF/Residential care

• Exceptions: cancer pain (active

and aftercare)/palliative care/hospice/MAT

• 300 MME limit if over 100

MME until 7.1.17, or documented medical necessity with no limit until 1.1.17

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Implementation Timeline

9 Department of Health and Human Services

January 1, 2017

• Required PMP check for new benzo or opioid, and every 90

days thereafter for chronic opioid Rxs

• 7d/30d: acute/chronic
• Pharmacists and veterinarians auto-enrolled by this date

Implementation Timeline

10 Department of Health and Human Services

July 1, 2017

• All opioids must be electronically prescribed by this date, unless

a hardship waiver is requested and granted by DHHS December 31, 2017

• Must have three credits of CME in opioid

use/abuse/risks/benefits by this date, then every two years thereafter

• Consider PCSS http://pcss-o.org/

Other DHHS Initiatives

11 Department of Health and Human Services

• 211 Maine
• Methadone
• MaineCare PA
• Education
• Dr. Christopher Pezzullo

State Health Officer christopher.pezzullo@maine.gov

12 Department of Health and Human Services

Questions?