Addressing the Opioid Epidemic New York State Department of Health - - PowerPoint PPT Presentation

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Addressing the Opioid Epidemic New York State Department of Health - - PowerPoint PPT Presentation

Jul 13, 2023 270 likes •617 views

Addressing the Opioid Epidemic New York State Department of Health Work presented was supported by 1 NU17CE002742, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not

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Addressing the Opioid Epidemic New York State Department of Health

Kitty Gelberg, Ph.D., MPH

Director, Bureau of Occupational Health & Injury Prevention

Work presented was supported by 1 NU17CE002742, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

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September 20, 2017 2

County of Death due to Opioids Rate per 100,000 Residents

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Opioid-related Overdose Deaths vs. Motor Vehicle Deaths, NYS, 1999-2015

500 1000 1500 2000 2500 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Opioid-related Overdose Deaths Motor vehicle-related Injury Deaths

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NYS – Opioid Epidemic

500 1000 1500 2000 2500 3000 3500 2010 2011 2012 2013 2014 2015

Number of Deaths Year

NYC ROS NYS

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September 20, 2017 7

Epidemic #1: Prescription Opioids

200 400 600 800 1000 1200 1400 2010 2011 2012 2013 2014 2015

Number of Deaths Year

Number of Prescription Drug Deaths, NYS

NYC Rx ROS Rx NYS Rx

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September 20, 2017 8

Epidemic #2: Heroin

200 400 600 800 1000 1200 2010 2011 2012 2013 2014 2015

Number of Deaths Year

Number of Heroin Deaths, NYS

NYC ROS NYS

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Epidemic #3: Synthetic Drugs (Fentanyl)

100 200 300 400 500 600 700 800 2010 2011 2012 2013 2014 2015

Number of Deaths Year

Number of Synthetic Drug Deaths, NYS

NYC ROS NYS

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Lethal dose of Fentanyl

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Burden on Coroners/Medical Examiners

  • Large number of deaths requiring

autopsies

– Time and expense

  • Responding to Information Requests

– Law enforcement, NYS, DAs, Press

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www.health.ny.gov/Opioids

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Build Local Health Department Capacity

  • Funding 4 counties based on opioid burden, size
  • f county and geographic location
  • Erie, Onondaga, Sullivan, Broome
  • Identifying strategies to implement through

broad-based County coalitions

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September 20, 2017 14

Prescriber Education

  • Aims to prevent poisonings, overdoses

and addictions before they occur

– Reduce opioid use in the general population

  • Engage providers in improving opioid

prescribing practices

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Opioid-Related Data

  • Develop/Distribute County Level Reports

(NYS Legislation)

  • Analyze multiple new datasets
  • Develop Data Dashboard
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Opioid-Related Data

http://www.health.ny.gov/statistics/opioid/

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Other Factors Influencing Opioid Trends

Event Implementation Date Risk Evaluation and Mitigation Strategy (REMS) for long-acting

  • pioids received FDA approval

July 9, 2012 I-STOP legislation signed by Governor Cuomo (Bill S7637) August 27, 2012 Updates to the Controlled Substance Schedule February 23, 2013 I-STOP Registry Review Mandated August 27, 2013 Opioid Prescriber Education Program September 1, 2013 Electronic Prescribing of all Controlled Substances March 27, 2015 CDC Guideline for Prescribing Opioids for Chronic Pain – United States – 2016 released March 15, 2016 Governor Cuomo signs legislation to combat the heroin and

  • pioid crisis

June 22, 2016 7-day opioid supply limit for opioid naïve patients July 22, 2016

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Community Programs Law Enforcement Firefighters Basic Life Support EMS School Settings Corrections & Parole Pharmacy

A Multi-Systemic Approach to Address Opioid Overdose

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Drug User Health Hubs Established 2016

  • Outpatient ambulatory care programs for drug users
  • Enhance local providers understanding and ability to

provide services to substance

  • Provide on-site medically assisted treatment –

buprenorphine.

  • Prevent overdoses; provide care post overdose.
  • Law Enforcement Assisted Diversion (LEAD): Low level
  • ffenders are diverted to SEP for care services instead
  • f being arrested.
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Drug User Health Hubs Core Elements

Syringes Buprenorphine Naloxone Hepatitis C Care

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Drug User Health Hubs

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What is Naloxone?

  • Naloxone is an

emergency medicine that can reverse an

  • pioid overdose.
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September 20, 2017 26 October 28, 2015 5,000 10,000 15,000 20,000 25,000

2014 Q4 2015 Q1 2015 Q2 2015 Q3 2015 Q4 2016 Q1 2016 Q2 2016 Q3

Overdose Responders Trained: Oct 1, 2014-Sept 30, 2016

Community Responders School EMS Fire Fighters Law Enforcement

16,045 2,622 3,532 3,563 82,922 8,358 11,202 15,677 8,651 12,724 108,684 TOTAL Note: Data reported by registered programs. 21,411 16,609 14,142

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Source: NYSDOH, AIDS Institute and Bureau of EMS and Trauma Systems

Note: Data as of June 2017. EMS totals represent only naloxone encounters that were reported in Regional Medical Control Data for Suffolk County, or electronically for other counties; therefore, the actual numbers of events may have been higher. Law enforcement totals do not yet comprehensively include reports from law enforcement agencies in New York City and Nassau County. Law enforcement and COOP program totals represent only naloxone administration reports submitted by law enforcement and registered COOP programs to the NYSDOH AIDS Institute. The actual numbers of naloxone administration events may have been higher.

12,659 11,033 968 658 17,307 14,595 1,575 1,137 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 20,000 Total EMS Law Enforcement Community opioid

  • verdose prevention

(COOP) programs 2015 2016

Total Naloxone Administration for NYS, by Responder Type

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Rationale for Creating the Naloxone Co-payment Assistance Program (N-CAP)

  • Increasing pharmacy access will allow more naloxone to get into the hands of people who

need it:

State resources can be devoted to covering naloxone for individuals not eligible for N- CAP

  • Uninsured;
  • Individuals using it in the

line of duty;

  • Vulnerable individuals:
  • individuals being

released from prison;

  • syringe exchange

program participants.

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Information will be available at pharmacies, registered programs, homeless shelters, LGBT centers

Getting the Word Out

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To find the nearest participating pharmacy or registered program, please visit:

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Syndromic Surveillance

  • Working to use Emergency Department

real-time data to identify unusual clusters

  • f overdoses
  • Planning use of the syndrome

– Alert community partners to enhanced

  • verdose risk

– Identify communities needing increased training, access to naloxone/buprenorphine

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Also provided with:

  • Observed # vs.

Expected # for each zip code

  • Details on each

case including hospital, day, age, sex and chief complaint SatScan results provided to program

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QUESTIONS?

Kitty Gelberg, Ph.D., MPH Kitty.Gelberg@health.ny.gov 518-402-7900