Data Series January 8, 2015 Harris Silver, M MD Co-chair, - - PowerPoint PPT Presentation

2nd Bernalillo County Opioid Abuse Accountability Summit Data Series

January 8, 2015

Harris Silver, M MD

Co-chair, Bernalillo County Opioid Abuse Accountability Initiative

1999 1999 2000 2000 2001 2001 2002 2002 2003 2003 2004 2004 2005 2005 2006 2006 2007 2007 2008 2008 2009 2009 2010 2010 2011 2011 2012 2012 2013 2013 New Mexico 15 15 15.2 15.2 14.4 14.4 16.3 16.3 19 19 16.3 16.3 19.8 19.8 21.4 21.4 22.5 22.5 26.4 26.4 21.6 21.6 23.3 23.3 25.9 25.9 24.1 24.1 21.8 21.8 Bernali lillo llo County 20.6 20.6 20.7 20.7 20.6 20.6 23.8 23.8 24.9 24.9 19.6 19.6 26.2 26.2 26.7 26.7 27.4 27.4 34 34 25.8 25.8 26.7 26.7 29.6 29.6 28.1 28.1 22 22

5 10 15 20 25 30 35 40 Deaths per 100,000 population

Total Overdose e Death Rates, Bernali lillo llo Co. & N & NM, 19 1999-2013 13

• 26%

26%

• 16%

16%

5 10 15 20 25 30 35

Deaths s per 100,000 people people

Drug Overdose e Death Rates by Ty Type, Bernali lill llo County, 1990 1990-2013 13

Total Rx illicit Both

Rates are age adjusted to the US 2000 standard population

2008 2009 2010 2011 2012 2013 New Mexico 3.2 3.8 4.4 6.1 7.8 9.1 Bernalillo 5.0 7.0 7.7 9.5 13.1 14.7 US 2.8 3.6 5 5.2 6.1 0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 16.0

Rate per 1,000 live births

Rate of N Neonatal l Abstinenc nce e Syndrome me (NAS) Hospital l In-Patie ient nt Discharg rges es, , Bernali lillo llo Co., New Me Mexico (NM), & t the US US (2008 (2008-201 013)

10,000,000 20,000,000 30,000,000 40,000,000 50,000,000 60,000,000 2006 2007 2008 2009 2010 2011 2012 2013

MME of buprenorphine

MME of B Buprenor

• rph

phine ne with Naloxone ne (Suboxo xone ne) Filled, Filled, Bernalil Bernalillo lo Co., Co., 2006 2006- 2013 2013

Source: NM PMP

2010 2011 2012 2013 Bernalillo Co - Male 103.7 132.8 107.9 119.6 Bernalillo Co - Female 107.5 117.1 107.8 117.2 NM - Male 93.5 123.1 118.6 120.2 NM - Female 103.4 126.9 119.5 124.2 0.0 40.0 80.0 120.0 160.0

Rate per 100,000 people

Total Drug P Poisoning Emergency Department Related Visits By S Sex, Bernalillo Bernalillo County County & & New M Mexico, 2010 2010-2013 2013

2010 2011 2012 2013 Bernalillo Co - Male 59.6 82.2 66.5 69.2 Bernalillo Co - Female 40.0 47.2 52.5 58.5 NM - Male 50.3 67.7 63.5 68.4 NM - Female 42.8 49.9 54.8 51.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0

Rate per 100,000 people

Opioid d Poisonin ing g Emergency cy Departmen ent t Related ed Visits By S Sex, Bernalil illo lo Co. & New Mexico, 2010 2010-201 013

2010 2011 2012 2013 Bernalillo Co - Male 39.9 55.7 46.2 44.3 Bernalillo Co - Female 16.2 22.1 23.2 23.8 NM - Male 27.8 36.3 35.7 37.3 NM - Female 11.5 14.3 16.4 16.4 0.0 10.0 20.0 30.0 40.0 50.0 60.0 Rate per 100,000 people

Heroin n Poisonin ing g Emergency cy Departmen ent t Related Visits s By S Sex, Bernalil illo lo Co. & New New Mexico, , 2010 2010-20 2013 13

2010 2011 2012 2013 Bernalillo Co - Male 42.0 24.4 53.8 44.2 Bernalillo Co - Female 51.1 37.4 62.1 45.2 NM - Male 46.6 55.1 56.0 43.9 NM - Female 65.5 62.2 66.0 49.8 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0

Rate per 100,000 people

Total Drug Poisoning ng Hospital l In- patient nt Discharge ges By S Sex, Bernalill llo

• Co. & N

New M Mexico, , 2010 2010-201 013

2010 2011 2012 2013 Bernalillo Co - Male 24.2 13.1 31.6 24.4 Bernalillo Co - Female 24.3 15.3 31.5 20.5 NM - Male 24.6 26.1 29.0 20.9 NM - Female 28.9 24.0 31.5 19.9 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0

Rate per 100,000 people

Opioid d Poisonin ing g Hospital l In-patie ient nt Dischar arge ges By S Sex, Bernalill llo

• Co. &

& New New Mexico, Mexico, 2010 2010-201 013

2010 2011 2012 2013 Bernalillo Co - Male 6.2 3.3 10.2 8.6 Bernalillo Co - Female 1.1 1.5 4.8 2.2 NM - Male 5.6 5.9 6.8 6.4 NM - Female 1.7 1.0 3.4 1.9 0.0 2.0 4.0 6.0 8.0 10.0 12.0 Rate per 100,000 people

Heroin n Poisonin ing g Hospital l In-patie ient nt Dischar arges ges By Se Sex, Bernalill llo

• Co. &

& New New Mexico,

• , 2010

2010-2013 13

2007 2009 2011 2013 Bernalillo Co. 12.8 15.2 10.8 10 New Mexico 11.7 14.3 11.3 8.5 2 4 6 8 10 12 14 16

Percent (%)

YRRS YRRS - Used Used Painkil ille ler r to Get High, Grades s 9-12, 12, Bernal alil illo lo Co. & N New Mexico co, , 2007-2013 2013

2007 2009 2011 2013 Bernalillo Co. 4.6 4.9 4.8 4.8 New Mexico 3.9 3.2 3.2 2.9 1 2 3 4 5 6

Percent (%)

YRRS YRRS - Current t Heroin Use, Grades 9-12, 12, Bernali lill llo Co. & & N New M Mexico, 2007-2013 13

80 71 126 138 119 205 122 457 709 770 731 786 880 608 553 924 1012 1287 1048 1273

100 200 300 400 500 600 700 800 900

500 1000 1500 2000 2500 2010 2011 2012 2013 2014 Counts of Reversals Counts of Enrollees

DOH DOH-PHD PHD-Ha Harm rm Reducti tion n Service ces s - Number r of Enrolle lees es (Lines es) ) and Reporte ted d Opioid id-Ov Over erdos

• se

e Reversa sals s (Bars), ), Bernal alil illo lo Co. & N New Mexico co, , 2010-2014 2014*

Bernalillo New Mexico New Mexico Bernalillo

*Data through October 2014 *NMDOH-ERD: 2013: 82 enrollees in NM; 2014: 86 Enrollees in Bernalillo Co., 249 in NM, 6 Reversals in NM

DOH DOH-PHD PHD-Harm Harm Reduction Reduction Services Services & & DOH DOH-ERD ERD-Co Co-Prescr cripti tion n Pilot Program N Naloxone Program Participation Participation – Enrollees Enrollees and and Doses Dispensed, Bernalillo Bernalillo Co.

• Co. &

& New New Mexico, Mexico, 2013 2013-2014* 2014*

County of Residence Residence Enrollees Enrollees 2013 2013 2014 2014 Harm Harm Reduction Reduction Co Co- Prescription Prescription Pilots Pilots Total Total Harm Harm Reduction Reduction Co Co- Prescription Prescription Pilots* Pilots* Total Total Bernalillo Bernalillo 608 (1,355) 608 (1,355) 553 (1,593) 86 (172) 639 (1,765) New M Mexico 1,048 (3,620) 82 (172) 1130 (3,792) 1273 (4,753) 249 (536) 1,522 (5,289)

For both, Harm Reduction and Co-Prescription Pilots (Data through October 2014), the numbers represent New Mexico Residents Enrolled. Numbers in parenthesis represent doses dispensed. *Co-Prescription Pilots: The total of enrollments include 86 enrollees of the UNM Chronic Pain Clinic (ascribed to Bernalillo County), 1 from San Miguel Co. Detention Center, and 25 from Santa Fe DC. For the former two sites no data on date of enrollment was available by the time this report was prepared

County of Residence OD Reversals ("Saves") 2013 2014 Harm Reduction Co- Prescription Pilots Total Harm Reduction Co- Prescription Pilots Total Bernalillo 138 138 119 119 New Mexico 709 709 770 6 776

DOH DOH-PHD HD-Ha Harm rm Reductio Reduction Service Services s & & DOH DOH-ERD ERD-Co Co-Pr Pres escri ript ption

• n

Pilot Program Number Number of R Reported d Reversals ls, Bernali lillo llo Co. & & New New Mexico, Mexico, 2013 2013-2014 14

*Many of the agencies have mobile services, which makes the assignment of Small Areas difficult in those instances

*Many of the agencies have mobile services, which makes the assignment of Small Areas difficult in those instances

*Many of the agencies have mobile services, which makes the assignment of Small Areas difficult in those

BARRIERS/OBST BARRIERS/OBSTACL ACLES/ ES/CHALL LLENG NGES

• Huge S

Size of the County

• Identifying and getting to know key

Identifying and getting to know key stakeholders stakeholders

• Lack o
• f access to key stakeholders/leaders
• Lack o
• f sense of overall community – many communities that

function function autonomously autonomously

• Non

Non-alignment of priorities among stakeholders alignment of priorities among stakeholders and leaders and leaders

• Lack o
• f resources
• Stigma/indifference

Stigma/indifference

• Lack o
• f political will / our needs low on priority list

list

• Not

Not enough volunteers enough volunteers relative to the relative to the amount of work amount of work

• Difficult

Difficult to to get get MDC inmates signed MDC inmates signed up for up for Medicaid Medicaid