Dr. Greg Lakin Chief Medical Officer Kansas Substance Use Disorder Central Authority Kansas Department of Health and Environment The Opioid Crisis – National and State Perspectives November 07, 2018
The Opioid Crisis in Kansas What is the Opioid Epidemic? To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas The Problem • In 2016, there were 63,632 drug overdose deaths in the United States In 2017, there were 72,000+ overdose deaths, 2/3 of which were linked to opioids. More than were ever killed by: guns, MVA, or HIV/AIDS in a single year. To protect and improve the health and environment of all Kansans
Division of Public Health The Opioid Crisis – National and State Perspectives To protect and improve the health and environment of all Kansans
Division of Public Health The Opioid Crisis – National and State Perspectives Background • In 2016, there were 63,632 drug poisoning deaths in the United States • 2017 provisional data – 70,467 deaths from 12/2016 – 12/2017 • Drug poisoning is the leading cause of unintentional injury death in the U.S. • Unintentional injuries became the 3 rd leading cause of death in 2016 • U.S. life expectancy decreased in 2015 and 2016 To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas • Drug poisonings are the leading cause of unintentional injury death in the U.S. • Unintentional injuries became the 3 rd leading cause of death in the U.S. in 2016 • The U.S. population’s average life expectancy decreased by 0.1 year in both 2015 and 2016 • 2017 trending toward another drop in life expectancy due to drug related deaths. To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas Image Source: CDC. Available at: https://www.cdc.gov/drugoverdose/epidemic/index.html To protect and improve the health and environment of all Kansans
Division of Public Health The Opioid Crisis – National and State Perspectives To protect and improve the health and environment of all Kansans
Division of Public Health The Opioid Crisis – National and State Perspectives 42,249 of the 63,632 U.S. drug overdose deaths involved a prescription or an illicit opioid To protect and improve the health and environment of all Kansans
Division of Public Health The Opioid Crisis – National and State Perspectives National Drug Overdose Mortality Rates • Gender – Males (26.2 deaths per 100,000) • Age – 35-44 (35.0 deaths per 100,000) • Race – Non-Hispanic whites (25.3 deaths per 100,000) Image source: National Center for Health Statistics To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas • Most who reported prescription opioid abuse prior to heroin cited accessibility and cost as primary factors for the heroin use/ transition. Source: Cicero TJ, Ellis MS, Harney J. Shifting patterns of prescription opioid and heroin abuse in the United States. New England Journal of Medicine. 2015 Oct 29;373(18):1789-90. To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas What is Happening in Kansas? To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas Kansas Drug Poisoning Death Rates/Counts 2005-2016 To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas Drug Poisoning Mortality in Kansas • 310 drug poisoning deaths in 2016 • 104 caused by natural or semi-synthetic opioids 36 caused by heroin • • Drug poisoning death rate decreased 8% in 2016 compared to 2015 To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas What is K-TRACS? 1 2 3 4 Secure, 24/7 Pharmacies PMP Advisory K-TRACS data is web- are required to privileged and Committee accessible report confidential composed of database, that outpatient prescribers and • Pharmacists and monitors prescriptions pharmacists Prescribers MAY Schedule II-IV daily. (Exempt access meets quarterly controlled – hospitals for • De-identified data and has authority substance inpatient care, available for to review/refer prescriptions, LTC, statistical, providers and and drugs of research or veterinarians, patients educational concern hospice) purposes dispensed in Kansas To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas Annual Average Age-adjusted Drug Poisoning Mortality Rate per 100,000 population by County, Kansas residents, 2010-2016 Data Source: 2010-2016 Kansas Bureau of Epidemiology and Public Health Informatics, Kansas Department of Health and Environment, Kansas Mortality Files. Only counties with at least 5 expected deaths per 100,000 population are shown due to unstable rates. To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas Annual Average Age-adjusted Opioid Poisoning Mortality Rate per 100,000 population by County, Kansas residents, 2010-2016 • 1,077 deaths from 2010 to 2016 were opioid-related deaths – any prescription opioids, heroin, or illicit opioid contributed to the death. Data Source: 2010-2016 Kansas Bureau of Epidemiology and Public Health Informatics, Kansas Department of Health and Environment, Kansas Mortality Files. Only counties with at least 5 expected deaths per 100,000 population are shown due to unstable rates. To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas Annual Average Age-adjusted Opioid Poisoning Mortality Rate per 100,000 population by County, Kansas residents, 2010-2016 • Six counties in Kansas had a rate higher than the 2016 national average of 13.3. • This is potentially an underestimate since there are drug poisoning deaths in Kansas that do not specific a drug. Data Source: 2010-2016 Kansas Bureau of Epidemiology and Public Health, Kansas Department of Health and Environment, Kansas Mortality Files. Only counties with at least 5 expected deaths per 100,000 population informatics are shown due to unstable rates. To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas • Patients with concurrent prescriptions for opioids and benzodiazepine is a risk factor for opioid poisoning and developing an opioid use disorder. • In 2017, there were 8 counties with at least 7% of county residents with concurrent prescriptions for opioids and benzodiazepine in 2017 . Image Source: http://www.preventoverdoseks.org/kpdo_data.htm To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas Having a mental illness, history of alcohol use disorder, or other substance use disorder is a risk factor for opioid poisoning and developing an opioid use disorder. County Level Prevalence of Depressive County Level Prevalence of Binge Drinker, Disorder, Kansas BRFSS 2015 Kansas BRFSS 2015 Numerator: Respondents who reported they had ever been Numerator: Male respondents having five or more told by a doctor, nurse or other health professional that they drinks on one occasion in the past 30 days or females have a depressive disorder (including depression, major having four or more drinks on one occasion in the past depression, dysthymia, or minor depression). 30 days. Denominator: All respondents, excluding unknowns and Denominator: All respondents, excluding unknowns refusals. and refusals. To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas Decreasing the Risk in the High Risk Population in Kansas? To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas Kansas Response • Established Kansas Prescription Drug and Opioid Advisory Committee to: • Development and implementation of a statewide strategic plan across multiple sectors to facilitate primary, secondary, and tertiary prevention activities for prescription and illicit drug abuse and overdose • Components: needs assessment, state plan, evaluation plan, and dissemination plan • Advisory Committee provides support to Governor’s Task Force on Substance Use Disorders To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas Kansas Response Substance Use Disorder Task Force • We have had six meetings since April 2018. The Task Force evaluated and prioritized recommendations by the Opiate Prescription Advisory Committee, as well as creating new recommendations in all aspects of SUD, including; prevention, education, neonatal abstinence syndrome, treatment, law enforcement and corrections. • The SUD Task Force submitted its final recommendations to Governor Colyer Sept. 1. To protect and improve the health and environment of all Kansans
The Opioid Crisis in Kansas Advisory Committee To protect and improve the health and environment of all Kansans
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