Managing the Effect cts of Op Opio ioid ids s on Your Pool - - PDF document

5/16/18 1

Managing the Effect cts of Op Opio ioid ids s on Your Pool

Battling the Opioid Crisis: It Takes All of Us Working Together

Government Communities and Support Systems Insurance Providers FDA and Pharma Medical Associations and Boards Health Care Providers

5/16/18 2

What are Opioids? Opioid ioids = = op

• pia

iates = = narcot

• tics

ics

Common Immediate Release:

• Vicodin (hydrocodone)
• Percocet, OxyIR (oxycodone)
• Dilaudid (hydromorphone)
• Opana (oxymorphone)
• Nucynta (tapentadol)
• Ultram (tramadol)

Common Long-Acting:

• Opana ER (oxymorphone ER)
• MS Contin (morphine ER)
• Methadone
• OxyContin (oxycodone ER)
• Butrans (buprenorphine patch)
• Duragesic patches (fentanyl)

Credit: MedCost

CDC: Centers for Disease Control and Prevention; www.cdc.gov

Someone in the United States dies approximately every 12 minutes due to an opioid-related drug overdose

5/16/18 3

Opioid Risks

Addiction Physical Dependence Drug Interactions Overdose Abuse Tolerance

Benzodiazepines –Xanax, Valium, Klonopin Muscle Relaxers Alcohol Antidepressants –Prozac, Lexapro, Zoloft Mixed Agonist/Antagonist and Partial Agonist Opioid Analgesics – Butrans, buprenorphine NOT A COMPREHENSIVE LIST! Many interactions can lead to hypotension, profound sedation, respiratory depression, coma and even death Credit: MedCost

Understanding the Opioid Epidemic

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention https://www.cdc.gov/drugoverdose/epidemic/index.html

1999 - 2016

630,000 Deaths

from Drug Overdose Overdose Deaths Involved an Opioid

2016

66%

Opioid Overdose Deaths

5 Times Higher in

2016 than in 1999

Credit: MedCost

5/16/18 4

The Opioid Epidemic – Closer Than You Think

70%

• f abused

prescription

• pioids come

from a friend

• r relative2

Obtained from US National Survey on Drug use and Health, 2008-2011.

10 20 30 40 50 60

Past-Year Non-Medical Users

Percent of Users

Sources of Prescription Opioids Among Past-Year Non-Medical Users2,3

Given by friend or relative for free Prescribed by > 1 physicians Stolen from friend or relative Bought from friend or relative Bought from drug dealer

• r other stranger

Other

60%

• f US citizens

have left over prescription narcotics in their home1

5/16/18 5

A Problem Unique to the U.S.

80%

• f all prescription
• pioids are written

and consumed in the United States1 CDC – US State Prescribing Rates 2016

1 National Institute on Drug Abuse 2 IMS Health, National Prescription Audit (NPATM). Cited in internal document: Preliminary Update on Opioid Pain Reliever (OPR) Prescription Rates Nationally and by State: 2010-2013.

2013

250,000,000

Prescriptions for Opioids This is enough for every American adult to have their own bottle of pills2

Source: U.S. Centers for Disease Control

5/16/18 6

The Arkansas Story

• Population < 3 Million People
• Drug companies sold 235,934,613 opioid pills in 2016.
• Opioids are the top-selling class of prescription drug in Arkansas (more than

twice as prevalent as the next).

• Manufacturers and distributors supplied nearly 2B mg of opioids to Arkansas

pharmacies in 2015.

• There are more opioid prescriptions in Arkansas than people
• Drug companies sell enough opioids in Arkansas for every man, woman, and child to

each take 80 pills per year.

• Overdose deaths in Arkansas have ballooned 262% from 5.1 per 100,000 citizens

in the year 2000 to 13.4 per 100,000 in 2016.

• Number of drug overdose deaths rose to 401—at least 335 of which are opioid-related

(2016 – Arkansas)

• Arkansas’s near-tripling in overdose deaths between 2000 and 2015 coincides with a

span in which opioid sales have quadrupled.

Source: Arkansas Municipal League

5/16/18 7

Vermont

5/16/18 8

+

POWERED BY DOMO | exported 23 Apr 2018

CIS Oregon Work Comp Program: Highest Rx Total Usage

All Time 171K Sum of RxPrice

5/16/18 9

+

POWERED BY DOMO | exported 23 Apr 2018

CIS Oregon Work Comp Program: Highest Rx per tablet

All Time 171K Sum of RxPrice

Prescription for Battling the Opioid Crisis

5/16/18 10

Re Resources

Federal government: Centers for Disease Control and Prevention

• The “Map:” https://www.cdc.gov/drugoverdose/maps/rxcounty2016.html
• “Overdose:” https://www.cdc.gov/drugoverdose/index.html
• “Understanding the Epidemic” https://www.cdc.gov/drugoverdose/epidemic/index.html

National League of Cities

• A Prescription for Action (2016 Report conducted jointly with NACo)
• https://www.nlc.org/article/a-prescription-for-action-ending-the-opioid-crisis
• Opioid Use Disorder: City Actions and Opportunities to Address the Epidemic
• https://www.nlc.org/resource/opioid-use-disorder-city-actions-and-opportunities-to-address-the-epidemic
• Prescription Drug Discount Program through CVS Caremark
• U.S. Communities Program – Discount for Narcan
• How Cities Can Fight the Opioid Epidemic With Life-Saving Medications (CitiesSpeak Blog): https://bit.ly/2KsRlSq

National Safety Council

• Prescription Nation 2018: Facing America’s Opioid Epidemic
• http://safety.nsc.org/prescription-nation-facing-americas-opioid-epidemic

Arkansas Municipal League & Association of Arkansas Counties

• Lawsuit against opioid manufacturers and distributers
• https://www.arcounties.org/site/assets/files/3397/2018-04-02secondamendedcomplaint.pdf