Opioid Task Force Kick-Off Meeting February 29, 2016 Scope of the - - PowerPoint PPT Presentation

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Opioid Task Force Kick-Off Meeting February 29, 2016 Scope of the - - PowerPoint PPT Presentation

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Opioid Task Force Kick-Off Meeting February 29, 2016 Scope of the Opioid Problem and Data Review Olivia Kasirye, MD, MS County Public Health Officer OVERVIEW The Opioid Epidemic Opioid Task Force Development Prevention Strategies

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Opioid Task Force Kick-Off Meeting

February 29, 2016

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Scope of the Opioid Problem and Data Review

Olivia Kasirye, MD, MS County Public Health Officer

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 The Opioid Epidemic  Opioid Task Force Development  Prevention Strategies

OVERVIEW

Opioid Task Force Kick-Off Meeting

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The Opioid Epidemic

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Definition: Opioids are any of various compounds that bind to specific receptors in the central nervous system and have analgesic (pain relieving) effects including prescription medications such as oxycodone (OxyContin), hydrocodone (Vicodin), morphine, methadone, codeine and illicit substances such as heroin and fentanyl.

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Adverse Effects of Opioids on the Brain

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 Since 2000, the rate of deaths from drug overdoses has increased 137%, with a 200% increase in deaths due to

  • pioids*

 Nearly 2 million Americans age 12 or older abused or were dependent on opioids in 2013**  20% to 30% of opioids prescribed for chronic pain are being misused***  Rate of addiction is 10%***

National Statistics

Sources: *MMWR/January 1, 2016/Vol.64/ **CDC National Center for Health Statistical Vital Statistics Report ***International Association for the Study of Pain Opioid Task Force Kick-Off Meeting

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 23% report having abused Rx medication at least once in their lifetime  31% believe “it’s okay to use prescription drugs that were not prescribed to them to deal with an injury or pain, as long as they are not getting high”  22% say their parents don’t care as much if they are caught using Rx drugs without a prescription, compared to getting caught with illegal drugs.

Teen Prescription Drug Misuse & Abuse

Source: US DEA Office of Diversion

Opioid Task Force Kick-Off Meeting

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Opioid Task Force Kick-Off Meeting

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Opioid Task Force Kick-Off Meeting

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Opioid Task Force Kick-Off Meeting

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Opioid Task Force Kick-Off Meeting

DEA EATH THS BY O OPIOID D POISO SONING (2006-2013) 2013)

YEAR 2006 06 2007 07 2008 08 2009 09 2010 10 2011 11 2012 12 2013 13

CALIFORN RNIA IA 1,469

469 1,65 651 1,784 84 1,971 971 1,909 909 1,898 898 1,712 712 1,934 34

SACRA CRAME MENTO TO COUNTY TY

106 106 79 79 94 94 83 83 89 89 68 68 64 64 111 111

 14,328 Deaths in California from 2006-2013  694 Deaths in Sacramento County from 2006-2013

Source: California Department of Public Health EpiCenter Injury Online Database

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Opioid Task Force Kick-Off Meeting

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Opioid Task Force Development

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Opioid Task Force Kick-Off Meeting

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 Identify and implement numerous high priority initiatives  Share resources & knowledge  Provide coordinated provider & community education  Develop policy recommendations & best practices

Purpose of Opioid Task Force

Opioid Task Force Kick-Off Meeting

the opioid epidemic!

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 Quarterly meetings beginning February 2016  Subcommittees

  • 1. Engaging Medical community, overdose prevention
  • 2. Public education, media and advocating for change
  • 3. Early intervention, treatment, and recovery
  • 4. Safe medication disposal

Structure of Opioid Task Force

Opioid Task Force Kick-Off Meeting

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Who Are The Players?

 Alcohol & Drug Services  Behavioral Health  Emergency Services  Hospitals & Service Providers  Dept. of Human Assistance  Law Enforcement  Non-profits & community groups  Public Health  Pharmacies  Probation  Schools & Universities  Social Services  Waste Management  Youth Representatives  Not exhaustive - others?

Opioid Task Force Kick-Off Meeting

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Prevention Strategies

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Opioid Task Force Kick-Off Meeting

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Understanding the Local Epidemic

Data Sources

Prescription data

  • CURES database

Death & Injury Data

  • Multi-cause of death files
  • OSHPD Hospital ED &

Patient discharge data

Analysis

Identify high prescribers,

unsafe prescribing etc.

Look at trends,

distribution, populations affected

Opioid Task Force Kick-Off Meeting

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Access to Resources

Opioid Task Force Kick-Off Meeting

Disseminate Information

  • Provider newsletters
  • Community education
  • Patients
  • Parents & teens
  • Older adults
  • Poison Control

Resource Availability

  • Treatment & referrals
  • Substance abuse
  • Mental health
  • Pain management
  • Support groups
  • Naloxone
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Current Treatment Available and Need for Capacity Building

Uma K. Zykofsky, LCSW Director, Behavioral Health Services Alcohol & Drug Administrator

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 Prevention  Self-Motivation for Treatment  Mandated Treatment  Partnerships/Collaborations  Evidence-Based Practices  Appropriate length and type of treatment episodes based on need  Balanced continuum of care inclusive of all types of treatment, sober

living environments, and recovery support services

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What Works and Leads to Positive Outcomes?

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  • Prevention Services
  • Education Services-DUI Programs
  • Outpatient Treatment Services
  • Intensive Outpatient Treatment Services
  • Medication-Assisted Treatment
  • Detoxification & Residential Treatment Services
  • Transitional Housing/Sober Living Environments

Handout: Alcohol & Drug Services Continuum of Care

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Alcohol and Drug Services Continuum of Care

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Countywide Collaborations

 Jail/Corrections  Public Health  Primary Health  Child Protective Services  Mental Health  Dept. of Human Assistance  Probation

Community Collaborations

 Contracted Providers  Community-Based

Organizations (CBOs)

 Prevention Initiatives

(Coalition)

 Sacramento Steps Forward

(Homeless Services)

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  • Driving Under the Influence (DUI) Programs
  • Drug Diversion Program
  • Prop 36 Program
  • Adult Drug Court
  • Juvenile Drug Court
  • Co-Occurring Mental Health Court
  • In Custody Alcohol and Drug Screening and

Assessments-Jail/Department of Corrections

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Collaborations with Criminal Justice

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Public Health

  • Opioid Task Force Development
  • Human Immunodeficiency Virus (HIV) Services
  • Sexually Transmitted Disease (STD) Services

Primary Health

  • Primary Care Center Alcohol and Drug Screenings
  • Case Management Services
  • Linkage to Appropriate Alcohol and Drug Treatment

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Collaborations with Public Health & Primary Health

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Nationally Recognized Family Drug Courts

  • Dependency Drug Court
  • Early Intervention Family Drug Court (EIFDC)
  • These courts refer clients to outpatient treatment, residential

treatment, detox, and case management/recovery support services

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Collaborations Child Protective Services

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  • Homeless Services (Guest House)
  • Alcohol and Drug Assessment and Referral
  • Education Groups, Outreach
  • Co-Occurring Mental Health Court Services
  • Outpatient Treatment
  • Residential Treatment
  • CalWORKs Program (Mental Health & Dept. of Human Assistance)
  • Outpatient Treatment
  • Detox, Residential Treatment
  • Mental Health Navigators
  • Linkage to services

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Collaborations with Mental Health

Opioid Task Force Kick-Off Meeting

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Modality Total Number Admissions Number of Admissions Opiates as Primary Drug of Choice % of Clients with Opiates as Primary Drug of Choice Outpatient - Adult 1,985 186 9% Outpatient - Youth 567 9 2% Residential 1,058 201 19% Detoxification 335 103 31% Medication-Assisted Treatment 2,159 2,139

99%

TOTALS 6,104 2,638*

43%

Alcohol & Drug Services Treatment Data Fiscal Year 2014-15

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Current Challenges

 Increased Service Demand

  • Residential Treatment
  • Detoxification Services
  • Medication-Assisted Treatment

 Need for Capacity Building  Limited Funding

  • Residential Treatment
  • Detoxification Services

 Wait Lists = Delay in Treatment

  • Residential Treatment
  • Detoxification Services

 Lack of

  • Sober Living Environments
  • Aftercare Services
  • Y
  • uth Residential Facilities
  • Re-entry/Support Services

 Limited Targeted Services

  • Severely Mentally Ill
  • Homeless
  • Developmentally Disabled
  • Older Adults

 Access to Care

  • Locations
  • Transportation

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Residential Treatment Services

  • Increased demand for Residential Treatment
  • Residential Treatment Facilities for Adults Only
  • No Youth Residential Treatment Facilities
  • Limited capacity due to funding constraints
  • Total Beds = 319
  • Average Wait Time = 3 months

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Detoxification Services

  • Increased demand for Detox Services
  • Detox Facilities for Adults Only (only 4 providers)
  • No Youth Detox Facilities
  • Limited capacity due to funding
  • Total Beds = 12
  • Average Wait Time = 30-45 days

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 4 contracted MAT Service Providers (Methadone Providers)  5 locations  Need to increase capacity  MAT keeps people productive, in the workforce and helps to

stabilize and improve level of functioning

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Medication-Assisted Treatment (MAT)

Number of MAT Clients Served Fiscal Year 2013-14 Number of MAT Clients Served Fiscal Year 2014-2015 % Increase From Prior Year 1,300 2,150 65%

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 Increase Collaboration/Partnerships  Prevention, Education and Awareness  Capacity Building for Treatment Services  Explore Funding Opportunities  Decrease Waitlists

 Coordinate with current Prevention

and Statewide efforts

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 Improve Substance Use Disorder Services through a

Statewide organized service delivery system

 Full continuum of multiple levels of funded evidence-

based services

 Increase program oversight, compliance and quality

assurance

 Improve coordination with other service systems

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ON THE HORIZON: Drug Medi-Cal (DMC) Organized Delivery System (ODS) Waiver Goals

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*5-Year State-Wide Demonstration Project*

53 Counties Expressed Interest

  • Phase I Bay Area (in progress)
  • Phase II Southern California
  • Phase III Central Valley (Sacramento County)
  • Phase IV Northern California
  • Phase V Tribal Delivery System

Steps for Waiver

1.

County to develop Implementation Plan

2.

County to develop Fiscal Plan

3.

Department of Health Care Services to approve County rates

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DMC-ODS Waiver Implementation

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Drug Medi-Cal Waiver Services & Requirements (Opt-in Model)

Requirements

Coordination with Criminal Justice and Hospitals Increased Quality Assurance

BOLD = new services and requirements

Services

Early Intervention Outpatient Services Residential Treatment Medication-Assisted Treatment (MAT) Withdrawal Management Additional Medication-Assisted Treatment (MAT) Recovery Services Case Management Physician Consultation

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