Outline RxSafe Marin overview Safe Prescribing Guidelines - - PowerPoint PPT Presentation

Outline

 RxSafe Marin overview  Safe Prescribing Guidelines

 Decreasing total opioid prescriptions  Decreasing benzodiazepine and opioid co-prescription

 Increasing community awareness of opioid risks  Increasing options for safe medication disposal

Call to Action: Marin County

41,518 104,625

20,000 40,000 60,000 80,000 100,000 120,000

2004 2013

198 222 289 300 295 344 471

2006 2007 2008 2009 2010 2011 2012

Number of Non-fatal ED visits

Narcotic Prescriptions Emergency Department Narcotic Related Visits

Non-Medical Use of Pharmaceuticals: Marin County 11th Graders

17% 13% 10% 7% 4% 3% 17% 22% 7% 7% 7% 3% 0% 5% 10% 15% 20% 25% Pain Killers Cold/Cough Stimulants Sedatives Diet Pills Barbiturates

Marin County California

Source: California Healthy Kids Survey, 2009-2012

What can we do as a community to prevent prescription drug misuse and abuse and save lives?

The Life of a Pill

Manufacture Marketing Prescribers Pharmacists Community Safe Use Unsafe Use Disposal

Public Health Approach

• “Every system is perfectly designed to get the results that it

gets.” – Paul Batalden, MD

• What are the key parts of the “system”?

– Healthcare, law enforcement, policymakers, community members, schools, public health, business etc.

• What are the results of the system?

– Overdose deaths – Addiction and dependence – Misuse

• How do we re-create the system to support safe medication

use?

Community Based Prevention Action Team Data Collection and Monitoring Action Team Law Enforcement Action Team Intervention, Treatment and Recovery Action Team Steering Committee: Data, Messaging, Policy

Representatives from: Marin County Office of Education, Marin County HHS, Healthy Marin Partnerships, Residents

Backbone Support: HHS

Prescribers and Pharmacists Action Team

• Goals:
• Reduce total amount of narcotics prescribed in Marin

County by 15% annually 2014-2016

• Increase doctors promoting proven non-opioid alternatives

for managing chronic pain

• Actions:
• Adopt safe prescribing guidelines for emergency rooms

and clinics

• Create infographics of proven alternatives for MDs to use

with patients

Strategic Goal: Prescribers and Pharmacists Action Team

Opioid Prescriptions in Marin County

Prescribing Guidelines Excerpt

• F. CAUTIONS REGARDING CO-MORBIDITIES OR

INTERACTIONS

• Caution should be used in patients taking
• ther sedatives, including alcohol,

antihistamines and benzodiazepines, as such use increases the risk of over-sedation and adverse events.

Opioid and Benzo Co-Prescribing by Age; Marin County, 2012-2015

2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 Younger than 15 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 and older Total Number of Patients Number of Patients on Opioids 2012-13 Number of Patients Co-Prescribed within 30 days 2014-15

Opioid and Benzo co-prescribing by age; Marin County, 2012-2015

6% 14% 15% 18% 23% 26% 27% 28% 42%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Younger than 15 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 and

• lder

Number on Opioids and Benzos within 30 days of each other Number on Opioids Alone

Prescribing Guidelines Excerpt

• B. PATIENT AND FAMILY INFORMATION
• Patients being offered opioids should be made

aware that opioids are the leading cause of drug overdose deaths nationally

Strategic Goal: Community Based Prevention Action Team

• Goal:
• Residents make informed and responsible choices

regarding prescription opioids

• Actions:
• Develop communication campaign highlighting the risks of
• pioid use

Prescribing Guidelines Excerpt

• H. SAFE STORAGE AND DISPOSAL
• Patients should receive education and

information on safe storage and disposal or return of controlled substances.

Strategic Goal: Law Enforcement Action Team

• Goal:

– Community members will have more locations where they can safely and conveniently dispose of unwanted medicines

• Actions:

– Adopt county-wide ordinance for safe medication disposal

Take-back Forum Key Stakeholders Represented

Environmental Interests Recovery Treatment Regional Partners Pharmacists Law Enforcement and Fire Probation / DA County Counsel Seniors Education Medical Waste Pharmaceutical Manufacturing Water and Sanitation Local Government Physicians HHS Representatives Stewardship Programs

Take-back Forum: Identified Challenges

• Drugs being misused are coming from medicine

cabinets

• Unintended environmental harm from home

disposal

• Existing disposal system is inadequate
• Lack of funding and resources to host additional

take back bins and events

• Manufacturers don’t share responsibility for

disposal

Prescription Drug Take Back Site Interactive Map

Recommendation:

• Marin County Board of Supervisors consider

an ordinance requiring drug manufacturers to share responsibility for designing, implementing, and maintaining a county-wide system for the safe and convenient disposal of unwanted medications for all Marin County residents.

Stay connected! www.RxSafeMarin.org Facebook.com/RxSafeMarin RxSafeMarin@gmail.com

THANK YOU