The Scope of the Opioid Epidemic in Wisconsin A State-Level Perspective Anthony (AJ) Ernst, Ph.D., LMSW-ACP Section Chief, Substance Abuse Services Division of Care and Treatment Services September 29, 2016 Protecting and promoting the health and safety of the people of Wisconsin
I have no financial disclosures to make. 2
Presentation Objectives • Describe the current scope of the opioid misuse epidemic in Wisconsin. • Describe efforts to address gaps in prevention and treatment of substance use disorders in Wisconsin.
Opioids • Morphine • Codeine Naturally occurring opioids- also called opiates • Thebaine • Diacetylmorphine (Heroin) • Hydrocodone (Vicodin) Semi-synthetic • Oxycodone (Oxycontin) opioids • Oxymorphone (Opana) • Hydromorphone (Dilaudid)
U.S. Overdose Epidemic Driven by Opioid Pain Relievers 18,000 Rx Opioids Heroin 16,000 Cocaine 14,000 16,235 Rx Opioid Deaths in Benzodiazepines 2013 12,000 Benzodiazepines + Rx Opioids Methadone 10,000 4,030 opioid 8,000 deaths in1999 6,000 4,000 2,000 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Original Data CDC Matt Gladden, CDC 5
Drug Overdose Deaths in Wisconsin 450 Opioid Pain Relievers 400 350 Number of deaths 300 Heroin 250 Benzodiazepines 200 150 Cocaine 100 50 0 Year Source: Wisconsin Department of Health Services, Office of Health Informatics 6
Majority of Opioid Overdose Hospital Visits in Wisconsin Involve Prescription Opioids 60 2,990 50 40 2,035 30 20 990 10 0 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 All opioids Rx opioids Heroin Source: Office of Health Informatics, DPH Death certificates (2010-2014)
New Hepatitis C Infections Source: Office of Health Informatics, DPH Death Certificates, WEDSS HCV Data 8
Rate of Deliveries With Maternal Opioid Use and Rate of Neonatal Abstinence Syndrome, Wisconsin, 2009–2014 From: Neonatal Abstinence Syndrome and Maternal Substance Use in Wisconsin, 2009-2014. Karina A. Atwell, MD; Harold B. Weiss, PhD, MPH, MS; Crystal Gibson, MPH; Richard Miller, MS; Timothy E. Corden, MD 9
Rx Opioid Deaths are Highest in Middle Age, Heroin Deaths are Highest in Young Adults Wisconsin, 2010-2014 (5-Year Average) 15 Rx drugs 13 Rate per 100,000 Pop. Heroin 11 9 7 5 3 1 -1 <15 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ Age Source: Office of Health Informatics, Division of Public Health Death Certificates (1999-2014) 10
A Comprehensive Approach to Behavioral Health Factors • Knowledge • Genetics • Nutrition • Attitude • Rest • Beliefs BODY MIND • Exercise • Hygiene • Religion • Housing SPIRIT WORLD • Higher • Work Power • Friends • Inner • Opportunities Strength
State Funded Services • Medication-Assisted • Clinical Approaches Treatment (MAT) • MAT • CCS • Comprehensive Community Services (CCS) • ROSC • Recovery-Oriented MIND BODY Systems of Care (ROSC) • Prevention WORLD Environmental SPIRIT • Faith-Based Services Strategies, Coalitions.. • CCS • ROSC • Peer Respite Services • Peer Certification
The Opioid Epidemic Solution: Working Together Tracking and Education Monitoring Enforcement • Prescriber • Prescription Drug • Identification verification at education Monitoring System pharmacies • Community (PDMP) • Law enforcement training on • Surveillance education prescription drug misuse and diversion • Naloxone Reversal access • Naloxone Access Medication Disposal Treatment Options Keeping medications safe at home • Medication assisted treatment • • Proper medication disposal guidelines • Outpatient and residential treatment at state-funded treatment providers consistent with FDA standards • Community take-back programs Policies Supporting all sectors
Resources • Alliance for Wisconsin Youth: www.allwisyouth.org • Substance abuse programs: https://www.dhs.wisconsin.gov/regulations/aoda/sa- only-directory.pdf • Opioid treatment: https://www.dhs.wisconsin.gov/opioids/treatment.h tm • “Reducing Wisconsin’s Prescription Drug Abuse: A Call to Action” https://scaoda.wisconsin.gov/scfiles/prevspf/FINAL0 1032012CSWReport.pdf
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