Wyoming Rodney A. Wambeam, PhD, Senior Research Scientist WYPCA in - - PowerPoint PPT Presentation

The Story of Opioid Use in Wyoming

Rodney A. Wambeam, PhD, Senior Research Scientist WYPCA in Casper, Wyoming May 16, 2018

May 16, 2018

The SEOW Report

https://wysac.uwyo.edu/wysac/projects/telling-the- story-of-opioid-use-in-wyoming-report/

Or go to wysac.uwyo.edu

Past Year Nonmedical Use

Figure 1: Past year nonmedical use of prescription pain relievers in Wyoming is comparable to the national average

Self-reported prevalence of nonmedical use of prescription pain relievers in the past year among U.S. civilians ages 12 and older living in Wyoming and the U.S.

5% 5% 4% 4% 4% 4% 5% 5% 5% 5% 4% 4% 4% 4% 3% 3% Wyom

• min

ing 5% 5% 5% 5% 5% 5% 5% 5% 5% 5% 5% 5% 5% 5% 4% 4% Natio ion 0% 5% 10% 15% 20% 2005-2006 2007-2008 2008-2009 2009-2010 2010-2011 2011-2012 2012-2013 2013-2014

Source: NSDUH, 2005-2014; Error bars represent 95% confidence intervals

Past Month Use

Figure 3: Past 30-day prescription drug misuse is more common among Wyoming high school students than middle school students

The percentage of Wyoming middle school (6th and 8th graders) and high school students (10th and 12th graders) who report using a prescription medication to get high in the past 30-days on one or more occasion.

1% 1% 2% 2% 1% 1% 1% 1% 1% 1% 6th & 8th grade des 6% 6% 6% 6% 4% 4% 3% 3% 3% 3% 10th h & 12th h grad ades

0% 5% 10% 15% 2008 2010 2012 2014 2016

Source: PNA, 2008-2016

Past Month Use

Figure 6: Nine counties exceed the state average in prescription medication misuse among high school students

The percentage of Wyoming high school students (10th and 12th graders) who report using a prescription medication to get high in the past 30-days on one or more occasions, broken down by county.

3.5% 1.5 2.2 5.5 3.6 3.2 2.6 4.0 5.3 10.5 3.4 2.1 2.6 4.2 3.5 2.7 1.9 4.2 3.8 7.4

0% 2% 4% 6% 8% 10% 12%

Wyoming Albany Big Horn Campbell Carbon *Converse *Crook Fremont Goshen *Hot Springs *Johnson Lincoln Natrona Park Platte *Sublette *Sweetwater Teton Uinta Washakie Source: PNA, 2012-2016

Young Adults

Figure 8: Majority of young adults deny lifetime misuse of prescription drugs

Percent of lifetime prescription drug misuse among Wyoming young adults ages 18-29.

No No 93% 93% Yes 7% 7%

Source: Wyoming Survey of Young Adults, 2016

Poisoning Deaths

Figure 10: Rates of poisoning deaths due to illicit and prescription opioids are stabilizing in Wyoming

Age-adjusted death rates per 100,000 population for opioid poisonings. Aggregate

• f ICD-10 Codes: Underlying Causes: X40

X41 X42 X43 X44 X60 X61 X62 X63 X64 X85 Y10 Y11 Y12 Y13 Y14; Contributing Causes: T40.0, T40.1, T40.2, T40.3, and T40.4

1.4 1.9 2.6 4.3 5.2 6.4 6.3 6.7 6.7 7.3 7.5 7.3 Wyoming 3.9 4.4 4.9 5.4 5.7 5.9 6.2 6.5 6.9 7.5 8.6 Nation 10.4 2 4 6 8 10 12

2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-2010 2009-2011 2010-2012 2011-2013 2012-2014 2013-2015 2014-2016

Source: CDC Wonder, 2003-2016; Error bars represent 95% confidence intervals

Hospitalizations

Figure 11: There is variability in prescription opioid-related inpatient discharges across the state of Wyoming

The rate per 100,000 of prescription opioid- related inpatient discharges from Wyoming hospitals 2014-2015, excluding urgent care

• facilities. The county data presented here is the

county of residence of the patient for the discharge, not the county of the facility. Aggregate of ICD9 Codes: 965.00, 965.02, 965.09, E850.1, and E850.2.

16 4 14 38 7 7 31 4 31 19 8 21 12 6 17 5 30 12 30 5 10 15 20 25 30 35 40 45 Wyoming Albany Big Horn Campbell Carbon Converse Crook Fremont Goshen Hot Springs Johnson Laramie Lincoln Natrona Niobrara Park Platte Sheridan Sublette Sweetwater Uinta Washakie Weston

Source: Wyoming Hospital Association, 2014-2015

Delivered to Pharmacies

Figure 13: Distributed morphine milligram equivalent doses per capita in Wyoming is consistently below the national average, with gap closing

The cumulative amount of opioid medication distributed at the retail level in per capita morphine milligram equivalents.

571 571 609 609 668 668 687 687 732 732 738 738 798 798 808 808 818 818 818 818 761 761 Wyom

• min

ing 706 706 803 803 840 840 896 896 975 975 987 987 943 943 967 967 917 917 895 895 845 845 Natio ion

200 400 600 800 1000 1200 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Source: ARCOS, 2006-2016

Prescribing Rate

724 724 759 759 782 782 795 795 812 812 809 809 813 813 781 781 756 756 706 706 665 665 Natio ion 799 799 808 808 810 810 810 810 804 804 782 782 805 805 815 815 809 809 754 754 711 711 Wyom

• min

ing

200 400 600 800 1000 1200 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 14: Wyoming’s

• pioid prescribing

rate is generally above the national average

Retail opioid prescriptions dispensed per 1,000 persons in the state of Wyoming and the U.S.

Source: QuintilesIMS Transactional Data Warehouse (TDW) 2006–2016

Prescribing Rate

Figure 15: One county in Wyoming prescribes more

• pioids than people

Retail opioid prescriptions dispensed in pharmacies by county per 1,000 persons,2014-2016

5 23 377 514 560 561 578 589 596 634 671 735 760 767 779 795 846 892 906 954 964 997 1,075 Crook Niobrara Goshen Albany Sheridan Platte Weston Big Horn Sublette Converse Johnson Teton Campbell Carbon Laramie Lincoln Natrona Sweetwater Fremont Washakie Park Hot Springs Uinta

Source: QuintilesIMS Transactional Data Warehouse (TDW) 2006–2016

Naloxone Use

Figure 12: Naloxone administration rate by county

• f incident per 100,000 of

county population from January 2016 through June 2017

Naloxone is administered at the highest rate in Fremont County.

42 45 52 70 77 81 89 92 92 99 102 113 124 129 126 147 176 249 286 50 100 150 200 250 300 Big Horn Goshen Lincoln Campbell Uinta Platte Natrona Converse Sublette Teton Albany Sheridan Weston Park Wyoming Carbon Laramie Sweetwater Fremont

Source: WATRS, 2016-2017

So…How Big is Wyoming’s Problem?

Thank You!

Rodney A. Wambeam, PhD 307-760-8928 rodney@uwyo.edu