Michael M. Miller, MD, FASAM, FAPA

Transcription

1 Michael M. Miller, MD, FASAM, FAPA Medical Director, Herrington Recovery Center (HRC) Rogers Memorial Hospital Oconomowoc, Wisconsin Vice Speaker Wisconsin Medical Society Clinical Adjunct Associate Professor University of Wisconsin School of Medicine and Public Health Assistant Clinical Professor Medical College of Wisconsin Past President, Wisconsin Society of Addiction Medicine Past President, American Society of Addiction Medicine At-Large Director, American Board of Addiction Medicine

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4 pdf/rx_abuse_plan.pdf The White House Office of National Drug Control Policy (ONDCP) EPIDEMIC: RESPONDING TO AMERICA S PRESCRIPTION DRUG ABUSE CRISIS

5 ONDCP Strategy on PDA Education: patients, parents, youth, and health care professionals Monitoring: Prescription Drug Monitoring Programs (PDMPs), multi-state data-sharing Rx Disposal Enforcement

6 ONDCP Strategy on PDA: Proper Drug Disposal While the administrative process to establish the DEA medication disposal rule is underway,19 DEA and other Federal agencies shall conduct additional take-back activities. Information about the takeback events shall be distributed to local anti-drug coalitions and other organizations (chain pharmacies, boards of pharmacies, boards of medicine, environmental agencies, etc). (DEA/ONDCP) Once DEA regulations on controlled substance prescription drug disposal have been established, develop and execute a robust public education initiative to increase public awareness and provide education on new methods of safe and effective drug return and disposal. (ONDCP/ EPA/DEA/FDA/CDC/HHS/SAMHSA/NIDA) Once DEA regulations have been established, engage PhRMA and others in the private sector to support community-based medication disposal programs. (ONDCP/FDA/DEA/HHS/CDC/ SAMHSA/EPA)

7 Annual Numbers of New Nonmedical Users of Psychotherapeutics: National Household Survey on Drug Abuse

8 Increasing Use of Prescribed Opioids Manchikanti & Singh 2008

9 Scope of the Problem Between 1992 and 2003: U.S. population increase of 14% Number of people abusing controlled prescription drugs jumped 81% 2x > than marijuana 5x > than cocaine 60x > than heroin Prescription pain medications (Opioids) are now the 4 th most abused substances in the U.S. Behind marijuana, alcohol, and tobacco Misuse of painkillers represents 3/4 of the overall problem of prescription drug abuse Prescription medications are now the leading cause of accidental death for ages Drug Enforcement Administration

10 Retail Sales of Opioid Medications (grams of medication ) % of Change Methadone 518,737 5,362, % Oxycodone 4,449,562 30,628, % Fentanyl Base 74, , % Hydromorphone 241, , % Hydrocodone 8,669,311 25,803, % Morphine 5,922,872 15,054, % Meperidine 5,765,954 4,272,520-26% Codeine 25,071,410 18,960,038-24%

11 Emergency Department Visits DAWN Data

12 Accidental Deaths Due to Prescribed Opioids Between 1999 and 2002: The number of opioid analgesic poisonings on death certificates increased 91.2% Heroin poisonings increased 12.4% Cocaine poisonings increased 22.8% 2007: The second leading cause of injury/death (after motor vehicle accidents) 2009: The number of deaths secondary to prescription drugs was 4 times the number due to illicit drugs. Machikanti 2007 MMWR 7/8/11

13 Prevention Strategies Lock Up Your Meds You are the Key National Family Partnership The responsible parties are: PARENTS and GRANDPARENTS PHYSICIANS who can educate parents about their role

14 It s not just diversion and misuse It s O.D.s and Overdose Deaths

15 Opioid Deaths are #1 Rx Drug Deaths Prescription Opioid O.D. Deaths Outpace Heroin Deaths

16 The CDC used death certificates to determine that there were 45,000 traffic accident deaths in 2006 and about 39,000 drug-induced deaths pooled US data

17 Treat Addiction Save Lives ASAM

18 Thank you! Michael M. Miller, MD, FASAM, FAPA Medical Director Herrington Recovery Center