State Epidemiology Outcomes Workgroup (SEOW)

Transcription

1 State Epidemiology Outcomes Workgroup (SEOW) MARYLAND STRATEGIC PREVENTION FRAMEWORK Advisory Council Meeting 31 January 213 SEOW Director, Linda Simoni-Wastila

2 Overview SEOW Who We Are and Mission Data NSDUH: National Survey on Drug Use and Health HSCRC: Health Services Cost Review Commission SMART: Substance Misuse and Abuse Reduction Team MPC: Maryland Poison Center FARS: Fatal Accident Reporting System Focus on 5 Areas: Opioid Analgesics Sedative-Hypnotics Marijuana Emerging Substances Alcohol 2

3 SEOW MARYLAND STATE EPIDEMIOLOGY OUTCOMES WORKGROUP 3

4 The Team Partnership with ADAA based at the University of Maryland Baltimore School of Pharmacy Pharmaceutical Health Services Research (PHSR) Department Pharmaceutical Research Computing Maryland Poison Center The Team Linda Simoni-Wastila, BSPharm, PhD (PHSR) Wendy Klein-Schwartz, PharmD (MPC) Corinne Woods, PharmD (PRC-Data Coordinator) Jeanne Yang (PRC-Programmer) Jenny Wei, PhD (PHSR-Post-Doctoral Fellow) Patience Moyo (PHSR-Doctoral Student) Jane Huang (PHSR-Doctoral Student) Pharmacy Students 4

5 SEOW: Mission The Maryland SEOW monitors the use of alcohol, tobacco, and other drugs and the consequences of such use in order to identify and prioritize the prevention and treatment needs of the state. To achieve this end, the Maryland SEOW oversees the collection, interpretation, and dissemination of statewide data that quantifies substance use and its consequences in the broader context of behavioral health for Maryland. The SEOW utilizes data to: Determine prevention and treatment priorities at the state, county, and local levels Identify, monitor, and interpret key indicators of use and consequences of tobacco, alcohol and substance use Support the state and jurisdictions as they assess need, develop interventions, and evaluate prevention and treatment efforts 5

6 OPIOID ANALGESICS 6

7 6 5 NSDUH: Nonmedical Use of Pain Relievers in Past Year Age 12+ years, MD vs US % Reporting Use US MD Years 7

8 NSDUH: Maryland Sub-State Regions North Central Northeast South West Carroll Howard Caroline Cecil Harford Kent Queen Anne's Talbot Calvert Charles Dorchester St. Mary's Somerset Wicomico Worcester Allegany Frederick Garrett Washington 8

9 14 12 NSDUH: Nonmedical Use of Pain Relievers in Past Year to to % Reported Use

10 Worcester Wicomico Washington Talbot Somerset St Marys Queen Annes Prince Georges Montgomery Kent Howard Harford Garrett Frederick Dorchester Charles Cecil Carroll Caroline Calvert Baltimore County Baltimore City Anne Arundel Allegany Maryland Overall HSCRC: Changes in Opioid-Related Inpatient and ED Visits from 28 to 211 Percentage Change in Inpatient Visits Worcester Wicomico Washington Talbot Somerset St Marys Queen Annes Prince Georges Montgomery Kent Howard Harford Garrett Frederick Dorchester Charles Cecil Carroll Caroline Calvert Baltimore County Baltimore City Anne Arundel Allegany Maryland Overall Percentage change in ED Visits

11 11

12 Total number of admissions SMART: Maryland Admissions for Prescription Opioid-Related Treatment by County of Residence, FY 212* * Data as of November

13 Total number of admissions 12, 1, 8, 6, 4, 2, SMART: Maryland Admissions for Opioid-Related Treatment, FY * 1,852 1,232 1,358 2,55 3,711 11,311 4,538 1,24 5,91 1,53 Rx Opioids Heroin Fiscal Year * Data as of November

14 % of total admissions SMART: Proportion of Total Admissions by Primary Substance Problem, FY * Alcohol Crack Other Cocaine Marijuana/Hashish Heroin Non-Rx Methadone Oxycodone Other Rx Opioids * Data as of November

15 SEDATIVE-HYPNOTICS 15

16 HSCRC: Inpatient Admissions and ED Visits: Sedative-Hypnotics In 211, 562 inpatient admissions and 1591 ED visits related to sedativehypnotics Between 28 and 211 Inpatient sedative-hypnotic-related hospital admissions increased.2% Largest increases in Kent County (.5%) and Allegany County (.6%) ED visits increased <.1%

17 * Data as of November

18 SMART: Proportion of Total Admissions with Benzodiazepines as Primary Substance, FY * 1.16 % of total admissions * Data as of November

19 SMART: County of Residence Among Patient Admissions for Benzodiazepine Related Treatment in FY 212* Total number of admissions * Data as of November

20 MARIJUANA 2

21 % Reporting Use NSDUH: Marijuana Use in Past Month Age 12+ years, MD vs US US MD Years 21

22 % Reporting Use NSDUH: Perceptions of Great Risk of Smoking Marijuana Once a Month Age 12+ years, MD vs US US MD Years 22

23 NSDUH: Age 12+ years, Use vs Perceptions of Great Risk of Smoking Marijuana Once a Month, MD % Reporting Use Perceptions of Great Risk of Smoking Marijuana Once a Month Marijuana Use in Past Month Marijuana Use in Past Year Years 23

24 NSDUH: Age years, Use vs Perceptions of Great Risk of Smoking Marijuana Once a Month, MD % Reporting Use Perceptions of Great Risk of Smoking Marijuana Once a Month Marijuana Use in Past Month Marijuana Use in Past Year Years 24

25 NSDUH: Age years, Use vs Perceptions of Great Risk of Smoking Marijuana Once a Month, MD % Reporting Use Perceptions of Great Risk of Smoking Marijuana Once a Month Marijuana Use in Past Month Marijuana Use in Past Year Years 25

26 % Reported Use Perceptions of Great Risk of Smoking Marijuana Once a Month 12 to

27 Total number of admissions 1, 8, 6, 4, 2, SMART: Maryland Admissions for Marijuana/Hashish Treatment, FY * 7,63 8,184 8,516 9,521 8, * Data as of November

28 SMART: Maryland Admissions for Marijuana/Hashish Treatment by County of Residence, FY 212* 2,5 2,257 2, Total number of admissions 1,5 1, , * Data as of November

29 EMERGING SUBSTANCES 29

30 What is Spice? Synthetic marijuana (cannabinoids) Typically contains several different ingredients Ingredients vary in potency, but are much more potent than THC Smoked like marijuana Adverse effects have been reported, including dysrhythmias, suicidal ideation, psychosis, and convulsions 3

31 Calls to MPC for Spice (Oct 21 through 212) DEA emergency scheduling of synthetic marijuana Federal Drug Policy Amendment Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

32 What are Bath Salts? Stimulants Effects similar to amphetamine and cocaine Substituted Cathinones Including methylenedioxypyrovalerone (MDPV) Mephedrone and methylone Commonly swallowed or snorted, but can also be smoked or injected Case reports suggest it may cause nausea, palpitations, violent behavior, paranoia, kidney and liver failure, suicide, and more 32

33 14 Calls to MPC for Bath Salts (211 through 212) Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec DEA emergency scheduling of bath salts Federal Drug Policy Amendment 33

34 ALCOHOL 34

35 6 5 NSDUH: Past-Month Alcohol Use Age 12+ Years, MD vs US % Reporting Use US MD Years 35

36 35 NSDUH: Past-Month Alcohol Use Among Underage (Age 12-2) Drinkers, MD vs US % Reporting Use US MD Years 36

37 28-21 Past-Month Alcohol Use 7 12 to % Reported Use

38 NSDUH: Past-Month Binge Drinking Age 12+ Years, MD vs US % Reporting Use US MD Years 38

39 25 NSDUH: Past-Month Binge Drinking Among Underage (12-2) Drinkers, MD vs US % Reporting Use US 5 MD Years 39

40 5 NSDUH: Past-Month Binge Drinking Age Years, MD vs US % Reporting Use US MD Years 4

41 Past-Month Binge Drinking 12 to % Reported Use

42 HSCRC: Inpatient Admissions and ED Visits: Alcohol In 211, 42,215 inpatient admissions and 26,659 ED visits related to alcohol Between 28 and 211 Inpatient alcohol-related hospital admissions increased.58% Largest increases in Kent (2.2%), Carroll (1.5%), and Frederick (1.2%) counties ED visits increased.18% Largest increases in St. Mary s (.7%), Carroll (.52%), and Worcester (.51%) counties

43 6 SMART: Age Distribution of Patients Admitted for Alcohol Treatment*, FY % of Total Admissions to 2 21 to to to 65 Over Fiscal Year * One of three substance-abuse problems reported at admission. 43

44 3, SMART: Maryland Admissions for Alcohol Related Treatment by County of Residence, FY 212* 2,5 2,461 Total number of admissions 2, 1,5 1, ,438 1, * Data as of November

45 Number of crashes FARS: Maryland Alcohol-Related Fatal Crashes No drivers died 1 driver died

46 Proximity of Alcohol-Related Fatal Crashes to Alcohol Outlets 46

47 Summary Opioid Analgesics Opioid analgesic use declining in US and MD Opioid-related hospital inpatient admissions up.2%; ED visits up <.1% 211 Hotspots: Prince Georges, Montgomery, Baltimore City, Worcester, Garrett Heroin treatment admissions stable Rx opioid/all opioid treatment admissions up from 15% 28 to 33% 212 Sedative-Hypnotics Hospital admissions up.2% 211 Hotspots: Cecil and Alleghany % Benzodiazepine treatment admissions/all treatment admissions inc from to

48 Summary Marijuana Use declining in US and Maryland overall BUT Among year olds: Perception of great risk declined from 33% - 26% Among year olds: Perception of great risk declined from 26% to 17% AND both past year and past month use increased Treatment admissions increasing Bath Salts and Spice Keep on eye on trends 48

49 Summary Alcohol Past-month use stable or declining (including underage drinkers) Binge-drinking among underage drinkers down 3.3% since 28 Binge drinking remains problem for year olds (up 3.5% from 21) Alcohol-related hospital admissions increased.58%; ED visits increased.18% Alcohol treatment admissions down or stable for all age groups 49