Diversion, Misuse and Trafficking of Methadone and Buprenorphine in the US and Europ
|
|
|
- Clare Fleming
- 5 years ago
- Views:
Transcription
1 Diversion, Misuse and Trafficking of Methadone and Buprenorphine in the US and Europ Richard C. Dart, MD, PhD Director, Rocky Mountain Poison and Drug Center Professor, University of Colorado
2 Prescription Opioid Deaths are Rising Internationally United Kingdom Drug Related Deaths Source: RADARS System, Denver Health and Hospitals
3 What is the RADARS System? History 2006, Denver Health and Hospital Authority (DHHA) Multiple pharmaceutical subscribers Independent program Denver Public Safety Net Hospital for 150 years State sanctioned independent authority Conflict of Interest Statement None, other than running system for DHHA as noted above. 3
4 RADARS System Scientific Advisory Board Principal Investigators Theodore J. Cicero, PhD Washington University at St. Louis Richard C. Dart, MD, PhD Denver Health and Hospital Authority Hilary Surratt, PhD Nova Southeastern University Mark W. Parrino, MPA American Association for the Treatment of Opioid Dependence Substance Abuse Experts Herbert D. Kleber, MD Columbia University Sidney Schnoll, MD, PhD Pinney Associates George E. Woody, MD University of Pennsylvania Epidemiology/Biostatistics Edgar Adams, ScD Covance Law Enforcement John Burke National Association of Drug Diversion Investigators Nabarun Dasgupta, MPH Founder Epidemico Alvaro Muñoz, PhD Johns Hopkins University 4
5 Challenges of Prescription Drug Abuse Surveillance Clandestine behavior Geographical variability Changes rapidly Multiple age groups Product specificity 15 active pharmaceutial ingredients (API) Opioids: Hydrocodone, oxycodone, hydromorphone, oxymorphone, morphine, fentanyl, tapentadol, tramadol, buprenorphine, methadone Stimulants Dozens of specific products (Vicodin, OxyContin, Opana ER, Suboxone, Subutex, etc.)
6 RADARS System Mosaic Acute Events 53 Poison Centers 46 States Drug Transactions Criminal Justice 280 investigator 50 states Entering Treatment OTP 73 programs 33 states Entering Treatment SKIP 125 practices 50 states New Initiates College Survey 2000 students 50 States Illicit Market Price StreetRx.com Users/Buyers 50 states
7 RADARS System Process Two Denominators Drug Diversion Poison Center OTP SKIP College Survey Numerators compiled by each program POPULATION RATE = Event Count by Area Population Disease burden on population Does not account for drug availability UNIQUE RECIPIENTS OF DISPENSED DRUG (URDD) RATE Event Count by Area = URDD URDD = Number of unique people filling prescription for drug (refills excluded) 7
8 TRENDS IN PRESCRIPTION OPIOID ABUSE IN THE UNITED STATES 8
9 Overall Opioid Abuse Trends in United States Population Rates, Population Rate 5 Availability Rate (URDD) 0 0,8 0,6 0,4 0, Poison Center Drug Diversion SKIP OTP 9
10 RADARS System Opioid Abuse Trends URDD Rates (Ranked Highest-Lowest) 2012 Rank Poison Center Opioid Treatment Survey of Key Informant Pts Drug Diversion 1 Methadone Oxymorphone Oxymorphone Oxymorphone 2 Oxymorphone Methadone Hydromorphone Hydromorphone 3 Buprenorphine Hydromorphone Methadone Methadone 4 Hydromorphone Buprenorphine Buprenorphine Buprenorphine 5 Morphine Morphine Morphine Morphine 6 Fentanyl Fentanyl Fentanyl Oxycodone 7 Tramadol Tapentadol Tapentadol Fentanyl 8 Oxycodone Oxycodone Oxycodone Hydrocodone 9 Tapentadol Hydrocodone Hydrocodone Tramadol 10 Hydrocodone Tramadol Tramadol Tapentadol 10
11 BUPRENORPHINE AND METHADONE DATA FOR THE UNITED STATES
12 How Many Patients Fill a Prescription? Unique Recipients of dispensed drug (URDD) 2009Q1-2012Q4 Methadone Combination Buprenorphine Tablets SI Buprenorphine Tablets Combination Buprenorphine Film
13 Diversion reports Buprenorphine Data Comparison RADARS System & CESAR Fax 1200 RADARS System Drug Diversion Program Diversion Reports Total Buprenorphine Total Methadone CESAR = Center for Substance Abuse Research 13
14 URDD rate per 1,000 Population rate 100,000 Opioid Treatment Program Past 30 Day Endorsements, ,4 1,2 1 0,8 0,6 0,4 0, Population Rate Availability Rate (URDD) Methadone high, but decreasing Bup-Single Ingredient Increasing slightly Bup-Naloxone Film Strip increasing slightly Bup-Naloxone Combination Decreasing Slightly Bup-Single Ingredient Highest, Increased, Flat Methadone Decreasing Bup-Naloxone Combination Lower, Flat Bup-Naloxone Film Strip Lowest, Decreasing
15 URDD rate per 1,000 Population per 100,000 Survey of Key Informant Patients Past 30 Day Endorsements, ,7 0,6 Population Rate Methadone high, but decreasing 0,5 0,4 0,3 0,2 0, Availability Rate (URDD) Bup-Single Ingredient Increasing Bup-Naloxone Combination Increasing Flat Bup-Naloxone Film Strip Increasing slightly Bup-Single Ingredient Increasing Dramatically Methadone Slight Decrease Bup-Naloxone Combination Increasing Bup-Naloxone Film Strip low, flat
16 URDD rate per 1,000 Population rate per 100,000 RADARS System Drug Diversion Cases ,25 0,2 0,15 0,1 0,05 0 2,5 2 1,5 1 0,5 Population Rate Availability Rate (URDD) Methadone high, but decreasing slightly Bup-Naloxone Combination Decreasing Slightly Bup-Naloxone Film Strip Increasing Bup-Single Ingredient Increasing Bup-Naloxone Combination Increasing Greatly Bup-Single Ingredient Increasing Greatly Methadone Slight Decrease 0 Bup-Naloxone Film Strip increasing slightly
17 Why Are Endorsements of Buprenorphine Strip So Low? The quickly replaced tablet in United States before generic tablets became available. But the rate of abuse endorsement was low Potential explanations Misidentification Serial numbers Different packaging (child proof) Others?
18 StreetRx Population Any person in US with access to the internet Definition/Type of Cases Utilize crowdsourcing methodology to calculate average price of specific prescription drug in particular location Validated by DD Coverage All 50 states 18
19 Comparison of StreetRx, RADARS System Drug Diversion and Silk Road Price per milligram of drug Dasgupta, Suratt, et al, J Med Internet Res,
20 Death Cases in Poison Center Program All Ages, 2009Q1-2012Q Total Methadone Total Combination Buprenorphine Tablets Total Single Ingredient Buprenorphine Tablets Total Buprenorphine Oral Films
21 Death Cases in Poison Center Program Ages under 12 years, 2009Q1-2012Q4 4 3 Total Methadone Total Combination Buprenorphine Tablets Total Single Ingredient Buprenorphine Tablets Total Buprenorphine Oral Films
22 Conclusions Prescription opioid abuse in the US may be plateauing, but still causes 16,000 deaths per year Methadone Endorsements in treatment programs decreasing More deaths than any other opioid But many deaths involve pills (treatment of pain) Buprenorphine Endorsements are relatively flat, but there is dramatic shift of products involved Abuse is increasing quickly perhaps due to generic availability Single-ingredient Subutex Combination tablet (Bup-naloxone; Suboxone ) Exceptional safety in all groups Endorsement of buprenorphine strip has been very low. Diversion has also been low. Why is the price of buprenorphine so high
23 Thank you!
Diversion, misuse and trafficking of methadone and buprenorphine
Diversion, misuse and trafficking of methadone and buprenorphine Global Addiction Conference Richard C. Dart, MD, PhD Professor, University of Colorado Prescription Opioid Deaths are Rising Internationally
Postmarketing Surveillance of Prescription Drug Abuse
Postmarketing Surveillance of Prescription Drug Abuse August 13, 2013 Richard C. Dart, MD, PhD Director, Rocky Mountain Poison and Drug Center, Denver, Colorado Professor, University of Colorado School
Prescription Opioid Dependence and Addiction: Experience in the United States
Prescription Opioid Dependence and Addiction: Experience in the United States September 27, 2013 Richard C. Dart, MD, PhD Director, Rocky Mountain Poison and Drug Center Professor, University of Colorado
Abuse, Misuse, and Diversion of Prescription Opioids: Evaluating the Problem and Proposed Solutions
Abuse, Misuse, and Diversion of Prescription Opioids: Evaluating the Problem and Proposed Solutions Eric Lavonas, MD, FACEP, FACMT, FAACT Associate Director, Rocky Mountain Poison & Drug Center Denver
A National Perspective on the Abuse and Diversion of Prescription Drugs
A National Perspective on the Abuse and Diversion of Prescription Drugs Hilary L. Surratt, Ph.D Steven P. Kurtz, Ph.D. ARSH: Center for Applied Research on Substance Use and Health Disparities Faculty
Prescription Drug Abuse: Colorado and Nationwide
Prescription Drug Abuse: Colorado and Nationwide Eric Lavonas, MD Associate Director, Rocky Mountain Poison and Drug Center Associate Professor, University of Colorado School of Medicine 1 What s the Problem?
Richard C. Dart, MD, PhD Executive Director, RADARS System Denver Health and Hospital Authority
Richard C. Dart, MD, PhD Executive Director, RADARS System Denver Health and Hospital Authority RADARS System 12 th Annual Scientific Meeting 95 Registrants Government 26 Academic 14 Industry/Pharma 28
RADARS System International Pre-Symposium 11 May Global Insights in Prescription Drug Misuse
RADARS System International Pre-Symposium 11 May 2017 Global Insights in Prescription Drug Misuse WELCOME 2 The Global Mosaic: RADARS System International Program Updates Jody L. Green, PhD, CCRP Director
The Evolution of Abuse Deterrent Drug Formulations: Testing Effectiveness from the Benchtop to the Real World
The Evolution of Abuse Deterrent Drug Formulations: Testing Effectiveness from the Benchtop to the Real World Richard C. Dart, MD, PhD Director, Rocky Mountain Poison and Drug Center Executive Director,
Key points. o Potential for nonmedical use, abuse, and diversion of new products
RADARS System Technical Report # 2012Q2-1 Use of unique recipients of dispensed drug (URDD) in assessing the burden of abuse, misuse, and diversion of prescription opioid products Key points Considering
Opioid Analgesics with Abuse- Deterrent Properties: Current Data and Future Opportunities
1 National Academy of Medicine Session 4 Opioid Analgesics with Abuse- Deterrent Properties: Current Data and Future Opportunities Richard C. Dart, MD, PhD Director, Rocky Mountain Poison and Drug Center
Category 4 Can we prove that ADF opioids really are?
Human Abuse Liability & Abuse-Deterrent Formulations Category 4 Can we prove that ADF opioids really are? March 7, 2016 Richard C. Dart, MD, PhD Director, Rocky Mountain Poison and Drug Center Executive
Evolution of the Opioid Epidemic
Clinical Directors Network, Inc. (CDN) Evolution of the Opioid Epidemic February 5, 2018 2:30 PM-4:00 PM EST Richard C. Dart, MD, PhD Director, Rocky Mountain Poison and Drug Center, Denver Health Professor,
Key points. Background
RADARS System Technical Report # 2012Q3-1 Prescription Opioid Abuse and Misuse rates from RADARS System are Highly Correlated with Rates from The Drug Abuse Warning Network (DAWN) Key points The RADARS
Challenges in Conducting Postmarketing Abuse Investigations
Challenges in Conducting Postmarketing Abuse Investigations Paul Coplan, ScD, MBA Risk Management & Epidemiology Purdue Pharma, L.P. ADF Guidance Meeting Washington DC, October 1, 2013 1 That which we
Evolution of the Opioid Epidemic
NYSAM - Intersection of Science, Policy and Treatment Evolution of the Opioid Epidemic Richard C. Dart, MD, PhD Director, Rocky Mountain Poison and Drug Center, Denver Health Professor, University of Colorado
Trends in Opioid Analgesic Abuse and Mortality in Europe
Current Challenges of Opioids EAPCCT Annual Congress 26 May 2016 Trends in Opioid Analgesic Abuse and Mortality in Europe Jody L. Green, PhD, CCRP Denver Health Rocky Mountain Poison & Drug Center Disclosure
Interventions in Prescription Opioid Abuse Do (or can) Prescription Monitoring Programs Make a Difference?
Interventions in Prescription Opioid Abuse Do (or can) Prescription Monitoring Programs Make a Difference? Richard C. Dart, MD, PhD Executive Director of RADARS System, Denver, Colorado Professor, University
Effect of Abuse-Deterrent Formulations and IR Opioids on Abuse, Overdose and Death from Rx Opioids
Effect of Abuse-Deterrent Formulations and IR Opioids on Abuse, Overdose and Death from Rx Opioids Richard C. Dart, MD, PhD Executive Director, RADARS System Professor, University of Colorado Competing
Mosaic approach for monitoring Healthy People 2020 objectives:
Mosaic approach for monitoring Healthy People 2020 objectives: A substance abuse surveillance system Karilynn Rockhill 1, Gabrielle E. Bau 1, Matthew S. Ellis 2, Theodore J. Cicero 2, Richard Dart 1 1
Trends in Opioid Analgesic Abuse and Mortality in the United States
The new england journal of medicine special article Trends in Opioid Analgesic Abuse and Mortality in the United States Richard C. Dart, M.D., Ph.D., Hilary L. Surratt, Ph.D., Theodore J. Cicero, Ph.D.,
A Toxicologists View of Addiction
A Toxicologists View of Addiction Deborah Motika, MS, MS, TC(NRCC) Senior Vice President, Toxicologist AGENDA Background : Addiction Toxicology 101 Drug testing 101 Question and Answer Session 2 ADDICTION
RADARS R SYSTEM INTERNATIONAL PRE-SYMPOSIUM. International Landscape of Prescription Medication Misuse
RADARS R SYSTEM INTERNATIONAL PRE-SYMPOSIUM International Landscape of Prescription Medication Misuse WELCOME 3 The Global Mosaic: Is Prescription Drug Misuse Really Different Among Countries? Janetta
pharmacoepidemiology and drug safety 2009; 18: ORIGINAL REPORT
pharmacoepidemiology and drug safety 2009; 18: 778 790 Published online 17 June 2009 in Wiley InterScience (www.interscience.wiley.com).1780 ORIGINAL REPORT Integrating nine prescription opioid analgesics
Substance Abuse in US and Europe
Substance Abuse in US and Europe Richard C. Dart, MD, PhD Director, Rocky Mountain Poison and Drug Center, Denver Health Professor, University of Colorado School of Medicine Supply of Legal Opioid Analgesics
Systematic Surveillance of Illicitly Manufactured Fentanyl Cases Initiated by Law Enforcement Steven P. Kurtz, PhD and Mance E.
Systematic Surveillance of Illicitly Manufactured Fentanyl Cases Initiated by Law Enforcement Steven P. Kurtz, PhD and Mance E. Buttram, PhD Nova Southeastern University Center for Applied Research on
Identification of Specific Drugs and Drug Diversion in Drug Overdose Fatalities
Identification of Specific Drugs and Drug Diversion in Drug Overdose Fatalities Svetla Slavova, PhD Sara LaMantia, MS Terry Bunn, PhD Tracey Corey, MD 2016 Safe States Annual Meeting April 13, 2016, Albuquerque,
Opioid Prescription and Illicit Drug Overdoses: On the Rise
Opioid Prescription and Illicit Drug Overdoses: On the Rise Cindy Haynes, MSA-PA, CHES Chronic Pain Program Coordinator Northern Piedmont Community Care Duke Division of Community Health Objectives Define
UnitedHealthcare Pharmacy Clinical Pharmacy Programs
UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number 2018 P 4000-3 Program Opioid Overutilization Cumulative Drug Utilization Review Criteria Medication Includes all salt forms, single and
Opioid Harm Reduction
Opioid Harm Reduction Lucas G. Hill, PharmD Clinical Assistant Professor, The University of Texas at Austin College of Pharmacy Clinical Pharmacist, CommUnityCare FQHCs Director, Operation Naloxone Mark
Prescription Drug Monitoring Program Update. Rebecca R. Poston, BPharm., MHL Program Manager August 26, 2017
Prescription Drug Monitoring Program Update Rebecca R. Poston, BPharm., MHL Program Manager August 26, 2017 Objectives Brief historical overview of opioids Review of PDMP information Discuss ideas from
Gabapentin diversion and misuse in the United States from a law enforcement perspective: Diversion rates and qualitative research findings
Gabapentin diversion and misuse in the United States from a law enforcement perspective: Diversion rates 2002-2015 and qualitative research findings Mance E. Buttram, PhD Steven P. Kurtz, PhD 2 nd European
PRESCRIPTION DRUG MONITORING PROGRAM
PRESCRIPTION DRUG MONITORING PROGRAM ST. LOUIS COUNTY Q2 2017 Contents Executive Summary... 2 User Registration & System Utilization... 4 Dispensation Rates... 6 Dispensation Rates by Geography... 6 Dispensation
Opioid Treatment in North Carolina SEPTEMBER 13, 2016
Opioid Treatment in North Carolina SEPTEMBER 13, 2016 Source Where Pain Relievers Were Obtained for Most Recent Nonmedical Use among Past Year Users Aged 12 or Older: 2007 Source Where Respondent Obtained
Post-Marketing Surveillance: Lessons Learned and Recommendations for the Future
+ Post-Marketing Surveillance: Lessons Learned and Recommendations for the Future Dr. Theodore J. Cicero, PhD Washington University in St. Louis, Department of Psychiatry + Conflicts of Interest/Disclosure
INTER-AMERICAN DRUG ABUSE CONTROL COMMISSION C I C A D
INTER-AMERICAN DRUG ABUSE CONTROL COMMISSION C I C A D SIXTY-THIRD REGULAR SESSION April 25-27, 2018 México D.F., México OEA/Ser.L/XIV.2.63 CICAD/doc.2385/18 25 April 2018 Original: English THE OPIOID
15 mg morphine 10 mg hydrocodone
Cari untuk: Cari Cari 15 mg morphine 10 mg hydrocodone 3-2-2013 Convert From CALCULATED MORPHINE EQUIVALENT BY RESOURCE: Average ( mg ) Range ( mg ) Standard Deviation of Sample ( mg ) Hydrocodone. I usually
Opioid Prescribing Guidelines for Patients in the Emergency Department
Opioid Prescribing Guidelines for Patients in the Emergency Department and Immediate Care Centers These guidelines are meant to assist clinicians in treating patients with acute and chronic pain in the
2004-L SEPTEMBER
BULLETIN INTELLIGENCE Buprenorphine: Potential for Abuse Product No. 2004-L0424-013 SEPTEMBER 2004 U. S. D E P A R T M E N T O F J U S T I C E NDIC Within the past 2 years buprenorphine a Schedule III
Hydrocodone 10mg vs oxycodone 10 mg. What is the difference between oxycontin and oxycodone hcl 1 acetaminophen with oxycodone and roxicodone 5mg
TE Te Hydrocodone 10mg vs oxycodone 10 mg What is the difference between oxycontin and oxycodone hcl 1 acetaminophen with oxycodone and roxicodone 5mg Manufacturer of oxycodone hcl 15 mg tablet side effects
RAPID Analysis of Routes of Administration: Oral to Non-Oral Transitions
RAPID Analysis of Routes of Administration: Oral to Non-Oral Transitions Dr. Theodore J. Cicero, PhD John P. Feighner Professor of Psychiatry Washington University in St. Louis, MO RAPID Program Overview
Opioid Deaths Quadruple Since 1999
THE COUNCIL OF STATE GOVERNMENTS CAPITOL RESEARCH AUGUST 2017 HEALTH POLICY Opioid Deaths Quadruple Since 1999 Since 1999, the number of overdose deaths involving opioids (including prescription opioids
The Epidemiology of Opioid Abuse Thomas Dobbs, MD, MPH 6/30/2017
The Epidemiology of Opioid Abuse Thomas Dobbs, MD, MPH 6/30/2017 The Mississippi Drug Abuse Project, Mississippi State Department of Health Working Group Manuela Staneva, MPH, Project Epidemiologist Meg
ARKANSAS DEPARTMENT OF HEALTH
Thank you for taking an interest in the Arkansas Prescription Monitoring Program (PMP). The goal of the PMP is to enhance patient care by ensuring the legitimate use of controlled substances. The following
Proposed Changes to Existing Measure for HEDIS : Use of Opioids at High Dosage (UOD)
Proposed Changes to Existing Measure for HEDIS 1 2020: Use of Opioids at High Dosage (UOD) NCQA seeks comments on proposed revisions to the Use of Opioids at High Dosage HEDIS measure. The current measure
Policy and Political Dynamics of the Opioid Addiction Crisis in the United States
Policy and Political Dynamics of the Opioid Addiction Crisis in the United States Mark W. Parrino, M.P.A. July 21, 2018 15 th Annual Midwest Conference on Problem Gambling and Substance Abuse Hilton Kansas
Generic Label Name Drug Strength Dosage Form Example Product (s) MME/Unit ACETAMINOPHEN WITH CODEINE
STATE OF TENNESSEE DEPARTMENT OF FINANCE AND ADMINISTRATION DIVISION OF HEALTH CARE FINANCE AND ADMINISTRATION BUREAU OF TENNCARE 3 Great Circle Road NASHVILLE, TENNESSEE 37243 This notice is to advise
Kentucky All Schedule Prescription Electronic Reporting (KASPER)
Kentucky All Schedule Prescription Electronic Reporting (KASPER) Phyllis Millspaugh Manager, Behavioral Health Prevention and Promotion Kentucky Cabinet for Health and Family Services Using PDMP Data to
Pharmacy Medical Necessity Guidelines: Opioid Analgesics
Pharmacy Medical Necessity Guidelines: Effective: January 1, 2019 Prior Authorization Required Type of Review Care Management Not Covered Type of Review Clinical Review Pharmacy (RX) or Medical (MED) Benefit
VIRGINIA DEPARTMENT OF HEALTH OFFICE OF THE CHIEF MEDICAL EXAMINER
VIRGINIA DEPARTMENT OF HEALTH OFFICE OF THE CHIEF MEDICAL EXAMINER To promote and protect the health of all Virginians Fatal Drug Overdose Quarterly Report Edition 216.3 Publication Date: January 217 METHODS,
Carefirst. +.V Family of health care plans
Family of health care plans Prior Authorization Form 1361M Opioids ER MME Limit and Post Limit This fax machine is located in a secure location as required by HPAA regulations. Complete/review information,
PRESCRIPTION DRUG MONITORING PROGRAM ST. CHARLES COUNTY Q1 2018
PRESCRIPTION DRUG MONITORING PROGRAM ST. CHARLES COUNTY Q1 2018 Contents Executive Summary... 2 User Registration & System Utilization... 4 Dispensation Rates... 6 Dispensation Rates by Geography... 6
20/0.8mg, 30/1.2mg, Films 90 MME/day Belbuca (buprenorphine) 75mcg, 150mcg, 300mcg, 450mcg 60 units per 90 days
Pre - PA Allowance Quantity Extended Release Tablets or Capsules 90 MME/day Medication Strength Avinza (morphine) 60mg, 75mg, 90mg Embeda (morphine /naltrexone) 50/2mg, 60/2.4mg, 80/3.2mg Exalgo (hydromorphone)
Opioids: Use, Abuse and Cause of Death. Jennifer Harmon Assistant Director - Forensic Chemistry Orange County Crime Laboratory
Opioids: Use, Abuse and Cause of Death Jennifer Harmon Assistant Director - Forensic Chemistry Orange County Crime Laboratory jharmon@occl.ocgov.com Opioid: Any psychoactive chemical that resembles morphine
JEANIE JARAMILLO-STAMETZ, PHARMD
JEANIE JARAMILLO-STAMETZ, PHARMD Jeanie Jaramillo-Stametz is an assistant professor for Texas Tech s School of Pharmacy and serves as the director of the poison control center and the director of their
Opiate Use among Ohio Medicaid Recipients
Opiate Use among Ohio Medicaid Recipients July 12, 2012 Ohio Colleges of Medicine Government Resource Center The Ohio State University College of Public Health Sponsored by The Ohio Department of Alcohol
Original Research Article Do Prescription Monitoring Programs Impact State Trends in Opioid Abuse/Misuse?pme_
Pain Medicine 2012; 13: 434 442 Wiley Periodicals, Inc. OPIOIDS, SUBSTANCE ABUSE & ADDICTIONS SECTION Original Research Article Do Prescription Monitoring Programs Impact State Trends in Opioid Abuse/Misuse?pme_1327
Frontline Florida: Emerging Drug Trends The Opiate Epidemic
# of Opioids Detected Among Decedents Number of Heroin Deaths Number of Rx Opioid Poisoning Patients Frontline Florida: Emerging Drug Trends The Opiate Epidemic James N. Hall, Epidemiologist Nova Southeastern
Gabapentin diversion and misuse: Data from law enforcement and substance users
Gabapentin diversion and misuse: Data from law enforcement and substance users Mance E. Buttram, PhD NDEWS Presents Webinar 14 March 2018 Objectives 1. Brief overview of gabapentin literature 2. Present
Appendix A. Socio-demographic Characteristics of Survey Respondents Compared to Current Population Survey (2013) Data
Data Supplement for Kennedy-Hendricks et al. (10.1176/appi.ps.201600056) Appendix A. Socio-demographic Characteristics of Survey Respondents Compared to Current Population Survey (2013) Data Un-weighted
Long-Acting Opioid Analgesics
Market DC Long-Acting Opioid Analgesics Override(s) Prior Authorization Step Therapy Quantity Limit Approval Duration Initial request: 3 months Maintenance Therapy: Additional prior authorization required
Long-Acting Opioid. Policy Number: Last Review: 12/2017 Origination: 09/2013 Next Review: 09/2018
Long-Acting Opioid Policy Number: 5.02.519 Last Review: 12/2017 Origination: 09/2013 Next Review: 09/2018 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for long-acting
Long-Acting Opioid Analgesics
Market DC Long-Acting Opioid Analgesics Override(s) Prior Authorization Step Therapy Quantity Limit Approval Duration Initial request: 3 months Maintenance Therapy: Additional prior authorization required
Opioid Analgesics. Recommended starting dose for opioid-naïve patients
Opioid Analgesics Goals: Restrict use of opioid analgesics to OHP-funded conditions with documented sustained improvement in pain and function and with routine monitoring for opioid misuse and abuse. Promote
Ingham County Opioid Surveillance
Medical Examiner Source: Ingham County Medical Examiner, *Data is current as of Jul 9, 2018 42 total drug-related deaths (Table 1 & Fig. 1) 34 deaths were opioid-related 30 opioid-related deaths were Ingham
Pediatric Toxicology Update
Pediatric Toxicology Update Suzan S Mazor MD Associate Professor Pediatric Emergency Medicine Medical Toxicology Seattle Children s Hospital University of Washington School of Medicine Washington Poison
Setting the Stage: Are Abuse-Deterrent Opioids Formulations Ready for Prime Time?
Setting the Stage: Are Abuse-Deterrent Opioids Formulations Ready for Prime Time? Lewis S. Nelson, MD New York University School of Medicine New York City Poison Control Center Opioid Abuse Liability
CAN YOU INJECT A G77 OPANA
CAN YOU INJECT A G77 OPANA Can You Inject A G77 Opana Opana taper after using for 3 weeks Can you cut opana er in half safely Opana sirloin tip roast recipe oven recipes easy recipes easy What is comparable
The Epidemiology of Opioid Abuse. Thomas Dobbs, MD, MPH Mississippi State Department of Health
The Epidemiology of Opioid Abuse Thomas Dobbs, MD, MPH Mississippi State Department of Health 1/12/2018 ACKNOWLEDGEMENTS DRUG ABUSE WORKING GROUP MISSISSIPPI STATE DEPARTMENT OF HEALTH Manuela Staneva,
USE OF OPIODS AT HIGHER DOSES IN PERSONS WITHOUT CANCER: MORPHINE EQUIVALENT DOSE EDIT
BACKGROUND: USE OF OPIODS AT HIGHER DOSES IN PERSONS WITHOUT CANCER: MORPHINE EQUIVALENT DOSE EDIT Approximately 10% of patients who are prescribed opioids and seek care from multiple doctors, are prescribed
The Unseen Consequences of Prescription Drug Abuse. Stephen Loyd, M.D.
The Unseen Consequences of Prescription Drug Abuse Stephen Loyd, M.D. Stephen Loyd, M.D. Receives no commercial support, in any form, from pharmaceutical companies or anyone else Medical Director for Substance
Fentanyl, Opioid Overdose and Naloxone
Fentanyl, Opioid Overdose and Naloxone Opioid Agonist Therapy Conference Saskatoon, SK April, 2016 Declaration No conflict of interest. Consultant in Addiction Medicine, SHR. Chair, College of Physicians
National Institute on Drug Abuse
National Institute on Drug Abuse Community Epidemiology Work Group (CEWG) NIDA Community Epidemiology Work Group 62 nd Semi- Annual Meeting June 2007 Seattle Honolulu Jim Hall Center for the Study and
Drug and Opioid Epidemic Report
Drug and Opioid Epidemic Report William Nettleton, MD, MPH Mary Franks, MPH For more information or questions about this report, contact hcsdata@kalcounty.com. 311 East Alcott St Kalamazoo, MI 49001 Phone:
Top 10 narcotic pain pills
Top 10 narcotic pain pills Click to go to the item or just scroll down the page. Doctors Respond to FDA Panel Recommendations FDA Considers Banning Popular Prescription Pain Medications and. Top 10 Natural
Spotlight on Health Policy Beyond the Clinical: The Opioid Epidemic. October 25, 2017
Spotlight on Health Policy Beyond the Clinical: The Opioid Epidemic October 25, 2017 Disclosures and Disclaimer Neither the Institute for Health Policy and Leadership (IHPL) nor I have any relevant financial
Potential Solutions to Epidemic Substance Abuse in US and Europe
Potential Solutions to Epidemic Substance Abuse in US and Europe Richard C. Dart, MD, PhD Director, Rocky Mountain Poison and Drug Center, Denver Health 1 Professor, University of Colorado School of Medicine
Recognizing Narcotic Abuse and Addiction and Helping Those With It
Recognizing Narcotic Abuse and Addiction and Helping Those With It Michael McNett, MD Medical Director for Chronic Pain Member, WI Med Society Opioid Subcommittee Ancient History 1995: OxyContin approved
Data Integration and Analysis for Improved Drug Overdose Surveillance in Kentucky
Data Integration and Analysis for Improved Drug Overdose Surveillance in Kentucky Svetla Slavova, PhD Terry Bunn, PhD Bureau of Justice Assistance Research-Practitioner Partnership & Data-Driven Pilots
Buprenorphine pharmacology
Buprenorphine pharmacology Victorian Opioid Management ECHO Department of Addiction Medicine St Vincent s Hospital Melbourne 2018 Page 1 Opioids full, partial, antagonist Full Agonists - bind completely
INTER-AMERICAN DRUG ABUSE CONTROL COMMISSION C I C A D
INTER-AMERICAN DRUG ABUSE CONTROL COMMISSION C I C A D SIXTY-FIRST REGULAR SESSION April 24-26, 2017 Washington, D.C. OEA/Ser.L/XIV.2.61 CICAD/doc.2299/17 21 April 2017 Original: English CANADA S OPIOID
Understanding and Combating the Heroin Epidemic
Understanding and Combating the Heroin Epidemic Kelly Dunn, Ph.D. Assistant Professor; Johns Hopkins School of Medicine Department of Psychiatry and Behavioral Sciences 1 Talk Outline What is causing the
NYSHFA/NYSCAL 16 th Annual Nurse Leadership Conference. Timothy J. Dewey Sr. Investigator NYS Bureau of Narcotic Enforcement.
NYSHFA/NYSCAL 16 th Annual Nurse Leadership Conference Timothy J. Dewey Sr. Investigator NYS Bureau of Narcotic Enforcement May 2, 2018 1 May 2, 2018 2 Bureau Overview May 2, 2018 3 HISTORY 1850--Bureau
Opioid Management of Chronic (Non- Cancer) Pain
Optima Health Opioid Management of Chronic (Non- Cancer) Pain Guideline History Original Approve Date 5/08 Review/Revise Dates 11/09, 9/11, 9/13, 09/15, 9/17 Next Review Date 9/19 These Guidelines are
Balancing access, quality and prevention of diversion of OST in Europe: a comparative analysis
Balancing access, quality and prevention of diversion of OST in Europe: a comparative analysis Access to OST Types of OST in France : High dose buprenorphine (HDB) (65%) Suboxone : HDB + naloxone (3%)
Opioid Management Program October 2018
Opioid Management Program October 2018 What Is the Opioid Management Program? This program is based on guidelines developed by the U.S. Centers for Disease Control and Prevention (CDC). It consists of
Prescribing Opioids in the Opioid Epidemic. Scott Woffinden, PA-C Jason Chapman, JD
Prescribing Opioids in the Opioid Epidemic Scott Woffinden, PA-C Jason Chapman, JD What's the Problem? http://www.zdoggmd.com/blank-script-taylor-swift-parody/ What's the Problem? CDC 115 Americans die
A LOOK AT ABUSE-DETERRENT OPIOIDS
JULY 2017 Drugs Under Review ICER s report reviewed evidence on ten abuse-deterrent formulations (ADF) of opioids. Nine of the drugs were extended release (ER) opioids, and one was immediate release (IR).
Drug Trends &Trafficking I/S Brian Dempsey
Drug Trends &Trafficking I/S Brian Dempsey 412-777-6945 brian.w.dempsey@usdoj.gov Sources Sources 360 Degree Strategy Strategic collaboration and guidance via three interconnected avenues. Community
Montgomery County Poisoning Death Review, 2016: Quarter I Updated June 20, 2016
Montgomery County Poisoning Death Review, 2016: Quarter I Updated June 20, 2016 Prepared by: Robert G. Carlson, Ph.D., Professor and Director, Project Director Linna Li, M.S., Data Manager Raminta Daniulaityte,
Drug Name (specify drug) Quantity Frequency Strength
Prior Authorization Form GEHA FEDERAL - STANDARD OPTION 1363-M Opioids IR MME Limit and Post Limit This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information,
WEBINAR TRIBAL LAW ENFORCEMENT AND DRUG ENDANGERED CHILDREN ISSUES IN INDIAN COUNTRY
WEBINAR TRIBAL LAW ENFORCEMENT AND DRUG ENDANGERED CHILDREN ISSUES IN INDIAN COUNTRY THANK YOU Supported by the Department of Justice- Office of Community Oriented Policing Services PRESENTED BY Steven
2017 Drug Use Trends in King County, Washington
May 2018 2017 Drug Use Trends in King County, Washington Contributors: Caleb Banta-Green, PhD MPH MSW, Jason Williams, PhD and the King County Community Epidemiology Workgroup Drug Specific Synopses for
RP PERCOCET STREET VALUE
RP 5 325 PERCOCET STREET VALUE Rp 5 325 Percocet Street Value Max dose of percocet a day Urgent care percocet bothell wa 98012 directions I need a substitute for percocet 10/325 percocet Percocet constipation
Reducing Opioid Deaths: Arizona s Emergency Declaration & Response
Reducing Opioid Deaths: Arizona s Emergency Declaration & Response September 15, 2017 Sheila Sjolander, Assistant Director Arizona Department of Health Services Emergency Declaration On June 5, 2017, Arizona
Opioid Overdose in Oregon Report to the Legislature
SEPTEMBER 2018 Opioid Overdose in Oregon Report to the Legislature This report summarizes the burden of opioid overdose among Oregonians as required by ORS 432.141. It describes Oregon s progress in reducing
Drug and Alcohol Dependence
Drug and Alcohol Dependence 149 (2015) 117 121 Contents lists available at ScienceDirect Drug and Alcohol Dependence journal homepage: www.elsevier.com/locate/drugalcdep Trends in abuse and misuse of prescription
Norco cost black market
P ford residence southampton, ny Norco cost black market Aug 16, 2013. Crowdsourced data provide a valid estimate of the street price of diverted prescription opioids. The (ostensibly free) black market
``Considerations for using opioid drug therapy in workers compensation include patient safety, drug effectiveness and financial impacts
Opioids Effective Case Management Opioids RELEVANCE IN WORKERS COMP Opioids are a diverse group of drugs that represent the strongest pain medications available. They are frequently prescribed for pain
APPROVED PA CRITERIA. Initial Approval: January 10, 2018 Revised Dates: April 11, 2018 CRITERIA FOR PRIOR AUTHORIZATION
Initial Approval: January 10, 2018 Revised Dates: April 11, 2018 CRITERIA FOR PRIOR AUTHORIZATION PROVIDER GROUP Pharmacy Opioid Products Indicated for Pain Management MANUAL GUIDELINES All dosage forms