Drug Overdose in New Mexico

Transcription

1 Drug Overdose in New Mexico Behavioral Health Collaborative January 8, 2015 Jim Davis, MA Drug Epidemiologist New Mexico Department of Health

2 Deaths per 100,000 persons 30.0 Drug Overdose Death Rates New Mexico and United States, New Mexico United States Year Source: United States (CDC Wonder); New Mexico (NMDOH BVRHS/SAES, ; NM-IBIS, )

3 Drug Overdose Death Rates by State, US, 2012 Source: CDC Wonder 12/11/14

4 Drug Poisoning Death Rates Leading States, U.S., 2012 Rank State Deaths per 100,000 1 West Virginia Kentucky New Mexico Utah Nevada U.S. Sources: CDC MMWR 63(26) Rates are age-adjusted to the 2000 US Standard Population.

5 Deaths per 100,000 population Leading Causes of Injury Death 35.0 New Mexico, Fall Motor Vehicle, Traffic Poisoning Rates age-adjusted to the US 2000 standard population Source: NMDOH BVRHS

6 Deaths per 100,000 population 30 Drug Overdose Death Rate by Type, NM, Total Prescription Illicit 2013 data are preliminary and subject to change Prescription and illicit categories are not mutually exclusive Rates are age adjusted to the US 2000 standard population Source: Office of the Medical Investigator; UNM/GPS population

7 Deaths per 100,000 population Drug Overdose Death rates for Selected Drugs, NM Rx Opioid Heroin Missing data for specific drugs in 2010 and 2011 omitted Categories are not mutually exclusive Rates are age adjusted to the US 2000 standard population Source: Office of the Medical Investigator; UNM/GPS population

8 Drug Overdose Death Rates by County, New Mexico, and U.S., 2012 Drug Overdose Deaths per 100,000 Population by County, NM and US 2012 County (# of deaths, % of total deaths) Rio Arriba (127, 5.4%) Mora (12, 0.5%) Sierra (30, 1.3%) Catron (5, 0.2%) Quay (14, 0.6%) San Miguel (46, 2%) Hidalgo (7, 0.3%) Taos (45, 1.9%) Torrance (22, 0.9%) Bernalillo (892, Santa Fe (186, 7.9%) Grant (34, 1.4%) Valencia (98, 4.2%) Lincoln (24, 1%) Colfax (15, 0.6%) Chaves (71, 3%) New Mexico (2,352, Eddy (55, 2.3%) Socorro (20, 0.9%) Otero (65, 2.8%) San Juan (113, 4.8%) Sandoval (116, 4.9%) Dona Ana (173, 7.4%) Guadalupe (4, 0.2%) Lea (52, 2.2%) Los Alamos (13, 0.6%) Luna (17, 0.7%) Roosevelt (13, 0.6%) McKinley (44, 1.9%) Curry (24, 1%) Cibola (13, 0.6%) Union (1, 0%) Harding (0, 0%) De Baca (0, 0%) US (2012) Rates are age-adjusted to the US 2000 standard population Source: NMDOH/BVRHS death files and UNM/GPS population Deaths per 100,000 population

9 Examples of common opioid prescriptions and the morphine milligram equivalent (MME) quantity for the prescription Prescription Total daily MME Fentanyl transdermal, 25 mcg per patch, each patch used for three days 60.0 Oxycodone, 15 mg, four times per day 90.0 Tramadol, 100 mg, four times per day 40.0 Methadone, 10 mg, two times per day 60.0 Acetaminophen/hydrocodone, 325 mg/5 mg, four times per day 20.0

10 MME per person Rx Overdose Deaths per 100, Prescription Overdose Death Rate and MME of Opioids Dispensed, NM MME/population Rx OD Death Rate Death rate age-adjusted to US 2000 standard population Source: Office of the Medical Investigator GPS pop; NM PMP

11 Doses dispensed Reversals reported Responses to the Drug Overdose Epidemic in New Mexico NMDOH Harm Reduction Program Syringe services (exchange +) since 1998 Naloxone distribution since Total Naloxone Doses Dispensed Reversals Reported Source: NM DOH Harm Reduction Program Source: NM DOH Harm Reduction Program

12 Responses to the Drug Overdose Epidemic in New Mexico Overdose Death as NM Department of Health Priority Indicator Prescription Drug Monitoring Program (PMP) changes in Web-based, direct inquiry system Require PMP registration for controlled substance license Reports to licensing boards of prescribers who meet certain risky prescribing criteria

13 Responses to the Drug Overdose Epidemic in New Mexico (Cont.) Governor s Prescription Drug Misuse and Overdose Prevention and Pain Management Advisory Council (SB215 out of 2012 Legislative Session) Recommendations, including for rule changes Professional Health Care Provider Boards Rules Changes ( ) Require PMP use, consultations on chronic pain Further work on PMP metrics and reporting Prescriber report cards Additional measures of prescribing practices

14 Responses to the Drug Overdose Epidemic in New Mexico (Cont.) Mainstreaming Naloxone Board of Pharmacy: Expansion of Naloxone Prescriptive Authority Human Services Department/Medical Assistance Division: Medicaid Reimbursement for Naloxone Rescue Kits NMDOH Naloxone Co-Prescription Pilot Programs launched in Taos, Roswell and Santa Fe Detention Center Pilot Planning with San Miguel County and Santa Fe County Detention Centers Working to get pharmacies to stock naloxone Encouraging co-prescription by opioid prescribers Wrench in the works: Cost of naloxone doubled in late 2014

15 Questions? Thank You