Treating the Opioid Crisis: Assessing Programs to Address Overdose Deaths in West Virginia

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University of Minnesota Morris Digital Well University of Minnesota Morris Digital Well Undergraduate Research Symposium 2018 Undergraduate Research Symposium 4-14-2018 Treating the Opioid Crisis:

1 University of Minnesota Morris Digital Well University of Minnesota Morris Digital Well Undergraduate Research Symposium 2018 Undergraduate Research Symposium Treating the Opioid Crisis: Assessing Programs to Address Overdose Deaths in West Virginia Ruby DeBellis University of Minnesota, Morris, Follow this and additional works at: Part of the Health Policy Commons Recommended Citation DeBellis, Ruby, "Treating the Opioid Crisis: Assessing Programs to Address Overdose Deaths in West Virginia" (2018). Undergraduate Research Symposium This Book is brought to you for free and open access by the Undergraduate Research Symposium at University of Minnesota Morris Digital Well. It has been accepted for inclusion in Undergraduate Research Symposium 2018 by an authorized administrator of University of Minnesota Morris Digital Well. For more information, please contact

Background WV had the highest rate of overdose deaths in the country in 2016, that being 881, or 52 deaths per 100,000 people The opioid epidemic costs the state an

3 Background WV had the highest rate of overdose deaths in the country in 2016, that being 881, or 52 deaths per 100,000 people The opioid epidemic costs the state an estimated $8.8 billion per year The high abuse rate of opioids is attributed in part to the large number of jobs in heavy manual labor such as mining, timbering, and manufacturing

11 $ saved in productivity due to decreased overdose fatalities $ saved in productivity due to decreased opioid addiction $ saved in healthcare, substance abuse treatment, and criminal justice costs Cost of Implementation Cost-Benefit Analysis of Policy Alternatives Current Trends Prescription Regulation Injection Facilities Behavioral Health Clinics A1. $0 A2. $84 million A3. $113 million A4. $ 161 million B1. $0 B2. $79 million B3. $ 93 million B4. $142 million C1. $0 C2. $80 million C3. $ 80 million C4. $144 million D1. $0 D2. $1 million D3. $ 9 million D4. $10 million Table 1. Projected net benefits of each policy alternative based on the four outcomes listed. The net benefit was calculated by subtracting the cost of implementation from the total amount saved (benefits). Note that the net benefit for letting current trends continue is equivalent to the cost of not implementing all three proposed policies. Net Benefit E1. -$956 million E2. $242 million E3. $277 million E4. $437 million

13 Efficacy Efficiency Equity Political Acceptability Current Trends Very Low Very Low Very Low Very Low Prescription Regulation Moderate High Very High Very High Injection Facilities High High High Moderate Behavioral Health Clinics Very High Very High Moderate Very High Table 2. Evaluation of criteria for each policy alternative. These rankings were based on information found in the next section of the paper and in the appendix, and were used to determine the final policy recommendation. Explanations for each ranking can be seen below.

17 Bardach, E., & Patashnik, E. M. (2016). A practical guide for policy analysis: the eightfold path to more effective problem solving. Fifth edition. Thousand Oaks, California: CQ Press. Blumenschein, Karen et. al. (2010, June). Review of Prescription Drug Monitoring Programs in the United States. Institute for Pharmaceutical Outcomes and Policy. CCBHCs Planning Grants. (2015, Oct. 28). Substance Abuse and Mental Health Services cadministration. Certified Community Behavioral Health Clinics. (2017, Feb. 6). Minnesota Department of Human Services. adultmental-health/ccbhc/ Christie, Chris et. al. (2017, Nov. 1). The President s Commission on Combating Drug Addiction and the Opioid Crisis. Final Report to President Trump. Cicero, T. J., Ellis, M. S., Surratt, H. L., et al. (2014, July). The Changing Face of Heroin Use in the United States: A Retrospective Analysis of the Past 50 Years. JAMA Psychiatry. 71(7) DEA Intelligence Report. (2017, May). The West Virginia Drug Situation. DEA Washington Division Office. %20Drug%20Situation%20-UNCLASSIFIED.pdf Derfel, A. (2015, November 29). Safe-injection sites are cost-effective to health system: study. Drug Overdose Death Data. (2017, Dec. 19). Center for Disease Control and Prevention. Eyre, E. (2016, December 22). Personal interview with R. Martin. National Public Radio. Eyre, E. (2018a, Feb. 11). Study: Opioid epidemic costs state $8.8B a year. The Journal. Eyre, E. (2018b, Jan. 8). WV lawmakers seek to limit opioid prescribing. Charleston Gazett . makers-s eek-to-limit-opioid-prescribing/article_1b088ea7-de2c-55c8-98de-a293bece51f4.html Farley, Rebecca. (2016). CCBHCs 101: Opportunities and Strategic Decisions Ahead. National Council for Behavioral Health /11/A11_CCBHCs-101.pdf Frieden, T., Paulozzi, L. (2014, July 1). Vital Signs Prescription Drug Overdose (Personal Interview). Centers for Disease Control and Prevention. Getting Paid as a CCBHC. (2018). National Council for Behavioral Health. Gregg, Patrick. (2017, Nov. 28). WVU chief economist: Opioid crisis has cost West Virginia nearly $1 billion. WVU Today. HIV/AIDS. (2016, May 17). Syringe Services Programs. Centers for Disease Control and Prevention.

18 Insite user statistics. (2018, Feb). Supervised Injection User Statistics. Vancouver Coastal Health. insite-user-statistics Justice, Jim et. al. (2017, Aug. 17). West Virginia Drug Overdose Deaths: Historical Overview West Virginia Department of Health and Human Resources. Lazzara, Liz. (2016, Oct. 6). Does Drug Rehab Work? See Success Rates and Statistics. The Recovery Village. - success-rates/#gref Lopez, German. (2018, Feb. 6). Why some US cities are opening safe spaces for injecting heroin. Vox Media. njection -sites-heroin-opioid-epidemic Lurie, J. (2017, June 23). Here s How the Senate Health Bill Will Make the Opioid Crisis Even More Devastating. Mother Jones. heres how-the-senate-health-bill-will-make-the-opioid-crisis-even-more-devastating/ Mangan, Dan. (2018, Jan. 22). West Virginia dispensed 31 million fewer pills but opioid OD deaths still rose. CNBC LLC. I n-opioid-painkillers-prescribed-deaths-rose.html McConville, Jim. (2018, Feb. 20). Opioid reduction bill now moves to House. The Journal. bill-now-movesto-house/ Miskowiec, Don & Rosenberg, Linda. (2017). CCBHC Demonstration. National Council for Behavioral Health. National-CCBHC-survey-write-up-FINAL pdf (NIDA) National Institute on Drug Abuse. (2014, November). How is heroin linked to prescription drug abuse? National Institute on Drug Abuse. (NPA) National Prescription Audit. (2012). Opioid Painkiller Prescribing infographic. Center for Disease Control. Opioid Use Disorder Affects Millions (2016, Nov.) National Institute on Drug Abuse. Park, H., & Bloch, M., (2016, Jan. 7). How the Epidemic of Drug Overdose Deaths Ripples Across America. The New York Times. 01/07/us/drug-overdose-deaths-in-the-us.html Picard, A. (2012, August 23). Vancouver's safe injection site cuts overdose deaths. The Globe and Mail. Retrieved from /vancouvers-safe-injection-site-cuts-overdose-deaths/article577010/ What is a CCBHC? (2018). National Council for Behavioral Health. West Virginia Department of Health and Human Resources. (2017, Dec. 5). WVU in the News: Receives $1 million from opioid settlement to open new treatment beds in West Virginia. WVU Medicine. receives-1-million-from-opioid-settlement-to-open-new-treatmentbeds-in-west-virginia

Blue Cross of Idaho Addresses State s Opioid Issue

Blue Cross of Idaho Addresses State s Opioid Issue BY THE NUMBERS - Opioid Management page 3 THE PROBLEM - How Preventing Pain Hurt Us page 4 THE SOLUTIONS - Idaho State Board Of Pharmacy Prescription