Data-Driven Multidisciplinary Approaches to Reduce Prescription Drug Abuse in Kentucky Hal Rogers PDMP Grant. Action Team Meeting.

Transcription

1 Data-Driven Multidisciplinary Approaches to Reduce Prescription Drug Abuse in Kentucky Hal Rogers PDMP Grant Action Team Meeting December 12, 2016

2 Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released December, Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at on Dec 8, 2016

3 States with the Highest Age-Adjusted Drug Overdose Mortality Rates, 2015 Deaths Population Crude Rate per 100,000 Age-Adjusted Rate per 100, West Virginia (54) 725 1,844, New Hampshire (33) 422 1,330, Ohio (39) 3,310 11,613, Kentucky (21) 1,273 4,425, Rhode Island (44) 310 1,056, Pennsylvania (42) 3,264 12,802, Massachusetts (25) 1,724 6,794, New Mexico (35) 501 2,085, Utah (49) 646 2,995, Tennessee (47) 1,457 6,600, Connecticut (09) 800 3,590, Delaware (10) , Maine (23) 269 1,329, Maryland (24) 1,285 6,006, Nevada (32) 619 2,890, Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released December, Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at on Dec 8, 2016

4 Kentucky Resident Drug Overdose Deaths, Age-Adjusted Rate per 100,000 Population Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released December, Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at on Dec 8, 2016

5 Kentucky Resident Drug Overdose Deaths, Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released December, Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at on Dec 8, 2016

6 Kentucky Resident Drug Overdose Deaths, Rate per 100,000 population Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released December, Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at on Dec 8, 2016

7 Kentucky Resident Drug Overdose Deaths, Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released December, Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at on Dec 8, 2016

8 Kentucky Resident Drug Overdose Deaths, Rate per 100,000 Population Involving Heroin Involving Natural/Semi-synthetic Opioids Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released December, Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at on Dec 8, 2016

9 Drug Overdose Deaths, Kentucky and the U.S. Age-Adjusted Drug Overdose Mortality Rate, Mortality Rate (# Deaths /100,000 Population) US KY Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released December, Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at on Dec 8, Data are provisional and subject to change.

10 Drug Overdose Deaths, Kentucky and the U.S. Mortality Rate (# Deaths /100,000 Population) Age-Adjusted Rate for Drug Overdose Deaths Involving Natural and Semi-synthetic Opioids (T40.2), U.S KY Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released December, Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at on Dec 8, Data are provisional and subject to change.

11 Drug Overdose Deaths, Kentucky and the U.S. Age-Adjusted Rate for Drug Overdose Deaths Involving Heroin(T40.1), Mortality Rate (# Deaths /100,000 Population) US KY Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released December, Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at on Dec 8, Data are provisional and subject to change.

12 Drug Overdose Deaths, Kentucky and the U.S. Age-Adjusted Rate for Drug Overdose Deaths Involving Synthetic Opioids Other than Methadone (T40.4), Mortality Rate (# Deaths /100,000 Population) U.S. KY Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released December, Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at on Dec 8, Data are provisional and subject to change.

13 Slide courtesy of the Kentucky Office of Drug Control Policy

14 Kentucky Resident Drug Overdose Hospitalizations Drugs Most Commonly Listed as Contributing to the Overdoses Jan 1, 2010 Jun 30, Number Heroin - - Pharmaceutical Opioids -Cocaine -Benzodiazepines Note: An overdose that involved multiple drugs was counted under each relevant drug category. Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. December Data source: Kentucky Inpatient Claims Files, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

15 1200 Kentucky Resident Drug Overdose Emergency Department Visits Drugs Most Commonly Listed as Contributing to the Overdoses Jan 1, 2010 Jun 30, , Heroin Cocaine Pharmaceutical Opioids Benzodiazepines Number Note: An overdose that involved multiple drugs was counted under each relevant drug category. Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. December Data source: Kentucky Outpatient Services Claims Files, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

16 Kentucky Resident Drug Overdose ED Visits Involving Opiates/Opioids (n=3,524), Oct 1, 2015 Sep 30, 2016 by Specific Drug/Drug Class N (%) Heroin 2,856 (81%) Pharmaceutical Opioids 689 (20%) Natural and Semi-synthetic Pharmaceutical Opioids 495 (14%) Methadone 46 (1%) Synthetic opioids, other than Methadone 119 (3%) Case selection: ED visits with: 1) any diagnosis (principal or secondary) in the ICD10CM code range T40.0 T40.4; and 2) 6 th character equal to 1, 2, 3 or 4 ( unintentional, self-harm, assault, undetermined intent) (i.e. adverse effect and underdosing were excluded); and 3) 7 th character A (initial encounter), or D (subsequent encounter) Note: An overdose that involved multiple drugs was counted under each relevant drug category. Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. December Data source: Kentucky Outpatient Services Claims Files, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

17 Total number of hospitalizations with a diagnosis (principal or secondary) for opioid misuse (i.e. opioid dependence, nondependent opioid abuse, or opioid overdose) Hospitalizations with a diagnosis for opioid misuse and a concurrent diagnosis for: HBV HCV HIV Endocarditis Bacteremia/Sepsis Osteomyelitis/Septic Arthritis Skin and Soft Tissue Infections 8,701 9,577 10,252 10,022 11, % 1.5% 1.7% 2.1% 2.2% % 14.4% 16.8% 21.0% 23.9% % 0.3% 0.4% 0.3% 0.5% % 0.6% 0.7% 0.8% 0.9% % 3.4% 3.8% 4.7% 5.6% % 0.6% 0.7% 0.8% 1.4% % 5.2% 5.8% 7.3% 7.2% Significant change in the percentage of co-existing diseases from 2010 to 2014 Yes; p<.0001 Yes; p<.0001 Yes; p= Yes; p<.0001 Yes; p<.0001 Yes; p= Yes; p<.0001 Note: Infectious disease percentages are not mutually exclusive within the same year; A case with multiple infectious disease diagnoses was counted under each relevant category. Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. December Data source: Kentucky Outpatient Services Claims Files, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

18 Slide courtesy of the Kentucky HIV Prevention Program, DPH * *

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23 Neonatal Abstinence Syndrome Counts and Rates, Kentucky-resident Newborns, Data Source: Kentucky Inpatient Hospitalization Claims Year NAS birth count Total birth count NAS birth rate , , , , , , , , , , , , , , ,060 49, ,090 49, Neonatal Abstinence Syndrome case definition: 1) Any mention of ICD-9-CM diagnosis code (ICD-10-CM code P96.1), AND 2) Any mention of ICD-9-CM diagnosis code V30-V39 (liveborn infant according to type of birth) (ICD-10-CM code Z38), AND 3) Kentucky resident, AND 4) Patient s year of birth matches the reporting year (inpatient files were searched for the reporting year and the first quarter of the following year). Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. December Kentucky Inpatient Hospitalization Claims Files, Frankfort, KY, [ ]; Cabinet for Health and Family Services, Office of Health Policy. Data for are provisional; therefore these results are subject to change.

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26 Svetla Slavova Kentucky Injury Prevention and Research Center Contact Information for Data Requests: