Do your Part Be the Solution
Objectives: 1) What is opioid addiction? 2) How bad is it? 3) What can be done? a) Prevention i. Primary prevention (reduce new cases) ii.. Secondary prevention (manage the impacts) ii. Harm reduction ( delay death) b.) Treatment and recovery
Opioids are painkillers your provider may prescribe if you've been injured or had surgery. The illegal drug heroin is also an opiate. Prescription opioids include: Vicodin Kadian, Avinza Oxycontin, Percocet Source: NIDA (). Opioids. Retrieved May 12, 2017, from https://www.drugabuse.gov/drugs-abuse/opioids
The origins of Opium But, it s all natural!
The Physiology of opioid Addiction Artificial endorphins Body stops producing it s own endorphins User feels sick/depressed Opioid peptides and receptors are throughout the peripheral and central nervous system
The Spectrum of Prescription Drug Abuse Taking someone else s prescription to selfmedicate Taking a prescription medication in a way other than prescribed Taking medication to get high From Improper Use to Abuse
Neonatal Abstinence Syndrome (NAS) 86% of pregnancies are unintended in women using opioids.
Heroin-involved overdose hospitalization Age Adjusted Rates per 100,000 2015 Preliminary Data for the Highest Ranking Michigan Counties 30 25 26.7 20 16.9 15 14.1 12 10 9.6 5 SOURCE: Michigan Inpatient Database obtained from Michigan Health & Hospital Associations Service Corporation. 0 St. Clair Wayne Macomb Genesee Oakland
Heroin Mortality Michigan Rates (2013-2015) St. Clair County 4.6-10.5
Risk for Overdose Mixing drugs/alcohol Tolerance/period of abstinence Quality (unregulated, unfamiliar medications) Using alone Decrease health/breathing function Prior history of overdose
Kaiser Family Foundation. (2017). Opioid Overdose Death by Type of Opioid. Retrieved from http://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-type-of- opioid/?activetab=graph¤ttimeframe=0&starttimeframe=16&selecteddistributions=natural-and-semisynthetic-opioids-eg-oxycodone-hydrocodone--synthetic-opioids-other-than-methadone-eg-fentanyl-tramadol-- heroin&selectedrows=%7b%22states%22:%7b%22michigan%22:%7b%7d%7d%7d&sortmodel=%7b%22colid%22:%22location%22,%22sort%22:%22asc%22%7d MICHIGAN Opioid overdose deaths by type 700 600 500 400 300 Natural and Semisynthetic Opioids (e.g. oxycodone, hydrocodone)* Synthetic Opioids, other than Methadone (e.g. fentanyl, tramadol)** Heroin 200 100 0 1999 2001 2003 2005 2007 2009 2011 2013 2015 *includes natural opioid analgesics and semisynthetic opioid analgesics **opioids including drugs such as tramadol and fentanyl. Synthetic opioids are commonly available by prescription.
death is only the tip of the iceberg Picture source: http://stocksmasters.com/iceberg-release-1-8-ethereums-important-client/
Tx admissions Emergency Department visits People taking prescriptions for nonmedical use People who are dependant or abuse
Contributing costs include: Increased health care Substance abuse treatment Criminal justice Loss of productivity And much more Source: The White House Council of Economic Advisers https://whitehouse.gov/briefings-state-ments/cea-reportunderestimated-cost-opioid-crisis/ Princeton University https://www.brookings.edu/wpcontest/uploads/2017/09/1_krueger.pdf
It s time to Talk about it Opioid Overdose deaths now surpass: Car Crash deaths Firearm deaths
Percentage of Students Reporting Use of a Prescription Drug not Prescribed to Them in the Past 30 days 8.0% 7.0% 6.0% 5.0% 4.0% 3.0% 2.0% 1.0% 0.0% Source: 2015-2016 St. Clair County Michigan Profile for Healthy Youth (MiPHY) 7th grade 9th grade 11th grade Painkillers such as OxyContin, Codeine, Vidodin, or Percocet Prescriptions such as Ritalin, Adderall, or Xanax 11-1-17
Percentage of Students Reporting Use of Other Drugs in the Past 30 Days 8.0% 7.0% 6.0% 5.0% 4.0% 3.0% 2.0% 1.0% 0.0% *=Without Dr. RX Ritalin, Adderall, or Xanax* Oxycontin, Codeine, Vicodin, or Percocet* Club Drugs Cocaine Steroids Heroin Meth 9th grade 4.4% 6.7% 1.9% 1.4% 1.7% 0.9% 1.2% 11th grade 7.6% 7.0% 3.0% 1.9% 1.1% 1.0% 1.1% Source: 2015-2016 St. Clair County Michigan Profile for Healthy Youth (MiPHY) 11-1-17
MMEs prescribed per capita (2015) Morphine milligram equivalents (MMEs) of opioids prescribed per capita in 2015, by county.
You have the right to discuss the risks and benefits of prescription opioids with your doctor. Ask for alternative treatments.
Source: National Safety Council, news release, March 22, 2017 from https://medlineplus.gov/news/fullstory_164283.html
UAW-Ford Campaign of Hope Educating employees about the seriousness of the opioid epidemic and treatment resources available to them at the plants Encouraging employees with a problem to seek help and reassuring that admitting their problem will not put them in jeopardy of losing their job The UAW and Ford strongly encourage those with opioid addiction to visit their local Employee Support Services Program office for help UAW-Ford Join Forces to Fight Opioid Epidemic. (2018). Retrieved https://www.at.ford.com/en/homepage/news-andclipsheet/news/2018/1/uaw-ford-join-forces-to-fight-opioid-epidemic.html
Rx Access Points Source: SAMHSA. (2016). Results from the 2015 National Survey on Drug Use and Health: National Findings
CDC. (2016). Syringe Services Programs. https://www.cdc.gov/hiv/pdf/risk/cdc-hiv-syringe-services-programs.pdf
Community Services Coordinating Body
Looking to get involved? Call (810) 987-5300 or go to www.scchealth.co Funding is provided by MDHHS and Region 10 PIHP
Questions? Comments? Annette Mercatante, MD, MPH Medical Health Officer St. Clair County Health Department (810) 987-5309 amercatante@stclaircounty.org