Community Kick-off Event August 3, 2017
Welcome County Commissioner Josh Parsons Mayor Tim Bradley, Mayors Association
Today s Agenda 8:00 am Welcome/Opening Remarks County Commissioner Josh Parsons Mayor Tim Bradley, Mayors Association 8:15 am A Snapshot of Lancaster County Jessica Klinkner, MPH CHES Lancaster General Health/Penn Medicine 8:30 am Framework for Action (Joining Forces) Alice Yoder, RN, MSN Lancaster General Health/Penn Medicine 8:45 am SWOT (Strengths, Weaknesses, Opportunities and Threats) Dani Beam, Facilitator 9:45 am Break 10:00 am 10:45 am 11:00 am Adjourn Common Themes from SWOT Next Steps/Closing Remarks
Snapshot of Lancaster County Jessica Klinkner, MPH CHES Lancaster General Health/Penn Medicine
Protective Factors for Substance Misuse and Abuse Community Rewards for Prosocial Involvement Family Family Attachment Opportunities for Prosocial Involvement Rewards for Prosocial Involvement School Opportunities for Prosocial Involvement Rewards for Prosocial Involvement Peer/Individual Interaction with Prosocial Peers Prosocial Involvement Rewards for Prosocial Involvement Belief in the Moral Order Religiosity 58% Have 3 or more Protective Factors Source: 2015 Pennsylvania Youth Survey
Risk Factors for Substance Misuse and Abuse Low Neighborhood Attachment Perceived Availability of Drugs Laws & Norms Favorable Toward Drug Use Family History of Antisocial Behavior Poor Family Management Parental Attitudes Favorable Toward Drug Use Parental Attitudes Favorable Toward Antisocial Behavior Family Conflict Academic Failure Low Commitment Toward School Rebelliousness Gang Involvement Perceived Risk of Drug Use Attitudes Favorable Toward Drug Use Attitudes Favorable Toward Antisocial Behavior Sensation Seeking Rewards for Antisocial Behavior Friend's Use of Drugs Interaction With Antisocial Peers Depressive Symptoms Source: 2015 Pennsylvania Youth Survey 36%Total Risk
Lancaster County Youth Heroin Use: 0.4% Narcotic Prescription Drug Use: 5.7% 42.4% took them from a family member living in their home 46.8% received them from a friend or family member 21.7% bought them from someone Source: 2015 Pennsylvania Youth Survey
Lancaster County Youth 26% of youth state that it is Sort of Easy or Very Easy to access prescription pain drugs Source: 2015 Pennsylvania Youth Survey
An estimated 32,866 people aged 12+ may be in need of substance abuse treatment at any given time. Source: Lancaster County Drug and Alcohol Commission 2016 Treatment Needs Assessment Summary
9-1-1 EMS Overdose/Poisoning Related Calls 1600 1400 1200 1000 Annualized for the remainder of 2017 800 600 400 200 0 2010 2011 2012 2013 2014 2015 2016 2017 through 6/29 Source: Lancaster County-Wide Communications
Source: Lancaster County-Wide Communications Emergency Overdose Reports 2014-2016
Successful Naloxone Reversals by Police Officers in Opioid Overdose Events Source: Pennsylvania Department of Drug and Alcohol Programs, Rev. 7/12/17
Hospitalization Rate for Opioid Overdose, 2016 Source: Pennsylvania Health Care Cost Containment Council, Research Brief
Drug Related Overdose Deaths 2016 Source: Analysis of Overdose Deaths in Pennsylvania, 2016. Prepared by the DEA Philadelphia Division and the University of Pittsburgh.
Drug Related Overdose Deaths 2016 Source: Analysis of Overdose Deaths in Pennsylvania, 2016. Prepared by the DEA Philadelphia Division and the University of Pittsburgh.
Change In Overdose Deaths 2015-16 Source: Analysis of Overdose Deaths in Pennsylvania, 2016. Prepared by the DEA Philadelphia Division and the University of Pittsburgh.
Change In Overdose Deaths 2015-16 Source: Analysis of Overdose Deaths in Pennsylvania, 2016. Prepared by the DEA Philadelphia Division and the University of Pittsburgh.
Most Frequent Drug Category in Overdose Deaths, 2015-2016 Sources: Analysis of Drug Overdose Deaths in Pennsylvania, 2015. Prepared by the DEA Philadelphia Division. Analysis of Overdose Deaths in Pennsylvania, 2016. Prepared by the DEA Philadelphia Division and the University of Pittsburgh.
Most Frequent Drug Category in Overdose Deaths, 2016 Source: Analysis of Overdose Deaths in Pennsylvania, 2016. Prepared by the DEA Philadelphia Division and the University of Pittsburgh.
Deaths by Drug Category By Quarter 2016 30 Number of Overdose Deaths 25 20 15 10 5 0 Q1 Q2 Q3 Q4 Fentanyl/FRS/NPSOs Heroin Prescription Opioid Benzodiazepines Source: Analysis of Overdose Deaths in Pennsylvania, 2016. Prepared by the DEA Philadelphia Division and the University of Pittsburgh.
Total Overdose Deaths 2014-2017 180 160 Number of Deaths 140 120 100 80 60 40 20 60 80 117 98 Annualized for the remainder of 2017 0 2014 2015 2016 2017 (1/1-7/26) Sources: Pennsylvania State Coroners Association Report on Overdose Death Statistics, 2014 Analysis of Drug Related Overdose Deaths in Pennsylvania, 2015. Prepared by the DEA Philadelphia Field Division Analysis of Overdose Deaths in Pennsylvania, 2016. Prepared by the DEA Philadelphia Division and the University of Pittsburgh. Lancaster County Coroners Office
Overdose Deaths by Gender 2014-2017 90 80 70 Number of Deaths 60 50 40 30 20 10 0 2014 2015 2016 2017 (1/1-7/26) Male Female Sources: Pennsylvania State Coroners Association Report on Overdose Death Statistics, 2014 Analysis of Drug Related Overdose Deaths in Pennsylvania, 2015. Prepared by the DEA Philadelphia Field Division Analysis of Overdose Deaths in Pennsylvania, 2016. Prepared by the DEA Philadelphia Division and the University of Pittsburgh. Lancaster County Coroners Office
2017 Overdose Fatalities: a Closer Look 71% Male Median Age: 37 Majority White (estimated) 29 out of 60 municipalities Source: Lancaster County Coroner s Office
Framing the Issue Alice Yoder, MSN RN Facilitator, Joining Forces Coalition Director, Community Health Lancaster General Health/Penn Medicine
Good News!
Framework for Action
Evidenced Based Strategies Infrastructure: Build leadership and support Collect, trend, and report data Coordinate current efforts, focus and expand evidence based practices Implementation of multi-strategies taken to scale source: Substance Abuse and Mental Health Services Administration (SAMHSA)
Evidenced Based Strategies Safe prescribing (primary care, emergency depts., hospital inpatient) Prevent overdose deaths with the antidote Naloxone Education & training source: Substance Abuse and Mental Health Services Administration (SAMHSA)
Evidenced Based Strategies Community: (prescription proper use, storage & disposal) Provider (screening and referral for mental health, addiction and pain) School-based programs (evidence-based) Workplace EAP and insurance coverage Support services
Best Practices Page 1 of 3
Best Practices
Increase awareness of issue and local resources available Mayor Tim Bradley Chair, Anti-Heroin Task Force
Facilitate the use of evidence based school and community programs and initiatives Eric Kennel Executive Director
Fund treatment resources Expand treatment resources Facilitate distribution of information and resources Rick Kastner Executive Director, Lancaster County Drug and Alcohol Commission
Distribute Naloxone to individuals and families dealing with opioid addiction Police, Corrections, Courts Distribute information to the community on the appropriate use, storage and disposal of prescription opioids and promote take-back locations Educate prison personal on warning signs of overdose Provide harm reduction training to prisoners prior to release Support drug court program Josh Parsons Lancaster County Commissioner
Assist employers in educating and providing resources to employees Advocate to health insurers regarding coverage Cheryl Irwin-Bass VP and COO
Administer Naloxone and ED warm hand-offs Educate and train Chief Darrell Fisher President, Lancaster County EMS Council
Reduce stigma associated with people in recovery Provide resources and support for people in recovery Scott Theurer Chair, Lancaster County Recovery Alliance
Increase screening for anxiety, depression, and stress and streamline connections to behavioral health providers Promote worksite EAP Focus on co-occurring screening, referral, and treatment Dale Brickley WellSpan Philhaven Co-Chair, Let s Talk Behavioral Health Provider Action Team
Alice Yoder Lancaster General Health/ Penn Medicine Facilitator