Data-Driven Prevention Initiative

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Data-Driven Prevention Initiative Arturo Brito, MD,MPH Deputy Commissioner New Jersey Department of Health Pain, Pain Management & Opioid Epidemic Symposium Princeton, New Jersey December 2, 2016 Reducing Opioid Misuse & Abuse in New Jersey

Objectives To summarize key state actions in recent years to tackle the opioid crisis in New Jersey To describe the role of the New Jersey Department of Health (DOH) To outline goals & objectives of a recently awarded grant from the Centers for Disease Control & Prevention (CDC) to (DOH)

Timeline of State Efforts May 2013 Overdose Prevention Act July 2013 State Commission of Investigation Report: Scenes from an Epidemic March 2014 Health Commissioner Waiver: Expansion of Scope for 1 st responders March 2014 GCADA Releases Master Plan April 2014 Governor Christie: Police Pilot Program (Ocean & Monmouth), Expands June

Timeline of State Efforts May 2014 Addiction Does Not Discriminate Campaign Launched June 2014 Health Commissioner : ASTHO Pledge to Reduce Prescription Drug Abuse & Deaths August 2014 State Opioid Core Working Group: Established post-samhsa Policy Academy September 2014 State Opioid Study Team Established October 2014 Facing Addiction Task Force

State Opioid Core Working Group Department of Law and Public Safety Office of Attorney General State Police Juvenile Justice Commission Department of Human Services Mental Health & Addiction Services Medicaid Department of Health Office of the Deputy Commissioner, Public Health Services Program Manager, HIDTA NY/NJ Regional Office (As of September 2016) Department of Children and Families Department of Corrections (As of September 2016) Governor s Council on Alcoholism and Drug Abuse Licensed Substance Abuse Prevention and Treatment Agency Parent Who Lost Child to an Opioid Overdose

NJSP Regional Operations Intelligence Center (ROIC) Fusion Liaison & Intelligence Training Unit An Intelligence Capability for Public Health & Public Safety Partners

Timeline of State Efforts December 2014 Drug Monitoring Initiative Regional Symposium I (II in June 2015) January 2015 NJ Selected for In-Depth Technical Assistance Initiative on Substance Exposed Infants June 2015 Attorney General Reaches Agreement to Receive Rebate on Naloxone Purchases July 2015 Prescription Monitoring Program Strengthened September 2015 RFPs for Opioid Overdose Prevention and Recovery Programs (OOPP & OORP) Awarded

State Efforts February 2015 Expansion of Overdose Prevention Act May 2015 Substance Exposed Infants- IDTA Site Visit September 2015 Prevention Pathways Defined 2016 Federal grants received

Prevention Pathways Prevention Pathways are evidence-informed, substance abuse mitigation strategies that utilize a comprehensive approach to prevent, reduce, and eliminate drug abuse & misuse in New Jersey.

Prevention Pathway Process Supply and Demand Communities Utilize entire spectrum of prevention Weaken risk factors Strengthen protective factors Reduce drug misuse, abuse, and dependence

Priority Prevention Pathway Communities 1. Per Capita Impact 2. Geographic Impact 3. Social Indicators 4. Trends 5. Community Readiness

Identifying & Collecting Data Strategically

Solving the Puzzle: Developing an integrated data system

NJ Opioid Study Team Goal To identify, use, and build upon existing data related to opioid use and misuse so as to drive state efforts in mitigating this public health problem.

NJ Opioid Study Team Objectives To identify existing data sources, analyze, and interpret information related to opioid use & misuse; To identify data gaps & address them, as appropriate; and To share opioid-related data in meaningful & useful ways with key State agencies & other partners in order to decrease morbidity & mortality associated with opioid use & misuse.

NJ Opioid Study Team Department of Health Deputy Commissioner, Public Health Services Director, Center for Health Statistics & Informatics Data Manager, Office of Emergency Medical Services Epidemiologist, HIDTA NY/NJ Regional Office (As of September 2016) Office of the Attorney General Unit Head, New Jersey State Police, Regional Operations Intelligence Center Forensic Administrator, Office of the Sate & Southern Regional Medical Examiners Offices

NJ Opioid Study Team Department of Children & Families, Clinical Services Director Department of Human Services Coordinator, Performance Evaluation & Presentation, Office of the Director, Division of Medical Assistance & Health Services (Medicaid) Director, Research, Planning, Evaluation & Information Systems, Division of Mental Health and Addiction Services, DHS

Data aspects Availability Source Methodology Potential use Limitations

Challenges Legal/ethical Epidemiological expertise/support Competing priorities

Successes Data Use Agreement (DUA) with State Police Contributions to State agency grants Uniform agreement with State Medical Examiner s Office Centers for Disease Control & Prevention (CDC) grant

CDC Grant: Data Driven Prevention Initiative $2.1 million (3 years) Components Base: Planning & Data Enhanced: Prevention in Action

Planning & Data Strategy 1: Planning Activity 1: Developing & Strengthening Partnerships Goal: Strengthen the effectiveness of existing interagency groups currently addressing the opioid crisis in New Jersey.

Planning & Data Strategy 1: Planning Activity 2: Develop a Prescription Drug & Heroin Overuse, Misuse & Abuse Prevention Strategy Goal: Build on the Prevention Pathways model to more effectively address the opioid crisis in New Jersey.

Planning & Data Strategy 2: Data Activity 1: Enhance Surveillance of Prescription Drug and Heroin Abuse & Overdose Goal: Streamline use of data that would most effectively lead to prevention, management, and treatment activities related to opioid overuse, misuse & abuse.

Planning & Data Strategy 2: Data Activity 2: Enhance Public Health Access & Application of Data from Multiple Sources Goal: Ensure access to relevant information for key stakeholders throughout the State so that prevention efforts can be implemented.

Prevention in Action Strategy 1: Enhance & Maximize PDMPs Activity 1: Make PDMPs easier to use & access Goal: Increase use & accessibility of the NJPMP by prescribers & pharmacists.

Prevention in Action Strategy 1: Enhance & Maximize PDMPs Activity 2: Conduct public health surveillance with PDMP data & publicly disseminate Goal: Improve the NJPMP s ability to serve as a public health surveillance tool.

Prevention in Action Strategy 2: Policy Evaluation Activity: Conduct a rigorous policy evaluation Goal: Enhance the understanding of New Jersey s existing opioid-related policies and their impact on public health indicators & improve their ability to reduce opioid overuse, misuse, abuse & overdose.

Comprehensive Approach- NJ s Strategic Plan to Addressing the Opioid Epidemic Expand & Strengthen Prevention Strategies. Improve Monitoring & Surveillance. Expand & Strengthen Control and Enforcement. Improve Access to & Use of Effective Treatment & Recovery Support. Use Data, Evaluation, & Research to Inform Interventions and Continuous Improvement. Secure/Align Resources and Infrastructure to Implement Comprehensive Approaches. Expand & Strengthen Key Partnerships and Collaborative Infrastructure.

Discussion LEARN MORE www.cdc.gov/drugoverdose/prescribing/guideline.html