Michael L. Buenger Administrative Director Supreme Court of Ohio Columbus, Ohio The Regional Judicial Opioid Initiative 17-305 Table of Contents The Regional Judicial Opioid Initiative PowerPoint Presentation... 1 The Regional Judicial Opioid Initiative i
ii Opiate Summit
OSBA/OJC Opiate Summit Michael L. Buenger, Esq. Administrative Director Supreme Court of Ohio The Regional Judicial Opioid Initiative The Regional Judicial Opioid Initiative 1
Defining the Problem as a Region - Population Combined population of the participating states is 75,092,570 or almost 25% of the country s population. Of that population, 27,688,665 live in Metropolitan Statistical Areas (MSAs) that cross two or more states. The five largest are: - Chicago MSA 9,551,031 (3 rd largest) - Washington DC MSA 6,097,684 (6 th largest) - Philadelphia MSA - 6,069,875 (7 th largest) - Cincinnati MSA 2,157,719 (28 th largest) - Louisville MSA 1,278,413 (43 rd largest) Also within the region is the Detroit MSA and the Toledo MSA that when combined has a population of 4,947,677. Defining the Problem as a Region - Population 2 Opiate Summit
Defining the Problem as a Region - Transportation Defining the Problem as a Region - Transportation The Regional Judicial Opioid Initiative 3
Defining the Problem - Deaths Defining the Problem Drug Poisoning 4 Opiate Summit
Defining the Problem Drug Poisoning Defining the Problem Drug Poisoning The Pharmacies Thriving in Kentucky s Opioid-Stricken Towns by Phil Galewitz / Kaiser Health News A Family Drug Center pharmacy in Manchester, Ky., one of 11 pharmacies in the city of 1,500 people that fill prescriptions for opioid drugs. The Atlantic Month, February 7, 2017 The Regional Judicial Opioid Initiative 5
Defining the Problem Drug Poisoning Clay s residents (population 21,000) filled prescriptions for 2.2 million doses of hydrocodone and about 617,000 doses of oxycodone in the 12-month period ending last September that s about 150 doses for every man, woman, and child. Defining the Problem Regional Drug Poisonings Drug Poisoning Death Rate per 100,000, by County (2010-2014) Source: CDC NVSS Multiple Cause of Death File 6 Opiate Summit
Defining the Problem Opioid Use Defining the Problem Multi Drug Abuse The Regional Judicial Opioid Initiative 7
Defining the Problem - Ohio Ten Year Growth in Drug Poisoning Deaths, Rate Per 10,000 Population 2006 2015 The Regional Judicial Opioid Initiative Goals Explore solutions to opioid problem that knows no borders Work more effectively across state lines to coordinate the judicial response to the crisis Develop regional working relationships between courts, treatment providers, and justice system partners 8 Opiate Summit
Regionally Approach on Three Fronts - Data Improving PDMP exchanges, data flows and record-linking on use, poisonings and deaths across boundaries. Regionally Approach on Three Fronts Regional Best Practices Develop regional best practices, coordinating MAT programs and drug court procedures, and spreading this throughout the region. The Regional Judicial Opioid Initiative 9
Regionally Approach on Three Fronts - Children Expand opportunities for cross-border emergency child placement and evaluation of family situations. Data Sharing - Objectives Improve sharing of controlled substances prescription drug information on offenders participating in a drug court program Prevent people from playing both sides of the border Ensure offenders fully compliant with drug court program requirement 10 Opiate Summit
Data Sharing What s Happening March 7 & 8 representatives from states involved in the RJOI met in Nashville to discuss data coordination. From the meeting came the following initiatives: - Ensure PDMP reciprocity amongst the states. - Establish a method to track overdoses and reversals (use of naloxone). - Develop data sharing to forecast the rise of future epidemics. - Provide training and education to all relevant stakeholders. HB49 contains provisions allowing drug courts direct access to Ohio s PDMP system OARRS Regional Best Practices - Objectives Identify best practices from an accountability and treatment perspective that can apply regionally. Expand cross-border treatment options. Encourage adoption of cross-border practices and protocols for testing & treatment facilities. The Regional Judicial Opioid Initiative 11
Regional Best Practices What s Happening The Substance Abuse and Mental Health Services Administration (SAMHSA) is planning on convening a policy academy this summer to work on the development of regional best practices. Promote regional training & education on standards of care and use of Medication Assisted Treatment (MAT) in drug courts. Children - Objectives Provide rapid but safe placement with relatives/caregivers in other states when parents arrested/hospitalized for opioid or substance abuse poisoning Minimize trauma & reduce foster system costs Modernize interstate placement of children Promote a regional approach that is not dependent on cross-border county agreement 12 Opiate Summit
Children Opiate Impact PCSAO Survey Regarding Opiate Epidemic Impacts Percent of Children Entering Custody in 2015 Whose Parents Were Using Drugs Statewide is 50% Children Opiate Impact Widespread Impact of the Opioid Crisis on Ohio's Children Percentage of county child welfare agency directors in 2016 who rated the abuse of the following substances as a serious problem in their community 100% 97% 80% 60% 40% 20% 37% 31% 23% 11% 9% 0% Opioids Stimulants Marijuana Other Alcohol Cocaine Source: Public Children Services Association of Ohio, survey of county child welfare agency directors, April 2016 (N=75). The Regional Judicial Opioid Initiative 13
Children What s Happening IMAGE: THINKSTOCK Children What s Happening In conjunction with the Council of State Governments (CSG) and in cooperation of several public and private partnerships, convene a study group to: - Examine the current state of emergency cross-border placement procedures. - Examine how current mechanisms and protocols can be changed to enable courts and child protective services to provide for rapid emergency cross-border placements. - Develop a regional agreement, if feasible, in place of county-to-county agreements. 14 Opiate Summit
Questions? The Regional Judicial Opioid Initiative 15