Preventing Opioid Misuse in Texas Kasey Strey, ACPS, SPF-Rx Project Director Jessica Duncan Cance, MPH, PhD, TTOR Lead Purpose Provide an overview of HHSC -funded opioid misuse prevention activities Discuss statewide strategic plan goals 2 1
Substance Abuse What are Opioids? What is primary prevention? Texas Targeted Opioid Response (TTOR) Strategic Framework for Prescription Drugs (SPF-Rx) Open Discussion Strategic Framework (SAMHSA) 3 What are opioids and how do they work? Source: CNN Available at: http://www.cnn.com/videos/health/2014/08/26/orig -am-animation-brain-on- heroin -sanjay-gupta.cnn 4 2
Opioid-Related Overdose Deaths in Texas 3 Deaths per 100,000 Population 2.5 2 1.5 1 0.5 0 1999 2004 2009 2014 Heroin Methadone Other and unspecified narcotics Other opioids Other synthetic narcotics 5 6 3
What is Primary? Upstream Photo Source: southernliving.com 7 What is Primary? To prevent disease or injury before it ever occurs. Examples include: Education about healthy and safe habits Legislation and enforcement 8 4
Opioid Misuse in Texas Existing Services Texas Targeted Opioid Response Strategic Framework for Prescription Drugs 9 in Texas 11 Regional Resource Centers 52 Coalitions 163 Youth Programs Community Organizational Interpersonal Intrapersonal Source: McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education & Behavior, 15(4), 351-377. 10 5
Texas Targeted Opioid Response (TTOR) Increased access to care and supports Reduction of service gaps within the continuum of care Increased awareness for the public through education and outreach 11 SPF-Rx Five -year SAMHSA grant Goals Raise awareness about the dangers of sharing prescriptions and the risks of overprescribing Build upon existing data and monitoring infrastructure to better plan prevention efforts related to prescription drug misuse First year strategic planning 12 6
SPF-Rx Objectives Initial Strategic Ideas Workforce Development Community Education Disposal and Storage Monitoring Think & Discuss 13 Workforce Development Professionals Prescribers Source: Shah, A., Hayes, C.J., & Martin, B.C. (2017). Characteristics of initial prescription episodes and likelihood of long -term opioid use: United States, 2006-14 2015. MMWR Morb Mortal Wkly Rep 2017; 66:265-269. 7
TTOR Workforce Development Projects Distributing federal guidelines and related materials to all prescribers in Texas Opioid Misuse Summit Medication Assisted Treatment (MAT) Advocacy Suicide Partners Pharmacists Physicians Dentists Veterinarians MAT Providers LMHA/ LBHA Recovery Coaches Oxford Houses Substance Abuse Providers Community Organizations Law Enforcement 15 Community Education Youth and Young Adults Communities Health Providers 16 8
TTOR Community Education Projects Expanding universal prevention programming Opioid 101 Comprehensive Overdose MAT Providers Substance Abuse Providers Partners Schools Community Organizations Pharmacists Physicians Dentists Veterinarians Public Health LMHA/ LBHA Law Enforcement Oxford Houses Criminal Justice Recovery Coaches 17 Disposal and Storage Take -Back Events & Drop -Boxes Individual Medication Disposal Pouches Lock -Boxes Source: Cance, J.D. (2016) Texas College Survey of Substance Use: 2015 Executive Summary. Available at: https://texascollegesurvey.org/wp -content/uploads/2016/12/texas-college-survey- 2015 -Executive-Summary-1.pdf 18 9
Prescription Opioid Misuse Approximately ten percent of Texas youth have ever misused prescription opioids Nearly ten percent of Texas college students misused prescription opioids in the past year Source: http://www.goodyearaz.gov/government/departments -divisions-a- z/police/community -policing/drop-box-for-prescriptions 19 Monitoring Texas Prescription Monitoring Program High Utilization Consistent Reporting Sources: NY, TN; PDMP Center of Excellence at Brandeis University, 2014, FL: Vital Signs Morbidity and Mortality Weekly Report, July 1, 2014 20 10
Texas Prescription Monitoring Program Moved from the Department of Public Safety to the Texas Board of Pharmacy in 2016 Prescriber mandate passed Spring 2017 (HB2561) Registration Look up prior to prescribing opioids, benzodiazepines, barbiturates, or carisoprodol 21 What Did We Miss? 22 11
Thank you Kasey.Strey@hhsc.state.tx.us Jessica.Cance@hhsc.state.tx.us 2017 Behavioral Health Institute Austin, TX 23 12