Data-Driven Multidisciplinary Approaches to Reduce Prescription Drug Abuse in Kentucky Hal Rogers PDMP Grant Action Team Meeting December 12, 2016
Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December 2016. Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Dec 8, 2016
States with the Highest Age-Adjusted Drug Overdose Mortality Rates, 2015 Deaths Population Crude Rate per 100,000 Age-Adjusted Rate per 100,000 1. West Virginia (54) 725 1,844,128 39.3 41.5 2. New Hampshire (33) 422 1,330,608 31.7 34.3 3. Ohio (39) 3,310 11,613,423 28.5 29.9 4. Kentucky (21) 1,273 4,425,092 28.8 29.9 5. Rhode Island (44) 310 1,056,298 29.3 28.2 6. Pennsylvania (42) 3,264 12,802,503 25.5 26.3 7. Massachusetts (25) 1,724 6,794,422 25.4 25.7 8. New Mexico (35) 501 2,085,109 24.0 25.3 9. Utah (49) 646 2,995,919 21.6 23.4 10. Tennessee (47) 1,457 6,600,299 22.1 22.2 11. Connecticut (09) 800 3,590,886 22.3 22.1 12. Delaware (10) 198 945,934 20.9 22.0 13. Maine (23) 269 1,329,328 20.2 21.2 14. Maryland (24) 1,285 6,006,401 21.4 20.9 15. Nevada (32) 619 2,890,845 21.4 20.4 Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December 2016. Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Dec 8, 2016
Kentucky Resident Drug Overdose Deaths, 1999-2015 Age-Adjusted Rate per 100,000 Population Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December 2016. Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Dec 8, 2016
Kentucky Resident Drug Overdose Deaths, 1999-2015 Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December 2016. Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Dec 8, 2016
Kentucky Resident Drug Overdose Deaths, 2014-2015 Rate per 100,000 population Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December 2016. Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Dec 8, 2016
Kentucky Resident Drug Overdose Deaths, 2014-2015 Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December 2016. Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Dec 8, 2016
Kentucky Resident Drug Overdose Deaths, 2014-2015 Rate per 100,000 Population Involving Heroin Involving Natural/Semi-synthetic Opioids Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December 2016. Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Dec 8, 2016
Drug Overdose Deaths, Kentucky and the U.S. Age-Adjusted Drug Overdose Mortality Rate, 2010-2015 Mortality Rate (# Deaths /100,000 Population) 35 30 25 20 15 10 5 0 US KY 29.9 25 25 23.7 24.7 23.6 16.3 12.3 14.7 13.2 13.1 13.8 2010 2011 2012 2013 2014 2015 Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December 2016. Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Dec 8, 2016. Data are provisional and subject to change.
Drug Overdose Deaths, Kentucky and the U.S. Mortality Rate (# Deaths /100,000 Population) 12 10 8 6 4 2 0 Age-Adjusted Rate for Drug Overdose Deaths Involving Natural and Semi-synthetic Opioids (T40.2), 2010-2015 U.S. 10.3 KY 3.5 3.7 11.1 9 8 3.5 3.5 7.7 8.9 3.8 3.9 2010 2011 2012 2013 2014 2015 Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December 2016. Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Dec 8, 2016. Data are provisional and subject to change.
Drug Overdose Deaths, Kentucky and the U.S. Age-Adjusted Rate for Drug Overdose Deaths Involving Heroin(T40.1), 2010-2015 Mortality Rate (# Deaths /100,000 Population) 8 7 6 5 4 3 2 1 0 7.4 US KY 5.5 5.1 4.1 3.4 3.4 1.4 2.7 1 1.9 0.9 1.3 2010 2011 2012 2013 2014 2015 Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December 2016. Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Dec 8, 2016. Data are provisional and subject to change.
Drug Overdose Deaths, Kentucky and the U.S. Age-Adjusted Rate for Drug Overdose Deaths Involving Synthetic Opioids Other than Methadone (T40.4), 2010-2015 Mortality Rate (# Deaths /100,000 Population) 9 8 7 6 5 4 3 2 1 0 U.S. KY 7.9 4.3 3.1 1.3 1.7 1.6 1.7 1.8 1 0.8 0.8 1 2010 2011 2012 2013 2014 2015 Produced by the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health, December 2016. Data sources: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Dec 8, 2016. Data are provisional and subject to change.
Slide courtesy of the Kentucky Office of Drug Control Policy
Kentucky Resident Drug Overdose Hospitalizations Drugs Most Commonly Listed as Contributing to the Overdoses Jan 1, 2010 Jun 30, 2016 600 500 400 Number 300 200 100 0 - - Heroin - - Pharmaceutical Opioids -Cocaine -Benzodiazepines Note: An overdose that involved multiple drugs was counted under each relevant drug category. Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. December 2016. Data source: Kentucky Inpatient Claims Files, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.
1200 Kentucky Resident Drug Overdose Emergency Department Visits Drugs Most Commonly Listed as Contributing to the Overdoses Jan 1, 2010 Jun 30, 2016 1,124 1000 800 Heroin Cocaine Pharmaceutical Opioids Benzodiazepines 847 885 686 Number 600 400 200 207 288 259 237 307 298 272 337 348 454 499 602 624 0 35 31 60 90 60 83 56 79 111 Note: An overdose that involved multiple drugs was counted under each relevant drug category. Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. December 2016. Data source: Kentucky Outpatient Services Claims Files, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.
Kentucky Resident Drug Overdose ED Visits Involving Opiates/Opioids (n=3,524), Oct 1, 2015 Sep 30, 2016 by Specific Drug/Drug Class N (%) Heroin 2,856 (81%) Pharmaceutical Opioids 689 (20%) Natural and Semi-synthetic Pharmaceutical Opioids 495 (14%) Methadone 46 (1%) Synthetic opioids, other than Methadone 119 (3%) Case selection: ED visits with: 1) any diagnosis (principal or secondary) in the ICD10CM code range T40.0 T40.4; and 2) 6 th character equal to 1, 2, 3 or 4 ( unintentional, self-harm, assault, undetermined intent) (i.e. adverse effect and underdosing were excluded); and 3) 7 th character A (initial encounter), or D (subsequent encounter) Note: An overdose that involved multiple drugs was counted under each relevant drug category. Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. December 2016. Data source: Kentucky Outpatient Services Claims Files, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.
2010 2011 2012 2013 2014 Total number of hospitalizations with a diagnosis (principal or secondary) for opioid misuse (i.e. opioid dependence, nondependent opioid abuse, or opioid overdose) Hospitalizations with a diagnosis for opioid misuse and a concurrent diagnosis for: HBV HCV HIV Endocarditis Bacteremia/Sepsis Osteomyelitis/Septic Arthritis Skin and Soft Tissue Infections 8,701 9,577 10,252 10,022 11,031 82 146 170 214 241 0.9% 1.5% 1.7% 2.1% 2.2% 1017 1379 1718 2100 2638 11.7% 14.4% 16.8% 21.0% 23.9% 23 29 39 35 53 0.3% 0.3% 0.4% 0.3% 0.5% 33 57 68 77 101 0.4% 0.6% 0.7% 0.8% 0.9% 267 322 385 471 623 3.1% 3.4% 3.8% 4.7% 5.6% 72 57 70 85 151 0.8% 0.6% 0.7% 0.8% 1.4% 456 500 591 731 790 5.2% 5.2% 5.8% 7.3% 7.2% Significant change in the percentage of co-existing diseases from 2010 to 2014 Yes; p<.0001 Yes; p<.0001 Yes; p=0.0150 Yes; p<.0001 Yes; p<.0001 Yes; p=0.0004 Yes; p<.0001 Note: Infectious disease percentages are not mutually exclusive within the same year; A case with multiple infectious disease diagnoses was counted under each relevant category. Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. December 2016. Data source: Kentucky Outpatient Services Claims Files, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.
Slide courtesy of the Kentucky HIV Prevention Program, DPH * *
Neonatal Abstinence Syndrome Counts and Rates, Kentucky-resident Newborns, 2000-2015 Data Source: Kentucky Inpatient Hospitalization Claims Year NAS birth count Total birth count NAS birth rate 2000 19 40,647 0.5 2001 46 44,754 1.0 2002 69 47,864 1.4 2003 98 49,045 2.0 2004 123 50,114 2.5 2005 133 50,543 2.6 2006 179 52,068 3.4 2007 209 52,766 4.0 2008 251 51,491 4.9 2009 327 50,348 6.5 2010 379 48,309 7.8 2011 522 48,769 10.7 2012 632 49,143 12.9 2013 756 49,335 15.3 2014 1,060 49,551 21.4 2015 1,090 49,222 22.1 Neonatal Abstinence Syndrome case definition: 1) Any mention of ICD-9-CM diagnosis code 779.5 (ICD-10-CM code P96.1), AND 2) Any mention of ICD-9-CM diagnosis code V30-V39 (liveborn infant according to type of birth) (ICD-10-CM code Z38), AND 3) Kentucky resident, AND 4) Patient s year of birth matches the reporting year (inpatient files were searched for the reporting year and the first quarter of the following year). Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. December 2016. Kentucky Inpatient Hospitalization Claims Files, Frankfort, KY, [2000-2016]; Cabinet for Health and Family Services, Office of Health Policy. Data for 2010-2016 are provisional; therefore these results are subject to change.
Svetla Slavova ssslav2@uky.edu Kentucky Injury Prevention and Research Center http://www.mc.uky.edu/kiprc/publications-and-reports.html Contact Information for Data Requests: KIPRCrequests@uky.edu