OFFICE OF THE Opioid Crisis: HHS Strategy and Advancing Pain Management Rachel Katonak, PhD, RN LCDR, Nurse Officer U.S. Public Health Service Public Health Analyst U.S. Department of Health and Human Services American Society for Pain Management Nursing September 7 rd, 018 HHS Secretary Alex M. Azar II Priorities Combating the opioid crisis Bringing down the high price of prescription drugs Addressing the cost and availability of health insurance Value-based transformation of our healthcare system Office of the Assistant Secretary for Health ADM Brett P. Giroir, M.D. Assistant Secretary for Health Senior Advisor to the HHS Secretary for Mental Health and Opioid Policy 1
Office of the Assistant Secretary for Health Dr. Vanila M. Singh, MD MACM Chief Medical Officer Chair, Pain Management Best Practices Inter- Agency Task Force Acting Regional Health Administrator, Region IX Office of the Assistant Secretary for Health U.S. Department of Health and Human Services Vanila.Singh@hhs.gov @cmohhs CDC s Unique Work In Action: Overdose Deaths are the Tip of the Iceberg For every 1prescription or illicit opioid overdose death in 016 there were 1people who reported having a substance abuse disorder involving heroin 1people who reported having a substance abuse disorder involving prescription opioids 7people who reported misusing prescription opioids in the last year,17people who reported using prescription opioids in the last year Source: SAMHSA (Detailed tables: https://www.samhsa.gov/data/sites/default/files/nsduh-dettabs-016/nsduh-dettabs-016.htm), NationalCenter for Health Statistics(NCHS): https://www.cdc.gov/nchs/data/databriefs/db9.pdf
Rise in Prescription Opioid Deaths in United States Deaths per 100,000 population 1 1 st Wave Over 18,000 people have died from prescription opioids since 1999 Natural and semisynthetic opioid death rate increased -fold from 1999 to 011 Methadone death rate increased 6-fold from 1999 to 007 0 1999 001 00 00 007 009 011 01 01 SOURCE: National Vital Statistics System Mortality File. Rise in Heroin Deaths in United States Deaths per 100,000 population 1 nd Over 70,000 people Wave have died from heroin since 010 Heroin death rate has increased over fold since 010 0 1999 001 00 00 007 009 011 01 01 SOURCE: National Vital Statistics System Mortality File. Deaths per 100,000 population 1 Rise in Synthetic Opioid Deaths in United States Likely Illicit Fentanyl rd Deaths from synthetic Wave opioids excluding methadone increased from approximately,100 in 01 to over 9,00 in 01 Synthetic opioid death rate (excluding methadone) has tripled in years 0 1999 001 00 00 007 009 011 01 01 SOURCE: National Vital Statistics System Mortality File.
Prescription Opioid Misuse Decreasing National Survey on Drug Use and Health Approximately 11. million individuals misused opioids in 017 of those, 11.1 million, were misusing prescription pain relievers. This is down by 1. million from 01 10 0 million American adults suffer from chronic pain daily or almost daily 19.6 million American adults Have high-impact chronic pain 11 Chronic Pain Among Suicide Decedents, 00 to 01: Findings From the National Violent Death Reporting System 1
Goal: Strike a Balance Important to balance the need to end the devastating effects of opioid misuse while also ensuring that pain patients can work with their doctors to develop an integrative pain treatment plan that optimizes function, quality of life, and productivity. Treat chronic pain End opioid misuse 1 HHS Five-Point Strategy to Combat the Opioid Crisis 1. Access: Better Prevention, Treatment, and Recovery Services. Data: Better Data on the Epidemic. Pain: Better Pain Management. Overdoses: Better Targeting of Overdose-Reversing Drugs. Research: Better Research on Pain and Addiction 1 Pain Management Best Practices Inter-Agency Task Force Comprehensive Addiction and Recovery Act of 016 Led by the Office of the Assistant Secretary for Health with participation from the Departments of Defense and Veterans Affairs, and Office of National Drug Control Policy Purpose: Propose updates and recommendations to address identified gaps or inconsistencies in pain management best practices https://www.hhs.gov/ash/advisory-committees/pain/index.html 1
Broad spectrum of pain management stakeholders physicians, dentists, and non-physician prescribers pharmacists and pharmacies pain research and addiction research, adolescent and young adult addiction research pain management professional organizations mental health treatment community addiction treatment community, individuals in recovery from substance use disorder pain advocacy groups, including patients veteran service organizations overdose reversal, including first responders state medical boards and hospitals prescription opioid use disorders in, members of the Armed Forces and veterans minority health 16 Pain Management Best Practices Inter-Agency Task Force Second Meeting September, 018 -September 6, 018 More information for upcoming public comment opportunities: https://www.hhs.gov/ash/advisory-committees/pain/index.html 17 Office of the Assistant Secretary for Health and the National Institutes of Health co-lead First coordinated plan to reduce the burden of chronic pain in the U.S.; and to achieve a system of care in which all people receive high quality, evidencebased pain care 18 6
Behavioral Health Coordinating Council Assistant Secretary for Health and Assistant Secretary for Mental Health and Substance Use co-lead Convening body provides guidance and recommendations on HHS behavioral health agenda Areas of focus (examples) Prescription Drug and Opioid Abuse Behavioral Health and Primary Care Integration Serious Mental Illness Workforce 19 OASH Region Opioid Collaborations Drug Courts Law Enforcement Social Workers Health Providers Syringe Services Programs Federal Agencies State Taskforces Community/ Faith-based Organizations Recovery Centers OASH Region engages a wide spectrum of partners throughout the 8 southeastern states to address the Opioid epidemic and its consequences. 0 Bolsters research across the National Institutes of Health to: Prevent Addiction through Enhanced Pain Management Improve Treatments for Opioid Misuse Disorder and Addiction New Acute to Chronic Pain Signatures (ACPS) program 1 7
https://health.gov/hcq/training-pathways.asp Reach Out Thank You Rachel Katonak, PhD, RN LCDR, Nurse Officer U.S. Public Health Service Public Health Analyst Office of the Assistant Secretary for Health U.S. Department of Health and Human Services Rachel.katonak@hhs.gov 8