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Rosemary Search, RN BSNHealth Promotions SpecialistLancaster General Health/Penn Medicine
Christine GloverCommunity Prevention MobilizerCompass Mark
www.LancasterJoiningForces.org
Pennsylvania Public and Community Health Conference
April 2, 2019
Objectives
• Recognize the use of evidence-based practices to address opioid addiction across systems
• Describe the importance of goal setting and data collection and analysis to achieve measurable outcomes
• Identify appropriate community partners to implement a county wide public health approach
2
Substance Abuse/MisuseFramework for Action
Continuum of Care
3Source: SAMHSA
4
Guidelines for Prescribing Opioids for Pain
• Determining when to initiate or continue opioids for chronic pain
• Opioid selection, dosage, duration, follow-up, and discontinuation
• Assessing risk and addressing harms of opioid use
Goal Setting
5
Strategic Plan
6
7
Saturate the Community with Unified Messaging
Over 102,000 Distributed
8
50171-Manheim Pike
10
11
Strengthening Efforts
• ED Warm Hand-off
• Naloxone Access
• Prescription Drug Take-Back
• Promotion of evidence-based school prevention programs
• Increased access to treatment and recovery services
12
Improve Data Collection and Public Reporting
• Improved timely reporting on outcomes (overdose deaths)
• Process measures tracked and shared at steering committee and public meetings (example below)
14
15
Strengthen efforts
Evaluation and
reporting
Improve patient safety
Saturate the community
Next 12 months
Data Collection and Analysis
16
Total Overdose Deaths, Lancaster County2014-present (as of 3/1/2019)
Sources: Pennsylvania State Coroners Association Report on Overdose Death Statistics, 2014Analysis of Drug Related Overdose Deaths in Pennsylvania, 2015. Prepared by the DEA Philadelphia Field DivisionAnalysis of Overdose Deaths in Pennsylvania, 2016. Prepared by the DEA Philadelphia Division and the University of Pittsburgh.Lancaster County Coroners Office
6080
117
168
108
130
20
40
60
80
100
120
140
160
180
2014 2015 2016 2017 2018 2019
Num
ber
of D
eath
s
17
2018 Overdose Deaths in Lancaster:A Closer Look
Source: Lancaster County Coroner’s Office
18
Unknown4%
20-2925%
30-3929%
40-4925%
50-5917%
Female22%
Male74%
Unknown4%
SexAge
PDMP Opioid Dispensing Rate
0
50
100
150
200
250
2016 Q3 2016 Q4 2017 Q1 2017 Q2 2017 Q3 2017 Q4 2018 Q1 2018 Q2
Opioid Dispensing Rate Per 1,000 Residents
Lancaster County Pennsylvania
Source: PA Prescription Drug Monitoring Program, Interactive Data Report
86,992total
dispensed66,850total
dispensed
19
PDMP Risky Prescribing Measures
Source: PA Prescription Drug Monitoring Program, Interactive Data Report
0
1
2
3
4
5
6
7
8
9
2016 Q3 2016 Q4 2017 Q1 2017 Q2 2017 Q3 2017 Q4 2018 Q1 2018 Q2
Rate of Individuals Per 1,000 Residents with Average Daily MME >90
Lancaster County Pennsylvania
3,869individuals
2,972 individuals
Narcan Administration Trends, 2017-2018
134 127
179
122
78
247
148
102
21 29
31
29
49
89
75
44
5
8
8
0
50
100
150
200
250
300
350
400
2017 Q1 2017 Q2 2017 Q3 2017 Q4 2018 Q1 2018 Q2 2018 Q3 2018 Q4
Num
ber
of In
cide
nts
Narcan Administration by First Responders
Narcan Administered by EMS Narcan Administered by Law Enforcement
Narcan Administered by Fire Department Total Overdose Deaths per Quarter 21
2018 Trends
• Overdose Deaths
• Narcan usage by first responders
• Risky Prescribing Behaviors
• Opioids Dispensed
22
23
How have we organized for
change?
Steering Committee
Community Groups
