PRESCRIPTION DRUG ABUSE/MISUSE IN OKLAHOMA Avy Redus, MS Project Coordinator [email protected]Claire Nguyen, MS Injury Epidemiologist [email protected]. gov Oklahoma State Department of Health Injury Prevention Service 405-271-3430 http://poison.health.ok.gov
Prescription Drug Abuse/misuse in Oklahoma. Claire Nguyen, MS Injury Epidemiologist [email protected]. Avy Redus, MS Project Coordinator [email protected]. Oklahoma State Department of Health Injury Prevention Service 405-271-3430 http://poison.health.ok.gov. Background. Poisoning - PowerPoint PPT Presentation
Text of Prescription Drug Abuse/misuse in Oklahoma
WHAT CAN BUSINESSES DO?Adopt workplace prescription drug policies• Prohibited behavior• Major medical insurance• Pharmacy benefit program• EAP• Crisis intervention• Assessment, referral• Short-term and follow-up counseling • Treatment monitoring
WHAT SHOULD PARENTS DO?Educate yourself• Defining• Risks• Signs and Symptoms • PreventionCommunicate the risks of
prescription drug abuse/misuse to your kids
• Children who know the risks of drugs at home are up to 50% less likely to use drugs than those who do not get the education
Safeguard your medicine cabinet
• Keep prescription medicine in a secure location; lock them up• Count and monitor the number
of pills you have• Ask your friends and family
members to do the sameGet help• 211• 1-855-DRUGFREE (1-855-378-4373)
SIGNS AND SYMPTOMS OF A DRUG OVERDOSE EMERGENCY
• Won’t awaken when aroused • Bluish purple skin tones for lighter skinned people and grayish or
ashen tones for darker skinned people • Slow, shallow, erratic, or absent breathing • Snore-like gurgling or choking sounds • Elevated body temperature • Vomiting • Irrational behavior or confusion Signs and symptoms of drug overdose may differ depending upon the type of drug consumed.
Emergency: If you suspect someone is experiencing a drug overdose, you must react to this true medical emergency by calling “911” without delay.
CONTACT INFORMATION•Call 211 for treatment referrals•Call OBNDD directly to report diversion
CASE STUDIESA male in his 40s with a history of knee pain due to years of working laying carpet. He had recently been released from rehab for his prescription pain medication addiction, but was prescribed more pain medications for his knee and back pain. He was home with his wife and not feeling well. His wife was doing laundry and could hear him snoring loudly. She noticed he was no longer snoring, went to check on him, and found him unresponsive. His death was pronounced by EMS. His toxicology report included five different prescriptions medications, two of which were opioids.
CASE STUDIESAn older adult female had recently been to the doctor and prescribed two new medications, fentanyl patches and oxycodone for pain. She was also previously prescribed hydrocodone. She fell asleep on the couch and her husband carried her to the bedroom and put her to bed. She slept most of the day, and her husband woke late that evening and noticed she would not move when he asked her. He called 911 and she was pronounced by EMS.
CASE STUDIESA female in her 30s suffered from arthritis and bipolar disorder. She went to rehab approximately a year before her death after overmedicating several times. Her husband worked out of town, but said she was in great spirits when he came home for the weekend. She complained of some pain from her arthritis, and told her husband she knows her body and doses herself. He woke in the middle of the night to her snoring, and several hours later became concerned when she did not get up to check on their crying baby. She was unresponsive with blue face, lips, and tongue. Her toxicology report included an antidepressant, opioid, and muscle relaxant.
CASE STUDIESA male in his 30s with a history of a work-related back injury 5-10 years previous. He had multiple surgeries on his back and neck since the injury. He was home alone and found unresponsive by family on their arrival to the home. He did not have a known history of substance abuse or mental health problems. He had a prescription for both of the drugs involved in his death.
CASE STUDIESA young adult male veteran had recurring pain from an injury sustained during a tour in Iraq. He suffered from depression and had a history of overmedicating. He was found unresponsive in the middle of the night and pronounced on arrival by a first responder. His death involved multiple prescription drugs, including prescription painkillers and antidepressants. He had a known prescription for almost all of the drugs.
STATE PLAN• Community/Public Education• Provider/Prescriber Education• Disposal/Storage for the
Public• Disposal/Storage for Providers• Tracking and Monitoring• Regulatory/Enforcement• Treatment/Interventions
LEGISLATION• HB 1781
Share PMP data• HB 1782
Expand use of naloxone• HB 1783
Limit hydrocodone refills• HB 1491
Notify providers of possible doctor shoppers
• Town hall meetings• Task forces/coalitions• Tool kit for primary care
• One-on-one prescriber education on pain management
• Continuing medical education
• Promotion of prescription monitoring program
Enhanced hospital policy• Limit on amount dispensed• Required check of PMP
Take-back events by law enforcement• Fixed disposal sites
Drug detox and treatment programs
REDUCE EXCESS SUPPLY AND INCREASE TREATMENT
More than half of deaths occurred at home• Emergency medical care not called or not able to reach
victim in time to reverse the overdose• Bystanders did not recognize as lethal overdose• Concern for liabilityFree naloxone for high risk patients
Source: Wilkes Co. Health Department; NC SCHS; CDC Wonder
Results: Opioid Prescribing
The overdose death rate dropped 71% in two years after the start of
Project Lazarus and the Chronic Pain Initiative.
• High prescription opioid unintentional poisoning rates
• Some degree of community awareness
• Coalition building capacity• Motivated community organizer• Support from the medical
establishment• Strong data utilization practices
State plan action itemsAssist with local plans• Link with DMH contactsPresentations• Train-the-trainer• Regional provider trainingEducational materialsProvide local data• Death, hospital discharge, PMPTechnical assistance