Robertson-James, Candace, DrPH

Sands, Danielle, MPH

English

La Salle University Digital Commons

La Salle UniversityLa Salle University Digital CommonsExplorer Café Explorer Connection10-11-2017The Opioid Crisis: Are We Asking the RightQuestions?Candace Robertson-James DrPHLa Salle University, robertsonjames@lasalle.eduDanielle Sands MPHFollow this and additional works at: http://digitalcommons.lasalle.edu/explorercafeThis Presentation is brought to you for free and open access by the Explorer Connection at La Salle University Digital Commons. It has been acceptedfor inclusion in Explorer Café by an authorized administrator of La Salle University Digital Commons. For more information, please contactcareyc@lasalle.edu.Recommended CitationRobertson-James, Candace DrPH and Sands, Danielle MPH, "The Opioid Crisis: Are We Asking the Right Questions?" (2017).Explorer Café. 60.http://digitalcommons.lasalle.edu/explorercafe/60The Opioid Crisis: Are We Asking The Right Questions? Candace Robertson-James, DrPHDanielle Sands, MPHOpioid Use Disorders/ Addiction Opioids are a class of drugs that include the illicit drug heroin as well as the licit prescription pain relievers oxycodone, hydrocodone, codeine, morphine, fentanyl and others.1Opioids interact with opioid receptors on nerve cells in the brain and nervous system to produce pleasurable effects and relieve pain.1Symptoms include2:strong desire for opioidsinability to control or reduce usecontinued use despite interference with major obligations or social functioninguse of larger amounts over timedevelopment of tolerancewithdrawal symptoms that occur after stopping or reducing use1American Society of Addiction Medicine, (https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf) 2 https://www.samhsa.gov/disorders/substance-use  Philadelphia Statistics• As of July 2017, Philadelphia ranked 5th in overdoes deaths• For all deaths in Philadelphia, overdoes is the leading cause, specifically due to the use of Fentanyl • In 2015, Philadelphia’s rate of 46.8 drug overdose deaths per 100,000 residents far outpaced other large cities, such as Chicago (15.4) and New York City (11.2)• 80% of drug overdose deaths in Philadelphia involve opioids, including prescription opioids, heroin, and fentanyl.McDaniel, J. (2017). Pa. overdose deaths again rise, but Philly no longer No. 1. Philadelphia, PA: The Inquirer.The Mayor’s Task Force to Combat the Opioid Epidemic, 2017Prescription Pain Reliever Misuse Figure 2. Main reasons for last episode of prescription pain reliever misuse among past year misusers aged 18 or older: 2015Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health (NSDUH), 2015.Figure 1. Past year misuse of prescription pain relievers among adults aged 18 or older: 2015Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health (NSDUH), 201580% of people who use heroin first misused prescription opioids (Muhuri et al., 2013)An estimated 4 - 6 % who misuse prescription opioids transition to heroin (Muhuri et al., 2013; Cicero et al., 2014; Carlson et al., 2016)8 - 12% develop an opioid use disorder (Muhuri et al., 2013; Cicero et al., 2014; Carlson et al., 2016)Medication Assisted Treatment & Overdose Prevention • Methadone, Buprenorphine, Naltrexone• Naloxone can temporarily reverse an overdose that is caused by an opioid • Naloxone blocks effects of opioids on the brain & restores breathing within two to eight minutes • Philadelphia, naloxone has been widely used and distributed: • administered approximately 4,000 times by the Fire Department &200 times by Philadelphia police in 2016.Cases & Discussion CasesCase 1  Prescription Opioids & the Epidemic Case 2  Naloxone –Who pays for it?Case 3       ACES & substance misuse riskCase 4 Substance Use & Adolescence / Young AdulthoodCase 5   Syringe Exchange (Prevention Point)Case 6 Veterans & Opioid Misuse Risk HHS & NIH Priorities • Improving access to treatment and recovery services• Promoting use of overdose-reversing drugs• Strengthening our understanding of the epidemic through better public health surveillance• Providing support for cutting-edge research on pain and addiction• Advancing better practices for pain managementNational Institute on Drug Abuse, 2017 (https://www.drugabuse.gov/drugs-abuse/opioids/opioid-crisis#six) • Consumer directed media campaign about opioid risks• Public education campaign about Naloxone• Destigmatize opioid use disorder & its treatment• Improve health care provider education • Establish insurance policies that support safer opioid prescribing and appropriate treatment• Increase provision of medication assisted treatment• Expand treatment access & capacity• Implement warm handoffs to treatment after overdose• Expand naloxone availability • Expand court’s capacity for diversion to treatmentRecommendations for Philadelphia Resources• www.AmericanAddictionCenters.org (national)• www.Discoveryplace.info (national)• Tips for family and friends• www.HealthyMindsPhilly.org (local)• Support and programs for recovery• www.PPPonline.org (local)• Medical, shelter, meals, case management • http://www.thehealingway.net/• https://www.addiction-treatment.com/find/opiate/philadelphia-pa/

The Opioid Crisis: Are We Asking the Right Questions?

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The Opioid Crisis: Are We Asking the Right Questions?

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