This presentation provides an overview of research in Alaska's policy responses to rises in opioid use between 2016 and 2018. It outlines outcomes from qualitative analysis of interviews.Institute of Social and Economic Research (University of Alaska Anchorage)
U.S. Department of Health and Human Services (SAMHSA #1U79SP020783

Barnett, Jodi

Hanson, Bridget

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Policy Evaluation During the Opioid EpidemicBridget Hanson, PhDJodi Barnett, MAUniversity of Alaska AnchorageThis project was supported by the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA) #1U79SP020783. These contents are solely the responsibility of the authors and do not necessarily represent the official views of the SAMHSA, the U.S. Department of Health and Human Services, the Alaska Department of Health and Social Services, or UAA-ISER.The Opioid Epidemic• 130 people die of opioid overdose every day in the U.S.• 2.2 million children affected (through 2017)• $117.5 billion in costs during childhood• By 2030: 4.3 million children and $400 billionCDC, 2018; Brundage et al., 2019CDC, 2018The Opioid Epidemic• Federal funds to Alaska in 2015• Alaska public health disaster declaration in Feb 2017• HHS declares public health emergency in Oct 2017051015202008 2010 2012 2014 2016 2018*Rate per 100,000Opioid Overdose DeathsU.S.¹ Alaska²1. Centers for Disease Control and Prevention; National Center for Health Statistics. *2018 data preliminary2. Alaska Division of Public Health; Health Analytics and Vital Records. Data Sources• Primary• Key informant interviews• Tracking of policy changes• Secondary• Overdose deaths• Treatment admissions• ER visitsKey informant interviews:• Fall 2016• 16 participants• Domains:• State climate• Partnerships and coordination• Policies, practices, and laws• Data and data monitoring• Knowledge and readiness• SWOT analysisFindings related to policy:• Strengths• PDMP reporting and timeliness improvements• Medicaid expansion• Good Samaritan laws• Access to naloxoneSB 74, which was our omnibus Medicaid Reform Bill, [and it] included all the recommendations of the controlled substances advisory committee to strengthen the Prescription Drug Monitoring ProgramSo, the Medicaid reform, as well as Medicaid expansion, will help expand access to treatment for people who are ‘recovery ready,’ as we say.Findings related to policy:• Strengths• PDMP reporting and timeliness improvements• Medicaid expansion• Good Samaritan laws• Access to naloxone• Weaknesses• Limited access to PDMP• Criminal justice approach• Opportunities• PDMP unsolicited reporting• Statewide prescribing guidelines• Expand immunity lawsTimeline of relevant policy changes: • Feb 2017 – disaster declaration• Standing order for naloxone• January 2017 – Opioid prescribing• Adopted guidelines• July 2017 – PDMP responsibilities• Providers/dispensers: registration, delegates, recording, and checking• Board of Pharmacy: unsolicited reports to providers/dispensers, reporting to legislature• July 2017 – Opioid prescribing• Limits and sanctions• 7-day maximum supply• July 2018 – PDMP updatedWhat has happened?051015202008 2010 2012 2014 2016 2018*Rate per 100,000Opioid Overdose DeathsU.S.¹ Alaska²1. Centers for Disease Control and Prevention; National Center for Health Statistics. *2018 data preliminary2. Alaska Division of Public Health; Health Analytics and Vital Records. 02004006008001,0001,2001,4001,6002013 2014 2015 2016 2017 2018People TreatedTreatment for Synthetic Opiates & Heroin as Primary Substance of Abuse (AKAIMS)HeroinSynthetic Opiates02004006002015 2016 2017All Opioid, Prescription Opioid, & Heroin Poisoning Discharges (HFDR)All Opioids Rx Opioids HeroinThe Challenge• Identifying specific influence of policies• Informing future policy development• Next steps: • Follow-up key informant interviews• Continued monitoring of secondary dataThank you! Questions?BLHanson4@alaska.edu

Policy Evaluation During the Opioid Epidemic

https://scholarworks.alaska.edu/bitstream/11122/11986/1/2019_11-PolicyEvaluationOpioidEpidemic.pdf

Policy Evaluation During the Opioid Epidemic

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