1. Rx for Success Next Steps to Prevent Prescription Drug Abuse Rebecca Hebner, MPH Substance Abuse Prevention Systems Coordinator

2. One Day in Colorado… DEATHSINJURYMISUSE

3. One Day in Colorado… DEATHSINJURYMISUSE In 2013, there were 839 prescription drug overdose deaths in Colorado. One in three caused by opioids. Almost 5,000 people were hospitalized, more than MVA, homicides or firearms. This is just a fraction of the harms to the 6% of Coloradans age 12+ who misuse prescription pain relievers.

4. Local Prescription Drug Abuse Data DEATHSINJURYMISUSE12 3 4 512 3 4 512 3 4 5 Regions from National Survey on Drug Use and Health

5. Local Prescription Drug Abuse Data Region 1Region 2Region 3Region 4Region 5Colorado Opioid Mortality (rate per 100,000 population, 2013) 5.46.14.89.32.85.6 Opioid ED Visits (rate per 100,000 population, 2013) 10.815.917.124.110.415.2 Nonmedical Use of Rx (percent of population age 12+, 2010-12) 5.95.75.24.95.25.6 DEATHSINJURYMISUSE12 3 4 512 3 4 512 3 4 5

6. 2013-2016 GOAL Prevent 92,000 Coloradans from Misusing Opioids 2011-2012 NSDUH: 255,000 Coloradans reported non-medical use of prescription pain medication in past year

7. 2013-2016 GOAL: Reduce prevalence of misuse among Coloradans age 12+ from 6.0% to 2.5%

8. State-Level Activity “Smooth the Road” for local level implementation Governor Hickenlooper’s Office & Dashboard Indicators CDPHE’s Core Violence Injury Prevention Program activities and Maternal Child Health Block Grant Priority area Colorado Consortium for Prescription Drug Abuse Prevention

9. Colorado Plan to Reduce Prescription Drug Abuse Strategies: 1)Improve surveillance data 2)Strengthen prescription drug monitoring program (PDMP) 3)Educate prescribers and providers 4)Increase safe disposal 5)Raise public awareness 6)Enhance access to treatment 7)Expand access to naloxone

10. Local Alignment with State Strategies Colorado Plan to Reduce Prescription Drug Abuse

11. 1) Local-level Data Surveillance Where’s the problem in your community Adult misuse?Youth misuse?ED visits?Tx Admissions? Visit the Data Dashboard Talk to Data and Research Workgroup, CDPHE, LPHAs Current misuse of Rx, NSDUHEver took Rx w/o prescription, HKCSEmergency Department admission, CHAOpioids as primary drug, OBH

12. 2) Support use of Prescription Drug Monitoring Program (PDMP) Encourage PDMP use among health care providers, pharmacists Continuing education opportunities Other communication, like tool kits and follow-up Facility policy for PDMP use PDMP data to monitor public health concerns coming soon!

13. 3) Provider & Prescriber Education on pain management, prescribing Promote continuing education on safe prescribing practices Online CME: “The Opioid Crisis: Guidelines and Tools for Improving Chronic Pain Management” More in development! Support uptake of evidence-based prescribing guidelines by your local prescribers Quad-board guidelines adopted by dental, medical, nursing, pharmacy, optometry, and podiatry boards

14. 4) Host Permanent Safe Disposal Sites Encourage your local law enforcement to host a FREE medication take-back box Recruit pharmacies, hospitals to change DEA registration and host medication take-back boxes CDPHE can help! Greg Fabisiak, greg.fabisiak@state.co.usgreg.fabisiak@state.co.us Promote DEA take-back event on 9/26/15: contact your local law enforcement to see if they are participating

15. 5) Raise Public Awareness TakeMedsSeriously.com: safe use, safe storage, safe disposal of prescription drugs Smart Choices, Safe Kids: family and community information to protect children around substances Other resources to promote Rocky Mountain Poison and Drug Center: 1 (800) 222- 1222 Good Samaritan Law: 911 immunity and naloxone administration OBH’s Treatment Directory: >600 facilities

16. 6) Promote Treatment Options Chat with our friends at Office of Behavioral Health! Connect health care providers, public with currently available treatment options OBH’s Treatment Directory: >600 facilities SBIRT screening for health care providers Expanding treatment capacity, provision of medication assisted treatment

17. 7) Expand access to Naloxone Encourage local pharmacies and harm reduction organizations to request standing orders for Naloxone Encourage local law enforcement, Sheriffs to carry Naloxone in case of emergencies Emergency departments upon discharge for opioids Upon discharge from prisons

18. Want more? How about… Connect with your local OBH grantees Check out the Strategic Prevent Framework-Partnership for Success Toolkit Join a work group with the Colorado Consortium for Prescription Drug Abuse Prevention Chose Substance Abuse as a MCH Block Grant Priority (and volunteer to support local action plan development!) Find inspiration with success stories, like Project Lazarus in North Carolina or Madison-Dade, WI “Safe Community” project

19. Questions? rebecca.hebner@state.co.us