Opioid Call History Utah Poison Control Center Marty Malheiro, MS, CHES Coordinator, Outreach Education

Introduction Misuse/abuse/overdose – far- reaching effects UPCC sees overdose in all ages –Intentional and unintentional Especially potent for children –“One Pill Can Kill”

Effects on the UPCC These calls result in adverse and toxic effects 20X more frequently Creates need for more ED referrals UPCC provides treatment recommendations –Higher acuity calls require increased staff time for consultation Increased consultations with MEs office

Reasons for Pain Medicine Calls Therapeutic errors – wrong med, double dose –More common in 60+ age group Intentional misuse/abuse –Taking someone else’s med –Taking drug to get high –Taking multiple meds with similar ingredients (Lortab® and Tylenol®) Concerns about withdrawal

Epidemiology of Opioid Calls 1, UPCC - Toxicall

Outcomes Of Opioid Calls Outcome% of Opioid Exposures Minor effect29.5 Moderate effect14.1 Major or fatal outcome6.1 No effect, not followed-non-toxic34.4 Potentially toxic, but not followed11.7 Unrelated effect UPCC – Toxicall 2008

Opioid Call History Statistics < Unk AgeTotal Unintentional a Intentional b Adverse Reaction c Other d TOTAL1,502 a Unintentional – unforeseen, unplanned event; i.e. child gaining access to a toxic substance, adult taking the wrong med b Intentional – misuse, abuse, suspected suicide c Adverse reaction - unwanted effect due to normal, prescribed, or recommended use d Other – include withdrawal and tampering UPCC – Toxicall 2008

Opioid Calls by Age Group years –73% intentional (50% self-harm) –13% severe or fatal outcome years –57% intentional (55% self-harm) –18% therapeutic errors –14% adverse reactions 60+ years –22% intentional (57% self-harm) –49% therapeutic errors –17% adverse reactions UPCC – Toxicall 2008

UPCCs Involvement Medical Director is on the Steering Committee –Consults with MEs office Outreach Coordinator is on Patient & Community Education work group –Participates on Medication Disposal group in SL County Include message in all outreach to never hesitate to call UPCC – free and confidential

Hot Off the Press!!! NSDUH Report February 5, 2009

Nonmedical Use of Prescription Pain Relievers in the Past Month, by Gender: Percentages, 2002 to 2007 NSDUH Report 2/5/09

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