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

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

4. 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

5. 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

6. Epidemiology of Opioid Calls 1,539 486 UPCC - Toxicall

7. 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 effect4.2 100.0 UPCC – Toxicall 2008

8. Opioid Call History Statistics <66-1213-1920-2930-3940-4950-5960+Unk AgeTotal Unintentional a 2441520576041407413564 Intentional b 0698228154103503119689 Adverse Reaction c 241347421915234169 Other d 4231119101510680 2502713434327517312013842 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

9. Opioid Calls by Age Group 13-19 years –73% intentional (50% self-harm) –13% severe or fatal outcome 20-59 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

10. 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

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

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

13. QUESTIONS