THE MANY FACES OF THE OPIOD EPIDEMIC

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Presentation transcript:

THE MANY FACES OF THE OPIOD EPIDEMIC Massachusetts Association of Public Health Nurses 21ST ANNUAL MAPHN CONFERENCE (MAY 2017) THE MANY FACES OF THE OPIOD EPIDEMIC Jennifer C. Rowe Assistant District Attorney Director, Crime Prevention Unit

Overdose Prevention in Norfolk County Strategic, Data-Driven Initiatives 172 fatal overdoses in 2016 43 motor vehicle homicide deaths in 2016 Massachusetts Association of Public Health Nurses

NORFOLK COUNTY OVERDOSE DEATH REVIEW PARTICIPANTS A detective from each of our 28 local police departments State Police Homicide and Narcotics assigned to CPAC at NDAO Boston DEA Diversion FBI HHS-OIG Investigators from: Board of Medicine Board of Pharmacy Board of Nursing Massachusetts Office of the Attorney General Massachusetts Association of Public Health Nurses

NORFOLK COUNTY OVERDOSE DEATH REVIEW Local Police Report Massachusetts State Police Report Patient Prescription History Cell phone data, if available DATA SOURCES Massachusetts Association of Public Health Nurses

NORFOLK COUNTY OVERDOSE DEATH REVIEW

NORFOLK COUNTY OVERDOSE DEATH REVIEW What gets referred? Where do we refer cases for review? What information can we share in referral process? NORFOLK COUNTY OVERDOSE DEATH REVIEW Referral Process for review of concerning prescribing and dispensing as seen in the patient prescription history of the decedent Massachusetts Association of Public Health Nurses

NORFOLK COUNTY OVERDOSE DEATH REVIEW Norfolk County Overdose Death Review Data 2013: 63 fatal overdoses 2014: 93 fatal overdoses 2015: 150 fatal overdoses 2016: 172 fatal overdoses 2016 Data Summary 133 male decedents 39 female decedents Youngest: 17 years old 78 were under the age of 35 26 of our 28 communities had at least one fatal overdose

NORFOLK COUNTY OVERDOSE DEATH REVIEW What have we learned and what are we doing about it? Massachusetts Association of Public Health Nurses

RISK FACTORS FOR SCHOOL AGED CHILDREN Prescribing opioid post operatively following orthopedic sports injury during high school Prescribing opioid following oral surgery during high school years Lowered tolerance Unsafe storage and failure to maintain control of medicine

Screening (SBIRT) Universally screen two grade levels each year School districts select which grade levels will be screened School districts select evidence-based screening tool Train those with a medical role in your school district School Nurses Athletic Trainer Grant: $2,500 to each school district for SBIRT implementation costs

MIAA RULE CHANGE - “Prior to any chemical health violation, a student’s request for and enrollment in a substance abuse treatment program shall not in and of itself constitute a violation of Rule 62 (MIAA Chemical Health Rule)”

Risk Assessment & Re-Entry of Students following substance use treatment lowered tolerance

NORFOLK COUNTY OVERDOSE DEATH REVIEW RISK FACTORS FOR ADULTS Lowered tolerance Drug maintenance and other medications Prior successful reversal Benzos + Opioids + drug maintenance Cash payments and early refills Poor access to treatment Massachusetts Association of Public Health Nurses

LOWERED TOLERANCE

NORFOLK COUNTY OVERDOSE DEATH REVIEW NORFOLK COUNTY CARES KIT

NORFOLK COUNTY OVERDOSE DEATH REVIEW

Pharmacy Outreach Program NORFOLK COUNTY OVERDOSE DEATH REVIEW Pharmacy Outreach Program GOALS Encourage consistent use of PMP prior to dispensing DISPENSERS

Pharmacy Outreach Program NORFOLK COUNTY OVERDOSE DEATH REVIEW Pharmacy Outreach Program GOAL > Building relationships between pharmacists and local police.

NORFOLK COUNTY OVERDOSE DEATH REVIEW Medicine Return Boxes

First Responder Nasal Naloxone NORFOLK COUNTY OVERDOSE DEATH REVIEW First Responder Nasal Naloxone

Transparency with aggregate, de-identified data

NORFOLK COUNTY COMMUNITY COALTIONS Avon Coalition for Every Student (A.C.E.S.) Braintree Community Partnership on Substance Abuse Brookline Coalition Against Substance Abuse (B-CASA) Cohasset Safe Harbor Dedham Coalition for Drug and Alcohol Awareness Dover Substance Prevention & Awareness Network (SPAN-DS) Foxborough – Substance Abuse Free Environment of Foxborough (SAFE) Franklin S.A.F.E. Coalition Holbrook Cares Impact Norwood Learn to Cope Medfield Cares About Prevention Milton Substance Abuse Prevention Coalition Needham Coalition for Youth Substance Abuse Prevention (NCYSAP) Stoughton – Organizing Against Substances in Stoughton (OASIS) Quincy – The Mayor’s Substance Abuse Task Force Randolph Substance Abuse Prevention Coalition Walpole Coalition for Alcohol & Drug Awareness Weymouth Substance Abuse Prevention Team (SAPT)

THE MANY FACES OF THE OPIOD EPIDEMIC Massachusetts Association of Public Health Nurses 21ST ANNUAL MAPHN CONFERENCE (MAY 2017) THE MANY FACES OF THE OPIOD EPIDEMIC Jennifer C. Rowe Assistant District Attorney Director, Crime Prevention Unit