California Opioid Hub and Spokes Project DHCS Marlies Perez, State Project Director Michael Freeman, Project Manager; Kevin Masuda, Project Analyst CA H&SS Implementation Team UCLA Richard Rawson, Principal Investigator Mark McGovern (Stanford), Learning Collaboratives Thomas Freese, Training/Technical Assistance Gloria Miele, Learning Collaborative Coordinator Beth Rutkowski, Training Liaison Training Coordinator and assistants Consultants John Brooklyn Tony Folland Barbara Cimaglio Regional CA Addiction and Primary Care MDs Evaluation Team Darren Urada, Principal Investigator Vandana Joshi, Co-Investigator Howard Padwa, Co-Investigator Data Collection Coordinator and assistants Advisors Betsy Hall Yih-Ing Hser Lynn Brecht UCLA Program Director Valerie Antonini Advisory Group Implementation & Evaluation experts, H&SS participants, community members, DHCS representatives, CSAM, CHCF CSAM Kerry Parker, Jean Marsters, MD, Steve Eickelberg, MD CHCF Kelly Pfeifer, MD

California Opioid Hub and Spokes Project Implementation Activities Implementation Team UCLA Chair: Richard Rawson; Co-Leader: Valerie Antonini Learning Collaboratives: Mark McGovern, Gloria Miele Purpose: Engage H&SS participants in process of shared learning and experience to facilitate implementation of services, assist with procedural changes, and provide opportunities for interactive problem solving. Activities: Conduct Regional Quarterly LC meetings Training and Technical Assistance: Thomas Freese, Gloria Miele, UCLA Trainers Purpose: Meet training and technical assistance needs of H&SS participants through just-in-time training including online self paced courses, in person and online training. Activities: Bi-annual Best Practices conferences, Bi-annual Clinical Skills trainings, Quarterly community-wide MAT training, and ongoing assistance with additional resources. Consultants Consultants will be available to provide additional technical assistance including: John Brooklyn, Tony Folland, Barbara Cimaglio, Kelly Pfeifer/CHCF, and California Addiction and Primary Care MDs. ------------------------------------------------------------------------------------------------------------------------------------------------- CSAM Jean Marsters, MD, Steven Eickelberg, MD, Kerry Parker Purpose: Provide support to providers in spokes to build confidence in prescribing Activities: Four-day mentored learning experiences for approximately 60 spoke participants who will attend the CSAM Annual Conference in August 2018 in San Francisco; updating of the Guideline for Physicians Working in CA Opioid Treatment Programs published in 2009; and two CSAM educational webinars

The National Opioid Crisis

Overdose Deaths per 100,000 New York Times: https://nyti.ms/2jVUlKb

Overdose Deaths per 100,000 New York Times: https://nyti.ms/2jVUlKb

Overdose Deaths per 100,000 New York Times: https://nyti.ms/2jVUlKb

Drug overdose deaths in 2016 most likely exceeded 59,000, the largest annual jump ever recorded in the United States, according to preliminary data compiled by The New York Times.

Vermont Data

New England Drug Overdose Deaths Drug Overdose Data. Source: http://blogs.cdc.gov/nchs-data-visualization/drug-poisoning-mortality/ Deaths per 100,000 Includes all drug overdoses, not just opioids. During 2015, drug overdoses accounted for 52,404 U.S. deaths, including 33,091 (63.1%) that involved an opioid. Source: CDC/NCHS, National Vital Statistics System, mortality data. Includes opioids and other drugs  Vermont Department of Health

New England Drug Overdose Deaths Drug Overdose Data. Source: http://blogs.cdc.gov/nchs-data-visualization/drug-poisoning-mortality/ Deaths per 100,000 Includes all drug overdoses, not just opioids. During 2015, drug overdoses accounted for 52,404 U.S. deaths, including 33,091 (63.1%) that involved an opioid. Source: CDC/NCHS, National Vital Statistics System, mortality data. Includes opioids and other drugs  Vermont Department of Health

The number of individuals using heroin at treatment admission has increased in the last five years Source: Alcohol and Drug Abuse Treatment Programs

Rate of Past Year Opioid Abuse or Dependence Rate of Past Year Opioid Abuse or Dependence* and Rate of Medication Assisted Treatment Capacity with Methadone or Buprenorphine Source: NSDUH 2003-2012 http://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf Original Data: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504312/ Am J Public Health. 2015 August; 105(8): e55–e63. Published online 2015 August.doi:  10.2105/AJPH.2015.302664 PMCID: PMC4504312 National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment Christopher M. Jones, PharmD, MPH, Melinda Campopiano, MD, Grant Baldwin, PhD, MPH, and Elinore McCance-Katz, MD, PhD More information: https://www.researchgate.net/publication/278040697_National_and_State_Treatment_Need_and_Capacity_for_Opioid_Agonist_Medication-Assisted_Treatment Source: N-SSATS 2003-2012 *Opioid abuse or dependence includes prescription opioids and/or heroin Source: AJPH 2015; 105(8):e55-63 Vermont Department of Health