1. A Community Mobilized to Take Action Marin County, California Kristen M Law, MA

3. County Health Rankings Comparison to Other Counties
Marin County ranked in the top 5% in: - Premature death rate - Adults self reported health
Mentally unhealthy days - Adult obesity - Teen birth rate - Uninsured adults - Primary care physicians per capita - High school graduation - Unemployment - Children in poverty - Physical activity - Violent crime rate High food environment index
Low rate of preventable hospital stays
Low violent crime rate
Ranked in the top 10% in: -Low percent of adults reporting fair or poor health
-Low average number of mentally unhealthy days
-High access to exercise opportunities
-High dentists per capita
-High mental health providers per capita
-High percent with some college
Ranked in the top 15% in: -Low percent of adults who smoke - Low percent of children in single-parent households - Low average daily air pollution
Ranked in the top 25% in: -Low number of physically unhealthy days - Adults without social/emotional support - Low percent driving alone to work

4. Marin County ranked in the bottom 50% in: - 1Excessive Drinking
-2Drug poisoning mortality rate
1 Data collected from Behavioral Risk Factor Surveillance System ( for social support indicator) and may vary from other local sources used in county health reports and factsheets. 2 Drug poisoning deaths was an additional measure and did not contribute to the overall county health rankings.

5. Urgency via Trend Lines
Narcotic Prescriptions
Emergency Department Narcotic Related Visits

7. Non-Medical Use of Pharmaceuticals Among Marin County 11th Graders
Source: California Healthy Kids Survey,

9. Public Health Approach
“Every system is perfectly designed to get the results that it gets.”
– Paul Batalden, MD
What are the key parts of the “system”?
Healthcare, law enforcement, policymakers, community members, schools, public health, business etc.
What are the results of the system?
Overdose deaths
Addiction and dependence
Misuse
How do we re-create the system to support safe medication use?

10. The Life of a Pill Marketing Prescribers Manufacture Pharmacists
Community
Safe Use
Unsafe Use
Disposal

11. A Systems Approach is a Comprehensive Approach
Prevention
Education
Surveillance
Monitoring (PDMPs)
Diversion Control
Law Enforcement
Licensure
Treatment
Recovery

12. Family/ Community Members
Treatment/
Recovery
Medical/ Pharmacists
Schools
Aging
Family/ Community Members
Law Enforcement
Public Health
Nonprofits
Like a jigsaw puzzle, each piece is important, and only when put together does the picture become clear. 12

13. Backbone Support: HHS Community Based Prevention Action Team
Law Enforcement Action Team
Intervention, Treatment and Recovery
Action Team
Steering Committee:
Data, Messaging, Policy
Representatives from:
Marin County Office of Education, Marin County HHS, Healthy Marin Partnerships, Residents
Data Collection and Monitoring
Action Team
Prescribers and Pharmacists
Action Team
Backbone Support: HHS

14. Three Year Vision and Measurable Action Plans
County wide relevant data on Prescription drug misuse and abuse
Fully funded continuum of services from intervention through treatment and recovery
Increased coordination and alignment of prescription drug misuse and abuse prevention strategies across all sectors
Cultural norm where prescription drug misuse and abuse is unacceptable
Intensive, measurable drug awareness learning and skill building across all stakeholder groups
Prevention of drug diversion and availability
Mandatory policy and procedures for physicians and pharmacists implemented and enforced
Report card generated and disseminated
Full continuums of services are affordable, accessible, and individualized
Sustainable, coordinated infrastructure supports Rx misuse/abuse prevention efforts
Residents make informed, responsible Rx choices
Community’s perceptions align with Rx misuse/abuse realities
Law Enforcement and Providers collaborate on drug diversion and availability
Narcotic prescription decreased by 15%
New prescribing data identified and collected
Rx prevention is a recommended standard of practice in all public schools
Pharmacists are aware of and have practices and protocols in place to minimize drug diversion
County Health Rankings on drug overdose deaths improve.
Increased opportunities for safe, convenient disposal
Current Rx drug related policies implemented, monitored and enforced; new policies created
Media outlets promote norms change

15. Methods for Sharing the Story & Mobilizing a Community

16. Strategic Goal for Data Action Team
Problem: An Epidemic Without a Surveillance System
Vision: Marin County will have county-wide relevant data on prescription drug misuse and abuse
Develop a report card with 5-10 key data elements to track prospectively
Engage community in selection of indicators of greatest relevance

17. Draft Report Card

18. LiveStories

19. Strategic Goal: Community Based Prevention Action Team
Goals:
Residents make informed and responsible choices (reduce demand)
Engage community in policy campaign development, implementation and enforcement (reduce access)
Actions:
Develop ongoing community-driven campaigns to increase messaging re: harm of Rx use/abuse.
Amend existing SHO in at least two jurisdictions to include consequences for Rx drugs at parties.

23. Key Ingredients for Success
See county as a “system” with many parts
Data mobilizes partners to focus on shared priorities
Centralized support
Coordinating and tracking Action Team efforts
Cheerleading and celebrating successes
Communication across partners
Connected to media
Mutual accountability
Tracking progress
Goals are transparent, measurable and public
Acknowledge personal and professional dimension
Political will and support

24. THANK YOU! Stay connected! www.RxSafeMarin.org
Facebook.com/RxSafeMarin