1. Gaston County Opioid Data
Velma V. Taormina MD MSE FACOG
Gaston County Substance Abuse Coalition Chairman
Gaston County DHHS Medical Director
October 22, 2016

2. Alarming Trends
25% of 2013 Community Health Survey responded that they use illegal drugs.
From , Gaston County had the 4th highest number of heroin overdoses in NC.
From , Gaston County had the highest number of prescription opioid overdoses in NC.
Gaston County had 6th highest number of meth lab busts in 2013
Prescribers write a high number of prescriptions of multiple at-risk drugs
Highest rates of hospital discharges and ED admissions due to acute poisonings of all Community Care of North Carolina regions.
Region 9 in CCNC is Gaston and Lincoln County
NORTH CAROLINA INJURY AND VIOLENCE PREVENTION
Prescription Opioid Codes used: cdeath1-cdeath21 any mention of T40.2 (Other Opioids), T40.3 (Methadone) and/or T40.4 (Other Synthetic Opioids) and unintentional intent (X40-X44)
NCDOJ site

3. Comparison of Rates of Unintentional Poisoning Deaths (x40-x49) for North Carolina and Gaston County,

4. North Carolina and Gaston County 2013 and 2014: Causes of opioids and illicit death (T36-T50)
Other opioids (oxycodone, hydrocodone, morphine, oxymorphone, etc)

5. What did the overdose victim in Gaston County look like in 2014?

6. Who was Likely to Overdose in Gaston County in 2014?
Could be a male or female
90% are White
None are Hispanic
48% were between the ages of 35-44
SOURCE:
Injury and Violence Prevention Branch
North Carolina Department of Health and Human Services

7. What are Their Stories?
We are going to give you an introduction to our case studies at the end of the morning so that you can be thinking about their management as we listen to our speakers.

8. Case #1
70-year-old retired banker with advanced osteoarthritis of the knees, not a surgical candidate due to congestive heart failure.
Prescribed Lortab 10/325 6x/day with pain relief and improved quality of life.

9. Case #2
84-year-old grandmother with COPD on supplemental oxygen and chronic pain related to severe lumbar DDD and facet arthropathy
Patient’s granddaughter living in the home is addicted to Crystal Meth

10. Case #3
51-year-old employed machinist with chronic back pain and radiculopathy with a history of 3 back surgeries including a multilevel fusion 5 years ago
Relocating from West Virginia and needing to establish pain management
Prescribed Oxycontin 60 mg three times a day, Oxycodone 15 mg every four hours and Valium 10 mg three times a day
Has benefited from periodic lumbar epidural steroid injections

11. Case #4
36-year-old female retail sales associate with a history of a 2-level lumbar fusion
Prescribed Oxycodone 15 mg every four hours from prior pain clinic and travelling from Charlotte for evaluation.
Requesting Fentanyl patch
NCCSRS showing opiate prescriptions from multiple prescribers over last 3 months. Outside records indicating patient has been discharged from multiple pain clinics
UDS results from ED visit last year positive for cocaine

12. Questions???