1. Managing the Opioid Epidemic in Louisiana Together We Can
Managing the Opioid Epidemic in Louisiana Together We Can! Conference November 7-9, Lafayette, LA Presentation: Thursday, November 9th-10:15am to 11:45am Facilitators: Leslie Brougham Freeman, Ph.D., LPP Director of Prevention Services/Office of Behavioral Health Mona Michelli, MSW, LCSW-BACS Section Administrator – Child Protective Services Department of Children and Family Services

2. National Statistics
Among those people who misused prescription pain relievers in the past year, more than 50% got them from friends or relatives, 40% from health care providers, and 10% from other sources(SAMHSA 2015 Natl. Survey on Drug Use and Health)
Sales of prescription opioids in the U.S. quadrupled from , but there was no overall change in pain reported by Americans
In 2016, roughly 62 million U.S. patients (1 in 5 people) had at least one opioid prescription filled/refilled.
4.3 million Americans are estimated to be engaged in non-medical use of prescription opioids.

3. Louisiana Statistics
According to the CDC, Louisiana ranked first in opioid prescribing in In 2016, Louisiana ranked 5th.
In 2016, the average opioid prescriptions written in the U.S. was prescriptions per 100 people.
In 2016, the rate in Louisiana was 110 opioid prescriptions per every 100 people.
In 2016, East Baton Rouge Parish overdose deaths exceeded motor vehicles and equaled homicide deaths.

4. LOUISIANA STATISTICS

5. Louisiana Prescription Monitoring Program (PMP)
Tracking Opioid Prescribing in Louisiana – 2010 to 2017
The Prescription Monitoring Program (PMP) is the statewide electronic database housed under the Louisiana Board of Pharmacy that counts the number and type of controlled prescription medicines filled by pharmacists.
Prescribers, pharmacists, and other healthcare professionals use this system to ensure that opioids are appropriately prescribed and not misused.
The PMP provides information on opioid prescriptions in totals, by demographics, and changes over time. The information is displayed in “rates” – which show the number of prescriptions in relation to the number of people in Louisiana.
To track Opioid prescribing in Louisiana, the number of prescriptions per 100 Louisiana residents is used.
The PMP started counting prescriptions in So far, 2013 had the fewest prescriptions per person (102 per 100 people). The opioid prescribing rates reached a high of 113 per 100 people in 2015, and dropped slightly to 110 per 100 people in 2016.

6. Louisiana Legislation
2017 Regular Session Legislative Summary
House Bill 192 was co-authored by Rep. Helena Moreno and Rep. Kirk Talbot and it limits first-time prescriptions of opioids for acute pain to a seven day supply, with exceptions when medically appropriate;
House Bill 490 by Rep. Walt Leger, creates a 13-member advisory council on heroin and opioid prevention and education;
Senate Bill 55 by Sen. Fred Mills, strengthens our Prescription Monitoring Program; and
Senate Bill 96 by Sen. Ronnie Johns broadens the Prescription Monitoring Program access to include counselors, parole officers, medical examiners, and coroners.

7. Louisiana State Response to the Opioid Crisis
SAMHSA GRANT OPPORTUNITY: $8.1 Million Awarded on May 1, 2017
The Opioid STR grant puts our state in a position to help those individuals who are effected by opioid abuse and misuse.
Will allow LDH to partner with local prevention and treatment providers to become more aware about this crisis, and to enhance prevention and treatment services.
PREVENTION-INTERVENTION-TREATMENT-RECOVERY

8. Louisiana STR Continuum

9. Prevention
Resource development and educational out-reach to targeted population groups
State-wide media campaign
Educational sessions for the public, providers, first responders, schools, and universities
Training, Education and Communications Consultant located at each Local Governing Entity
Education for prescribers on the PDMP

10. Intervention Naloxone education, access and distribution
Prescription limits
Screening and referral for Re-Entry
Training, to include Medication Assisted Treatment (MAT) and non-opioid alternatives, for health care practitioners (including medical schools), primary care facilities, OTP staff, Local Governing Entity staff

11. Treatment
Training, to include Medication Assisted Treatment (MAT) and non-opioid alternatives, for health care practitioners (including medical schools), primary care facilities, OTP staff, Local Governing Entity staff
Provide opioid treatment program (OTP) capacity slots at 9 OTP Clinics
Care coordination with Local Governing Entities for treatment services
Regional Resource coordinators located at OTP clinics
Department of Corrections (DoC) Re-Entry program clinical staff support

12. Recovery Oriented System of Care Support
Regional Behavioral Health Peer Recovery Support Specialists in Local Governing Entities (LGEs)
Care coordination between community providers and LGEs, FQHCs, primary care offices and emergency rooms.
Linkage to OTP Resource Coordinators
Recovery Coaching development

13. Department of Children and Family Services
COLLABORATION EFFORTS WITH DCFS
Mona Michelli, MSW, LCSW-BACS Section Administrator – Child Protective Services
Department of Children and Family Services

14. Overview of Impact on Child Protective Services
Direct Impact Receipt of reports of infants born affected by illegal substance use Receipt of notifications of infants born affected by legal substances that are used in a lawfully prescribed manner
Indirect Impact
Receipt of reports that indirectly result from the use of substances, including Opioids

15. Number of Victims with a Valid Drug or Alcohol Affected Newborn Allegation

16. Valid Victims of Drug or Alcohol Affected Newborns by Region

17. Types of Drugs Reported as Contributing Factors During CY 2016

18. Collaboration Efforts Between LDH and DCFS
Coordinated efforts on referrals of DCFS clients for substance abuse assessments and necessary treatment through the Local Governing Entities (LGE’s);
Use of DCFS TANF funding to support substance abuse treatment, specifically for parents with children;
Collaborative efforts amongst DCFS, LDH and other stakeholders in the development of the “Louisiana Substance Use in Pregnancy Toolkit”;
Partnership in implementing federal legislation, the Comprehensive Addiction and Recovery Act, that specifically addresses the Opioid epidemic;
DCFS development of quarterly regional stakeholder meetings, with key participants from LDH, to address the needs of substance exposed newborns, share resources, identify gaps/barriers to service delivery, and develop strategies to address identified gaps/barriers to improve outcomes for these children and families.

19. GROUP DISCUSSION
ACCESSING RESOURCES

20. NEXT STEPS: YOUR CALL TO ACTION
Contact: Leslie Brougham Freeman, Ph.D., LPP
(225)
Contact: Mona Michelli, DCFS
(225)