1. Mayor Jacobs Prescription Drug Task Force Update Presentation to Board of County Commissioners September 23, 2014

2. Presentation Outline  Recap of the Prescription Drug Problem  Progress of State and Local Efforts  Education and Awareness Initiatives  Drug Trends  Summary

3. The Prescription Drug Problem An Epidemic……

4. 2010 - 7M people took prescription drugs non-medically

5. Of those 12 and older, 70% obtain pain relievers for free, bought or took from friends or family

6. Florida had 90 of the top 100 Prescribing Physicians dispensing the most Oxycodone in a given year

7. Oxycodone Purchases by State Medical Practitioners Source: DEA January 2010- June 2010 41.3M

8. 2010 - Florida had over 920 Registered Pain Management Clinics

9. 2010 - Florida was one of eight states that did not have an operational Prescription Drug Monitoring Program

10. 2010 - 22,000 deaths due to Prescription Drugs

11. Neonatal Abstinence Syndrome n umber treated for drug withdrawal in Florida increased 173% between 2006-2009

12. In 2010 – Over 60 Registered Pain Management Clinics in Orange County Orange County Pain Management Clinics

13. 8% of Orange County High School students report using prescription pain relievers

14. 2010 - Orange County had 147 Prescription Drug-Related Deaths

15. Presentation Outline  Recap of the Prescription Drug Problem  Progress of State and Local Efforts  Education and Awareness Initiatives  Drug Trends  Summary

16. 2011- Comprehensive Legislation  Banned dispensing of Schedule II and Schedule III controlled substances  Required physicians to either electronically prescribe or use counterfeit-proof prescriptions  Added criminal violations to support enforcement  Implemented the Prescription Drug Monitoring Program & improved reporting requirements for dispensing physicians and pharmacists from 15 days to 7 days

17. Oxycodone Purchases by State Medical Practitioners Source: DEA January 2013- June 2013 41.3M 2013 – 182,903 Oxycodone Purchases

18. Florida’s Drug Enforcement Strike Forces  Seven Drug Enforcement Strike Forces were created by the Governor and Attorney General reduce the supply of diverted prescription drugs

19. FL Pain Management Clinics 19 Source: Dr. John Armstrong, FL Surgeon General – Orange County Prescription Drug Abuse Summit

20. Prescription Overdose Deaths in Florida Plunge After Tougher Measures, Report Says – July 1, 2014 “This tells us that policies and enforcement work,” Dr. Frieden said. “This is an epidemic that was caused largely by inappropriate prescribing, and it can be fixed to a significant extent by improving prescribing.”

21. Progress of Local Efforts  Mayor Jacobs Prescription Drug Task Force Extent of the Problem Collaborative, Multi-Jurisdictional Approaches Provide Viable Solutions  June 2012 - Board of County Commissioners passed zoning regulations and conditions for new Pain Management Clinics

22. Orange County Pain Management Clinics 2014 – 21 Registered Pain Management Clinics in Orange County

23. Pain Management Clinics Decrease in Pain Management Clinics  Illegal Pain Clinics & Rogue Pharmacies Investigated & Prosecuted  Voluntary Relinquish  Disciplinary Relinquish  Denied Disciplinary  Administratively Revoked  Appeal in Process  Closed  Expired  Withdrew

24. Progress of Local Efforts  Cities enacted ordinances on pain management clinics  Emergency Departments implement chronic pain management plan  Promote and support DEA Prescription Take Back Days

25. Progress of Local Efforts  Increased education and awareness on dangers of misuse/abuse of prescription drugs  Oxycodone harder to come by and more expensive  Central Florida physicians are prescribing less oxycodone than in past  Prescription Drug-Related Deaths have decreased by 30%

26. Presentation Outline

27. Education & Awareness Initiatives  Held first Orange County Prescription Drug Abuse Summit - focus on Neonatal Abstinence Syndrome  Increase training for law enforcement, drug retail industry & prevention providers  Lock Your Meds Campaign – Informed Families worked with Publix Pharmacy Stores to promote awareness campaign  Walgreens promotion of DEA Prescription Drug Take Back Day

28. Education & Awareness Initiatives Public Education Campaign – Securing Your Medications Campaign/OutreachNumber Reached Theatre/Radio/Internet Streaming Ads 2.5 Million Impressions Department Motor Vehicles1.1 Million Impressions High Schools (11) Lock Your Meds Campaign 15,000 Students Lock Your Meds Pledge Cards 1,650 Students/1,750 Parents Community Meetings/Trainings/Events 154 Trainings/Events

29. DEA Prescription Take Back Day Orange County collected over 3.4 tons of unwanted & expired medications

30. Education & Awareness Initiatives  Thirteen Permanent Prescription Drug Disposal Containers  Locations open Monday –Friday Orange County Sheriff’s Office Headquarters and Substations 1-4 Orlando Police Department Winter Park Police Department Ocoee Police Department Belle Isle Police Department Windermere Police Department Winter Garden Police Department UCF Police Department & UCF Health Services

31. Education & Awareness Initiatives DEA Secure & Responsible Drug Disposal Act (2010)  Allow transfer unwanted & unused controlled medications to authorized collectors for disposal  Authorized Collectors – retail pharmacies, hospital/clinic with on-site pharmacy, authorized manufacturers, narcotic treatment programs & distributors  Only Law Enforcement can conduct take-back events

32. Education & Awareness Initiatives DEA Secure & Responsible Drug Disposal Act (2010)  Long-term facilities can dispose of controlled medications for residents  Expands public opportunity for safe disposal  Effective Date of DEA Act – October 9, 2014

33. Presentation Outline  Recap of the Prescription Drug Problem  Progress of State and Local Efforts  Education and Awareness Initiatives  Drug Trends  Summary

34. Responsible Manufacturing 34 Source: Dr. John Armstrong, FL Surgeon General – Orange County Prescription Drug Abuse Summit

35. Drug Trends  Law Enforcement has seen increase in abuse of other prescription drugs Hydrocodone Dilaudid Methadone and Xanax (Parachuting) Promethazine with Codeine (Lean) Tramadol

36. Drug Trends  Law Enforcement has seen increase in abuse of heroin  88% increase in total drug deaths involving heroin 201226 deaths 201349 deaths (Orange and Osceola Counties)

37. Presentation Outline  Recap of the Prescription Drug Problem  Progress of State and Local Efforts  Education and Awareness Initiatives  Drug Trends  Summary

38. Summary  Decrease in number of pain management clinics  Decrease in the number of prescription drug-related deaths  Continue to engage and collaborate with partners in public and private sectors  Advance our education and awareness campaign with youth, parents, older adults and community partners  Promote permanent prescription drug disposal containers

39. Prescription Drug Take Back Day September 27 th 10am-2pm

40. Mayor Jacobs Prescription Drug Task Force Update Presentation to Board of County Commissioners September 23, 2014