Presentation Transcript

1. Safe Communities EriePrescription Drug Abuse Task Force

   Safe States Alliance annual meeting Dr. Kim Burns, LECOM - Chairman Patty Puline, ECDH – IP Coordinator August, 2012

2. Geoff Crankshaw

   Erie County Department of Health Northwest regional highway safety network Presenter Safe States alliance annual meeting August 14, 2012
3. Prescription Drug Abuse Prevention
4. Kim Burns, R.Ph, J.D. Lake Erie College of Osteopathic Medicine Assistant Professor LECOM School of Pharmacy University of Pittsburgh School of Pharmacy, 1994 – cum laude Duquesne University Law School – 2002 – cum laude PA Licensed Pharmacist PA Licensed Attorney Areas of Expertise Pharmacy Law and Ethics Patient Safety and Medication Related Errors Chair – Safe Communities Task Force – Prescription Drug Abuse Community Pharmacy Practice – 14 years experience Noted author – professional abstracts, white papers, presentations local, state and national on pharmacy law topics
5. Patty Puline, Injury Prevention Coordinator Erie County Department of Health Curriculum Developer CDC Grant Reviewer/Consultant PA Commission on Crime and Delinquency Practitioner US Department of Justice Consultant Safe States Alliance National Review Committee State Injury Prevention Committee – PA Department of Health Safe Communities/Safe Kids/Child Death Review Coordinator Erie County Council Liaison Erie County Care Management Board of Directors Certified HIV Counselor/Tester – State of Pennsylvania Certified Sexual Assault Counselor Senior Advisor-Teen AIDS Peer Corps – Harvard University
6. Lead Agencies/Partners Kim Burns, R.Ph., J.D., School of Pharmacy, Lake Erie College of Osteopathic Medicine, Chair, Safe Communities Erie, ECDH Prescription Drug Abuse Task Force Jack Daneri, District Attorney, Erie County Bob Merski, Sheriff, County of Erie Nora Drexler, National Project Manager, Alutiiq LLC Elaine Surma, Senior Investigator, PA Attorney General’s Office, Drug & Alcohol Enforcement Unit Janet Thompson, Executive Director, Erie County Medical Society Richard Ortoski, DO, Vice Chair, Erie County Board of Health Dr. Paul Carnes, M.D., Saint Vincent Health Center – pain specialist John Di Mattio, Erie County Office of Drug and Alcohol
7. Areas of Focus Violence and injury prevention State department of health grant 2011-2014
8. Prescriber Survey Conduct a survey of prescribers Gain insight into what prescribers think Targeted prescribers include oral surgeons, orthopedic surgeons, osteopathic doctors, addictions treatment specialists, pain specialists, and hospice providers. Handouts available (copies of survey)
9. PDP Task Force Establish/maintain Prescription Drug Poisoning (PDP) Task Force Address the issues related to prescription drug poisoning Task Force Representatives: County Department of Health, coroner; sheriff; law enforcement, district attorney; mental health; substance abuse; pain specialists; private practice; hospitals; pharmacists; toxicologists, prescribers.
10. Adult Death Review Perform a Prescription Poison Death Review pilot project Goals include: Identify/verify risk factors for overdose, misuse and/or abuse of prescription drugs Identify any data gaps hindering full understanding of the risk factors 3. Identify the type/sources of prescription drugs involved in local deaths 4. Report findings/make recommendations to Task Force, local medical society, State DOH and Board of Health.
11. MUST for Seniors Facilitate the use of “Take Your Medicines Safely” curriculum and videos to prevent prescription drug misuse and drug interactions among older adults.
12. LECOM Collaboration Advanced Pharmacy Practical Experience (APPE) elective rotation created between ECDH and LECOM School of Pharmacy (Patty Puline and Kim Burns) Start date Aug. 2012 Work plan developed for student participation in many of the goals mentioned already Approximately 8-10 students per year; 6 week rotations
13. Med Return Units Purchase and distribute Med Return Units for local participating law enforcement agencies. Design and distribute established DEA protocols, follow up for transport to National Take Back events. Pharmacy students to inventory and tally contents at each location, present findings as a report to preceptor, and share among professionals. Media and community awareness at all levels. Social media outreach to Erie community.
14. Medication Management Program Work with LECOM school of Pharmacy, local hospitals and home health agencies to pilot an in-home medication management system. Collaborate on a comprehensive approach to pilot project. Enroll people that currently take multiple medications Have had in hospital or ER visits this year Identified as high risk for unsafe medication use Coordinate standardized medication records In home surveys and follow up reports Evaluation of pilot project – share through ECDH.
15. Target Population at Risk Self-inflicted poisoning was the… #1 cause of injury hospitalization ages 15-44 #2 reason for hospitalization ages 45-64 #5thleading cause of injury hospitalization for children ages 5-14
16. How can Partners Help? Attend meetings Share resources (human, technical, material) Conference/health fairs Link to knowledge experts Promote each other’s events Email/listserv connections Social Networks Website listings Agency referrals Leads for expansion into other markets Grant news and funding sources available Partnership suggestions Participation in national or state awareness weeks/months/annual events – ex. NPHW
17. Target Population at Risk Alarming increase in adult unintentional prescription drug poisoning nationwide Leading cause of injury death in Erie County 2004-2008 4thleading cause of injury hospitalizations Locally, unintentional poisoning ranked: 2ndas cause of injury hospitalization among ages 0-4 3rd for injury hospitalizations among ages 65+ 4th among ages 25-64
18. Prescription Drug Abuse
19. Prescription Drug Abuse:National Statistics Nearly 15, 000 people die every year from overdoses involving prescription painkillers Prescription painkillers refers to opioid or narcotic pain relievers, including drugs such as Vicodin (hydrocodone), Oxycontin (oxycodone), Opana (oxymorphone), and methadone Nonmedical use of prescription painkillers costs health insurers up to 72.5 billion dollars annually in direct health care costs
20. Children At Risk Everyday 2,500 children ages 12 to 17 abuse a pain reliever for the first time Prescription and over-the-counter (OTC) medications are fast becoming the new “party” drugs for many teenagers. The new trend amongst youth is known as “pharming”, or kids using prescription and OTC medications for recreational use One in five teens has used powerful narcotic pain relievers for non-medical reasons. Half of the 1 in 5 teens say they get the medications from friends and relatives for free; more than 60% say prescription medications are easy to get from the family medicine cabinet  
21. White House Plan Main goal is to minimize abuse of RX drugs while ensuring access to their legitimate use Calls for a multiagency plan in 4 major areas Education (HCP, patients, schools, youth…) Monitoring (PDMPs, REMS) Proper disposal Enforcement
22. Factors That Put Populations at Risk Availability of prescription drugs DTC advertising Increased availability of opioid analgesics Prescribing and dispensing practices; patient noncompliance Lack of increase in monitoring or education Current PA prescription drug monitoring program (PDMP) only covers schedule II drugs; not accessible to HCP Presence of prescription drugs in the home gives access to small children, teens, visitors Inadequate disposal options
23. Risk Factors for Youth and Adults at Risk Availability of both legal and illegal substances Lack of knowledge and understanding about the *Health effects of individual drugs *Drugs in combination *Misuse or abuse of drugs Addiction to one or more substances Presence of depression/psychiatric disorders.
24. Goals Complete a survey with prescribers to gather information regarding nature and extent of the problem II. Establish a Prescription Drug Poisoning Task Force consisting of community experts on prescription drug abuse, misuse, overdose, and deaths. III. Collect and analyze data on adult prescription drug deaths that occur in a selected one-year period, and create a strategic plan based on the findings.

25. Goals

    Reportfindings and share data to funding sources, safety partners, Safe Communities Erie Coalition members. V. Increase intent to make changes in prescribing practices among prescribers. VI. Increase awareness and knowledge about prescription drug misuse and interactions. Patty Puline - 2012
26. Inputs VII. Distribute flyers on proper storage and disposal of prescription and over-the-counter drugs. VIII. Increase knowledge and protective attitudes/beliefs about prescription drug misuse and abuse among high school students. IX. Distribute education materials to elementary students using social networking, online resources, and local partnerships. X. Collect data on meds collected at events/units
27. Prescription Drug AbuseActions Taken Include… Prescribing practices Health literacy related to misuse of prescription drugs Proper storage and disposal of prescription drugs Increased communication (prescribers, pharmacists, public health) Improve statewide prescription drug monitoring program Education to providers (prescribers/pharmacists) / community education (adults/teens/schools)
28. Educate Healthcare Providers Educate healthcare providers with prescribing and dispensing authority Best practices: Prevent and identify prescription drug abuse and misuse among patients.
29. Media Campaign Promote key messages via media Disseminate fact sheets and scripts on the following topics: Proper storage and disposal of prescription and over-the-counter drugs Importance of medical and pharmacy communities to reduce the risk for prescription drug misuse and drug interactions Brochure available for handouts
30. Poison Prevention Week Participate/support/coordinate Poison Prevention Week (March) with Safe Kids Erie and LECOM School of Pharmacy to promote awareness of poison prevention for children. Teach classes in concert with LECOM pharmacy Look alike poison prevention kits for loan to schools
31. Educational Sessions Facilitate classroom and large-group educational sessions with leadership from Lead and Seed, an evidence-based, SAMHSA approved 5 stage youth leadership model Partnership with ECDH VIPP Staff, Coalition Pathways. Raise awareness about dangers of prescription drug misuse and abuse Influence knowledge, attitudes and beliefs of middle/high school students, using Lead and Seed evidence-based model for action and change Utilize Prescription Drug Abuse training DVD from PA Attorney General.

32. Spectrum of Prevention

    Influence Policy and Change Organizational Practices (physician practices; policies to monitor prescription drugs) Foster Coalitions and Networks (Safe Communities Erie County Prescription Drug Poison Prevention Task Force) Educate Providers (Prescribers) Promote Community Education (dissemination of fact sheets, and other media) Strengthen Individual Knowledge & Skills (school-based, community-based, and home-based teaching). Patty Puline - 2012

33. Outcomes

    Creation of Community-based Prescription Prevention Task Force Creation of process for adult poison death review Improved approaches to abuse and misuse Increased awareness and knowledge Increased proper storage and disposal knowledge/methods Increased knowledge strategies to reduce prescription drug poisoning Increased knowledge among cohort of high-risk prescription drug users Increased safe methods of disposal – Med Return Units Patty Puline - 2012
34. Questions? Contact: Patty Puline, Injury Prevention Coordinator Erie County Department of Health ppuline@ecdh.org (814) 451-6543 (814) 434-0227 Kim Burns, Associate Professor LECOM School of Pharmacy kburns@lecom.edu (814) 866-8461