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Kentucky Legislative Update

Kentucky Legislative Update. Van Ingram Executive Director Office of Drug Control Policy Kentucky Justice and Public Safety Cabinet Kentucky Coalition of Nurse Practitioners/Nurse Midwives April 15, 2014. Contents. 2013 National Survey on Drug Use and Health

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Kentucky Legislative Update

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  1. Kentucky Legislative Update Van Ingram Executive Director Office of Drug Control Policy Kentucky Justice and Public Safety Cabinet Kentucky Coalition of Nurse Practitioners/Nurse Midwives April 15, 2014

  2. Contents • 2013 National Survey on Drug Use and Health • House Bill 1 (2012) Provider Training • Kentucky Overdose Data • Legislative Update Justice & Public Safety Cabinet

  3. National Survey onDrug Use and HealthJanuary 8, 2013

  4. NATIONAL TRENDS States with Rates between 5.33 and 6.37 1 Oregon 6.37 5.25-7.71 2 Colorado 6.00 4.96-7.24 3 Washington 5.75 4.76-6.92 4 Idaho 5.73 4.74-6.91 5 Indiana 5.68 4.68-6.89 6 Arizona 5.66 4.60-6.94 7 Nevada 5.62 4.57-6.89 8 Delaware 5.61 4.61-6.82 9 Arkansas 5.55 4.60-6.68 10 New Mexico 5.45 4.47-6.64 Justice & Public Safety Cabinet

  5. NATIONAL TRENDS States with Rates between 4.80 and 5.32 11 Alaska 5.32 4.41-6.42 12 Oklahoma 5.19 4.26-6.30 13Rhode Island 5.18 4.26-6.27 14 Vermont 5.13 4.24-6.19 15 Michigan 5.11 4.57-5.72 16 Ohio 5.00 4.49-5.56 17 Tennessee 5.00 4.14-6.02 18 Louisiana 4.87 4.09-5.80 19 Montana 4.84 4.02-5.80 20 Missouri 4.83 4.03-5.78 Justice & Public Safety Cabinet

  6. NATIONAL TRENDS States with Rates between 4.46 and 4.79 21 West Virginia 4.79 3.97-5.75 22 California 4.68 4.13-5.30 23District of Columbia 4.68 3.79-5.76 24 Wyoming 4.68 3.85-5.68 25 South Carolina 4.62 3.81-5.59 26 Virginia 4.60 3.79-5.58 27 Minnesota 4.57 3.79-5.49 28 New Hampshire 4.57 3.77-5.53 29 Kansas 4.56 3.77-5.50 30 Wisconsin 4.51 3.68-5.52 31 Kentucky 4.48 3.70-5.41 Justice & Public Safety Cabinet

  7. NATIONAL TRENDS Among persons aged 18 to 25, the rates of past year nonmedical use of pain relievers declined in 14 states: Florida, Kentucky, Louisiana, Maine, Massachusetts, Michigan, New Hampshire, New York, Ohio, Oklahoma, Rhode Island, Texas, Utah, and West Virginia. Justice & Public Safety Cabinet

  8. HB1 Provider Training

  9. HB 1 TRAININGS • ODCP, OPERATION UNITE and KENTUCKY COALITION OF NURSE PRACTITIONERS/NURSE MIDWIVES HAVE SPONSORED 4 TRAININGS Justice & Public Safety Cabinet

  10. HB 1 TRAININGS Overview of HB1 and Regulations C. Lloyd Vest, JD How to Recognize Drug Abuse and Dependence in Patients Gregory Jones, MD How to Discuss Drug Issues with a Patient Gregory Jones, MD An Update on KASPER - Post House Bill 1 David Hopkins Opioid Therapy: Risks vs. Rewards Gregory Jones, MD Justice & Public Safety Cabinet

  11. HB 1 TRAININGS MOREHEAD 119 TRAINEES 83 PRESCRIBERS PAINTSVILLE 147 TRAINEES 55 PRESCRIBERS BOWLING GREEN 239 TRAINEES 170 PRESCRIBERS MANCHESTER 110 TRAINEES 80 PRESCRIBERS Justice & Public Safety Cabinet

  12. HB 1 TRAININGS • 615 TOTAL TRAINEES • 388 PRESCRIBERS • AVAILABLE ONLINE • MEETS LICENSING BOARDS REQUIREMENTS Justice & Public Safety Cabinet

  13. HB 1 TRAININGS Justice & Public Safety Cabinet

  14. The Good, Bad, and Ugly of Addiction Justice & Public Safety Cabinet

  15. Kentucky Overdose Data

  16. 2012 OVERDOSE DATA • 1004 OVERDOSE FATALATIES IN 2012 • 19 FEWER THAN 2011. THE FIRST DECLINE IN OVER A DEACDE • 888 UNINTENTIONAL • 59 SUICIDES • 57 UNDETERMINED Justice & Public Safety Cabinet

  17. 2012 OVERDOSE DATA • LARGEST INCREASE CAMPBELL COUNTY. FROM 25 IN 2011 TO 54 IN 2012 • LARGEST DECREASE, FLOYD COUNTY WITH 23 FEWER DEATHS IN 2012 THAN 2011 • MOST PER 100,000 LESLIE COUNTY WITH RATE OF 85 PER 100,000 Justice & Public Safety Cabinet

  18. 2012 OVERDOSE DATA • DEATHS ATTRIBUTABLE TO HEROIN ROSE 550% • ALPROZOLAM MOST DETECTED SUBSTANCE AT 41.44% OF ALL MEDICAL EXAMINER CASES Justice & Public Safety Cabinet

  19. 2012 OVERDOSE DATA • YOUNGEST OD DEATH AGE 16 • OLDEST 72 • AVERAGE AGE 40 • MALE 58% • FEMALE 42% Justice & Public Safety Cabinet

  20. FIRST 3 QUARTERS OF 2013 • 639 TOTAL OVERDOSE DEATHS REPORTED DURING three quarters OF 2013 • 170 OR 26% HAVE HEROIN IN THE TOXICOLOGY REPORT • OVERWHELMING MAJORITY POLY DRUG Justice & Public Safety Cabinet

  21. 2013 • JEFFERSON 94 • FAYETTE 26 • KENTON 26 • BOONE 20 • CAMPBELL 8 • FRANKLIN 5 • 17 COUNTIES 1 or 2 • 97 COUNTIES NONE Justice & Public Safety Cabinet

  22. Heroin vs. OxyContin Source: National Survey on Drug Use and Health OxyContin users (for nonmedical reasons) Heroin users Justice & Public Safety Cabinet

  23. HEROIN Justice & Public Safety Cabinet

  24. HEROIN Justice & Public Safety Cabinet

  25. HOW DID WE GET HERE? • LONG HISTORY OF OPIOD/PAINKILLER ABUSE • INCREASING NUMBERS OF IV DRUG USAGE • ABUSE DETERRANT FORMULATIONS • CRACKDOWN ON ROUGUE PAIN CLINICS • GREATER AWARENESS FROM PRESCRIBERS • ESTABLISHED DRUG CARTELS RECOGNIZING DEMAND Justice & Public Safety Cabinet

  26. HOW DID WE GET HERE? PRICE AVAILABILITY PERCEPTION OF RISK PUBLIC ATTITUDES Justice & Public Safety Cabinet

  27. HOW DO WE ADDRESS IT? • PUBLIC EDUCATION • INCREASED ACCESS TO TREATMENT • ENHANCED PENALTIES FOR MAJOR TRAFFICKERS • GREATER ACCESS TO NALOXONE Justice & Public Safety Cabinet

  28. Legislative Update

  29. HB1 – Pain Management Facilities • Physician ownership requirement on all pain management facilities (PMF) • Exception for those health facilities operating as a PMF on April 24, 2012 • No sanctions or convictions imposed on facility or employees Justice & Public Safety Cabinet

  30. PMF Oversight • KBML responsible for licensure standards for physician-owned pain management facilities. • OIG, Division of Health Care is responsible for licensure standards for existing pain management facilities that qualify for the physician-ownership exemption of HB1. Justice & Public Safety Cabinet

  31. Non-Physician Owned PMFs • 29 non-physician owned PMFs were identifiedon April 24, 2012 (HB1 passage date)  • 8 closed prior July 20, 2012 (HB1 effective date) • 13 closed after the HB1 effective date • 4 illegal or non-physician owned PMFs discovered after HB 1 effective date • 6PMFs were sent cease and desist letters • 5PMFs licensed by the Cabinet for Health and Family Services • 1 PMF license pending Justice & Public Safety Cabinet

  32. Federal Actions - Hydrocodone • Hydrocodone combination products to be rescheduled from CIII to CII • Approved by FDA • Pending recommendation to HHS and approval by HHS and DEA • FDA approved CII pure hydrocodone product • Zohydrotm ER manufactured by Zogenix, Inc. • Available March 2014 • Not abuse-resistant formulation Justice & Public Safety Cabinet

  33. Attorney General Settlement • 32 MILLION • 1 MILLION EACH TO INDEPENDENCE HOUSE & CHRYSALIS HOUSE • 500K TO RECOVERY CENTER IN NORTHEAST KY • 2.5 MILLION TO RECOVERY SCHOLARSHIPS • 6 MILLION FOR KASPER UPGRADES • 19 MILLION FOR ADOLESCENT TREATMENT Justice & Public Safety Cabinet

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