Serving our community by
improving health
The Addiction Crisis
November 2014
The Disease of Addiction
– Primary Chronic Disease of Brain Reward,
Motivation, Memory and Related Circuitry.
– A neurobiological disease that changes how
brain cells organize to process information
and mediate behavior.
Valley Health Data
Overview
• 5-10x increase in heroin ODs in Valley Health
EDs since 2010
• 3x increase in substance exposed newborns
at WMC since 2010
• VHS heroin poisoning patients:
– 91.1% Caucasian
– 75.2 % male
– 48.3 % <25 YO
Opiate Overdose Deaths
NW Virginia
30
25
20
15
10
5
0
2011
2012
2013
2014
* Without the use of NARCAN (A drug used to immediately counteract the effects
of Opiates) the death toll would be much higher.
Commonly Abused Medications
• OPIOIDS: Derived from the opium poppy, or
synthetic versions of it, and used for pain relief.
• BENEZODIAZEPINES: Central nervous system
depressants used as sedatives, to induce sleep,
prevent seizures, and relieve anxiety.
• AMPHETAMINE LIKE DRUGS: Central nervous
system stimulants used to treat Attention Deficit
Hyperactivity Disorder (ADHD).
Quick Facts
• Prescription Drug Abuse has always been around:
“Grand Daddy Of All Drug Abuse”.
• Is the Nation’s fastest growing drug problem and has been
classified as an epidemic.
• In 2011, 41,340 unintentional drug overdose deaths occurred
in the United States, increase for 12th consecutive year; one
person dies every 12.45 minutes1. 22,810 (55%) were
prescription drug overdose deaths, of which opioid pain
relievers were involved in 16,917 deaths (74.165 %)1.
• Opioid pain relievers were involved in more overdose deaths
than cocaine and heroin combined1.
• Enough prescription pain relievers were prescribed in 2012 to
provide every American adult with a bottle of pills1.
1SOURCE:
CDC National Center for Health Statistics/National Vital Statistics Report; June 2014
CDC Vital Signs: Opioid Painkiller Prescribing; July 2014
6
Circle of Addiction
Oxycodone
(Percocet®, Percodan®, Roxicodone®)
Hydrocodone
OxyContin®
OPANA®
ZohydroTM ER
(Vicodin®, Lortab,® Lorcet®)
Heroin
7
Drug Poisoning Deaths Involving Opioid Analgesics,
Cocaine, and Heroin: United States, 1999-2011
% CHANGE
2006-11
18,000
16,000
+ 23%
Number of Deaths
14,000
12,000
10,000
8,000
6,000
- 37%
4,000
+ 110%
2,000
-
1999
2000
2001
2002
2003
2004
Opioid analgesic 4,030
Cocaine
3,822
4,400
5,528
7,456
8,517
9,857
10,928 13,723 14,408 14,800 15,597 16,651 16,917
3,544
3,833
4,599
5,199
5,443
6,208
7,448
6,512
5,129
4,350
4,183
4,681
Heroin
1,843
1,784
2,092
2,084
1,879
2,010
2,089
2,402
3,041
3,278
3,036
4,397
1,963
2005
2006
2007
2008
Note: Not all drug poisoning deaths specify the drug(s) involved, and a death may involve more than one specific substance.
The rise in 2005-2006 in opioid deaths is related to non-pharmaceutical fentanyl (see
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5729a.htm). *Heroin includes opium.
Source: National Center for Heath Statistics/CDC/ National Vital Statistics Report, Final death data for each calendar year (June 2014).
2009
2010
2011
Addiction
Select Initiatives
• Launched a system-wide Emergency Department Pain
Treatment Guidelines June 2014
• Enhancing our philosophy around pain management
• Educating our staff and medical staff on best practices
• Educating our patients and clients on safe medication
management
• CME Dinner “Prescription Drug Abuse Crisis” attended
by >200 providers
• VH Wide monthly Employee Education- Addiction
Awareness
Addiction
Select Initiatives
• Educational outreach on substance abuse and
addiction
• Successfully partnered to expand/market
prescription drug “take back” programs
• Increased data sharing to support regional
grant applications
Addiction
Select Initiatives
• Collaborating with community partners to:
• develop a comprehensive, sustainable and
effective addiction treatment model
• to address this growing public health issue
through prevention, education and
treatment
Serving our community by
improving health
The Addiction Crisis
November, 2014