ASTHO President’s Challenge
15 x 15: Reduce Prescription Drug
Misuse and Deaths 15% by 2015
Terry Cline, Ph.D.
Commissioner of Health
Oklahoma Secretary of Health and Human Services
Prescription drugs as the primary driver of
overdose deaths.
(Top 15 drug or drug classes, US 2010)
But deaths are just the
“tip of the iceberg…”
Source: CDC. Vital Signs: Overdoses of Prescription Opioid Pain Relievers—United
States, 1999-2008. CDC Policy Impact: Prescription Painkiller Overdoses. Available at:
www.cdc.gov/homeandrecreationalsafety/rxbrief/
Building a Strategic Map: The Role of Partners
Prioritize multi-sector efforts and identify collaborations, partnerships,
stakeholders, and corresponding efforts to address prescription drug abuse.
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American Academy of Pain Management
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American Pharmacists Association
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American Association of Poison Control
Centers
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American Society of Addiction Medicine
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PDMP Center of Excellence (Brandeis
University)
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Centers for Disease Control and Prevention
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Clinton Foundation
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Federation of State Medical Boards
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Kanawha-Charleston Health Department
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Maryland Poison Control Center
National Alliance for Model State Drug Laws •
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National Association of Chain Drug Stores
National Association of County and City Health •
Officials
National Association of State Alcohol and Drug
Abuse Directors
National Governors Association
National Institute on Drug Abuse
Office of the Army Surgeon General
Ohio Department of Health
Oklahoma State Department of Health
Pennsylvania Department of Drug and Alcohol
Programs
Personal Advocate
Pharmaceutical Research and Manufacturers
of America
Project Lazarus
Safe States Alliance
Substance Abuse and Mental Health Services
Administration
Tennessee Department of Health
United States Department of Justice
University of Kansas School of Medicine
University of Rochester Medical Center
Vermont Department of Health
White House Office of National Drug Control
Policy
Ongoing Work:
“Expand and Strengthen Key
Partnerships and Collaborative
Infrastructure”
Prevention
Education
Surveillance
Monitoring
(PDMPs)
Diversion Control
Law Enforcement
Licensure
Treatment
Recovery
Comprehensive and Cross-sector Strategies
Strategic Map
2014 President’s Challenge
Goal:
• Improve health outcomes and reduce human and
economic costs associated with prescription drug
misuse, abuse, and overdose.
Pledge:
• Reduce the rate of nonmedical use and the
number of unintentional overdose deaths involving
controlled prescription drugs* 15 percent by 2015.
*(including opioid analgesics, stimulants, tranquilizers, and sedatives)
2014 President’s Challenge
Encourages all S/THOs to apply strategies to achieve
measurable reductions in controlled prescription drug
misuse, abuse, and overdose
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Identify at least one policy or program to
implement, improve, or evaluate in the next year
Move beyond “silo-based” approaches to focus on
collaboration with partners to carry out aligned,
comprehensive efforts
Neonatal Abstinence Syndrome (NAS): Tennessee
Impact of NAS on Infant Health Care Expenditures, CY 2011
Metric
Number of Births
Cost for Infant in First Year of
Life
Average Cost per Child
Average Length of Stay (days)
TennCare Paid Live
Births1
TennCare nonLBWT Births
TennCare Live
LBWT Births2
NAS Infants
45,205
40,437
4,768
528
$350,936,293
$171,336,964
$179,599,329
$33,249,612
$7,763
$4,237
$37,668
$62,973
4.8
3.2
18.3
32.5
Percentage of Newborns in DCS Custody within One Year of Birth, CY 2011
Infants Born in CY 2011
NAS Infants
Total # of Infants
55,578
528
Total # Infants in DCS
767
120
% in DCS
1.4%
22.7%
1
2
This sample contains only children that were directly matched to TennCare’s records based on Social Security Number.
Any infant weighing under 2,500g at the time of birth was considered low birth weight (LBWT).
Geospatial Analyses Reveal “Hotspots”
Source: Ohio Department of Alcohol and Drug Addiction Services
SFY 2012 Annual Report
This map uses hot spot analysis to display the number of clients in
treatment who list heroin (left), prescription opioids (right) as a
primary drug of choice by zipcode.
Oklahoma – Significant Timeline
Sept. 2012
Governor Mary Fallin’s Prescription Drug
Task Force Created
February 2013
Finalized State Plan
October 2013
Distributed Opioid Prescribing Guidelines
December 2013 Governor’s Launch of Plan and Media
Campaign
April 2014
Naloxone Program Will Begin
Oklahoma – 2013 Legislative Session
HB 1781 – Prescription Drug Monitoring Program (PDMP) Access
Grants the Department of Health and the Department of Mental Health and
Substance Abuse Services access to PDMP; shared data may be used for statistical,
research, substance abuse prevention provided that confidentiality is maintained.
HB 1782 – Naloxone
Allows first responders to administer opiate antagonists without a prescription when
encountering a person exhibiting signs of a drug overdose, and allows prescriptions to
family members so they can administer in an overdose situation.
HB 1783 – Emergency Rule Changes Hydrocodone Refills
Limits hydrocodone refills with no automatic refills; new prescription required.
$1.2 million appropriated specifically for prescription drug initiatives annually
2014 President’s Challenge
As of 03/26/2014, 26 states and one territory have accepted the Challenge!
www.astho.org/rx