Prescription Drugs in ArizonaOctober 28, 2016

Cara Christ, MD, MSDirector/State Health Official

National Issue• Estimated 2 million people in the US have a prescription

opioid use disorder– 2014: More than 14,000 people died from Rx opioid overdose

• 300% increase in opioid prescription sales since 1999– Without overall change in reported pain

• 249,000,000 prescriptions for opioids were written (2013)– Enough for every adult in America to have a bottle of pills

• America accounts for ~5% of the world’s population– Consume 80% of the global opioid supply

Drug and Alcohol Data Review

25th 50th 1st

41st: Drug DeathsAZ: 18.1 (rate)US: 13.5

Drug Deaths

17th : Excessive drinkingAZ: 16.6% US: 17.6%

15th : Binge DrinkingAZ: 14.9%US: 18.0%

41st (2010)

38th (2012)

35th (2015)

Number of Injury Deaths by CauseArizona, 2010-2015

Cause of Death2010 2011 2012 2013 2014 2015**

Poisoning1,176 1,143 1,097 1,240 1,260 1,335

Acute Drug Overdose1,052 1,020 968 1,099 1,132 1,199

Motor Vehicle Crashes672 724 705 720 651 779

Falls775 784 787 880 890 1,021

Firearms910 954 919 931 852 930

Suffocation364 351 341 381 410 403

Total Injury Deaths4,499 4,627 4,496 4,836 4,600 5,081

Number of Drug Overdose Deaths Involving Selected Drugs, Arizona 2005-2015

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 20150

50

100

150

200

250

300

350

400

450

500

Opioid pain relievers* (T40.2-T40.4)

Cocaine (T40.5)

Heroin (T40.1)

Benzodiazepines (T42.4)

Other and unspecified narcotics (T40.6)

Psychostimulants with abuse potential** (T43.6)

Other and unspecified drugs (T50.9)

Year

Num

ber o

f dru

g po

isoni

ng d

eath

s

401Deaths due to Rx Opioid

Overdose (2015)

Arizona Specific Statistics

>1Death Per Day due to Rx

Opioid Overdose(2015)

2 weeks Rx pain relievers dispensed to medicate every AZ adult

around the clock (2013)

237Deaths due to Heroin

Overdose(2015)

438Babies Born with Neonatal

Abstinence Syndrome (2014)

235%Increase in Babies Born

with Neonatal Abstinence Syndrome since 2008

Source: ADHS Vital Records, Birth and Death Certificate Data. http://http://www.americashealthrankings.org/measures/Measure/AZ/Drugdeaths

Number of AZ Newborns with Drug Exposure, 2008-2013

2008 2009 2010 2011 2012 20130

100

200

300

400

500

600

700

247

413 417 431

549

645

160

10078 67 62 53

22 24 15 31 2721

Narcotics

Cocaine

Fetal Alcohol Syndrome (FAS)

Problem Statement

The misuse and abuse of opioids within Arizona leads to a higher rate of addiction, overdose, neonatal abstinence syndrome, DUI-Ds and ultimately a significant increase in deaths. • This is disproportionately represented within

Arizona’s highly vulnerable population, often those receiving services from Medicaid.

3 Major Ways to Combat the Problem

• Prevent prescription opioid drug abuse– Appropriate prescribing practices

• Access to treatment– Especially Medication Assisted Treatment (MAT)

• Reverse overdoses with Naloxone

What else does public health do?• Surveillance

– Death certificates, HDD, child fatality and maternal morbidity reviews, EMS/trauma data, board of pharmacy data

– Provide data/presentations• Education

– Promote & implement prescribing guidelines– Develop & implement educational campaigns

• Work with federal and local public health partners– Recently hosted the Surgeon General, June 2016– Applied for supplemental to CDC grant to expand to additional counties– Evaluate and promote federal resources

• Home Visiting Programs for at risk families• Injury Prevention• State Health Improvement Plan: Injury Prevention & Substance Abuse

Questions?Cara Christ, MD, MS | Director

Cara.Christ@azdhs.gov | 602-542-1025

@drcarachrist

facebook.com/azdhs @azdhswebsite: azhealth.gov