Tackling the Opioid Epidemic

LiveStories, a company that provides an integrated civic dats hub to health departments recently hosted a webinar on the growing opioid epidemic in the United States. The guest speakers for the webinar were Dr. Tina Kim, Cory Kendrick, and Jackie Pollard from LA County Public Health department, and Summit County health department in Ohio. It was interesting to see how this crisis is impacting different areas of the country, and what the public health departments are doing to combat the problem.

First,  Cory Kendrick and Jackie Pollard discussed the growth of opioid use in the summit county Ohio area. For this area specifically, there was a 400% increase in opioid overdose when fentanyl, and its derivatives such as carfentanyl, were introduced in the area. Jumping from 100 OD ER visits in June 2016 to over 400 visits in July 2016. But while this drastic increase just pushed the area over the edge, they discussed problems that have contributed over the last decade. First, the incorporation of pain as the “5th vital sign” for physicians. FDA approval of highly addictive pain killers, the intractable pain act of 1998, Medicare and Medicaid grading system, direct consuming advertising by pharmaceutical companies, and unregulated pain management clinics. With all of these factors contributing, Ohio has seen a 413% increase in OD death since 1999. Most recently, Ohio had 4050 OD deaths in 2016, 58.2% of which were caused by fentanyl or its derivatives.

With all of these stats in mind, it’s clear that this crisis is quickly becoming a major problem for many areas of the country. Additionally, many accidental overdoses have been reported throughout the United States by children, police, or any other bystander who just happens to touch the fentsnyl substance, Fentanyl is approximately 1000 times stronger than morphine, and carfentanyl is about 1000 times stronger than that, just touching the substance can cause absorption through the skin and lead to overdose in those who are not use to the substance. So what can be done to decrease the grip that opioids have on America? Ohio has taken many steps to address this. At the state level, they have increased penalties for trafficking fentanyl, restricted prescribing guidelines for physicians and emergency rooms (a person can only go 7 days without seeing a doctor for a refill on medication), strict licensing guidelines for pain management clinics, drug take back programs, approval of naloxone (narcan) friends, family, and law enforcement, and lastly mandatory school based opiate prevention program.

At the county level, summit county has also initiated specific initiatives to further combat the problem. Summit county has distributed over 40000 drug disposal bags to pharmacists, supplied naloxone to community jails and schools, created a task force to further advance the initiatives, expanded medication assisted treatment and residential treatment services, offers a syringe exchange program, and lastly stated a quick response team for overdoses specifically in the community.

After this discussion, Dr. Tins Kim discussed the opioid crisis in LA county, and the number were very interesting, while overdoses have steadily risen in LA county recently, it has it been as drastic as most areas in the country, However, the health department knows that it could rise st anytime, and has stated to take action to prevent a drastic rise. LA county has started a prescription drug coalition to prevent the problem from expanding, the coalition consists of nine action teams, with 6 priorities, that possess 10 key objectives. Objectives include decreasing use, changing policy to prevent an influx of prescription drugs, and nary other objectives that are similar to the actions taken in Ohio.

It is clear that this crisis is a serious problem, as the United States population consists of 5% of the world population, but 80% of the world opioid abuse and 99% of hydrocodone use, strong changes need to be made to effectively change the course of this crisis.