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Results Review
1.2.A.i: Decrease the rate of opioid overdose deaths from 9.8 per
100,000 in 2015 to 9.0 in 2020
John Wiesman Charissa Fotinos
Secretary Deputy Chief Medical Officer
Background:
Background:
10
694
6 # of
382
deaths
4 Heroin 278
2 Fentanyl
90
0
1999 2001 2003 2005 2007 2009 2011 2013 2015
Source: DOH Death Certificates (Note: prescription opioid overdoses exclude synthetic opioid overdoses)
1.2.A.i: Decrease the rate of Opioid overdose deaths from 9.8 per 100,000 in 2015 to 9.0 in 2020
Background:
20
10
0
American White* Black* Hispanic Asian*
Indian Alaska
Native*
*Non-Hispanic
Source: DOH Death Certificates
1.2.A.i: Decrease the rate of Opioid overdose deaths from 9.8 per 100,000 in 2015 to 9.0 in 2020
Background:
Opioid-related disease
burden in Washington Deaths
694
Opioid
Overdose
Hospitalizations
1,451
1. Opioids involved in an overdose death listed as underlying cause of death. Washington State death certificate data, 2016.
2. Washington Hospital Discharge Data, Comprehensive Hospitalization Abstract Reporting System (CHARS), 2016.
3. Treatment and Assessment Report Generation Tool, 2015.
4. National Survey on Drug Use and Health, 2013-2014.
1.2.A.i: Decrease the rate of Opioid overdose deaths from 9.8 per 100,000 in 2015 to 9.0 in 2020
Partners
State agencies: Federal agencies:
Department of Health Dept. of Health and Human Services
Department of Social and Health Drug Enforcement Agency
Services Local and tribal agencies:
Health Care Authority Elected leaders
Department of Labor & Industries Counties, cities and tribal governments
Department of Corrections Local boards of health
Washington State Patrol Other partners:
Attorney Generals Office Washington State Medical Association
Office of the Insurance Commissioner Washington State Hospital Association
Office of Superintendent of Public Washington State Dental Association
Instruction
Washington State Pharmacy Association
UW Alcohol & Drug Abuse Institute
Washington State Nurses Association
UW Medicine
The Washington Health Alliance
Agency Medical Directors Group
Private practice physicians
Prescribing Boards and Commissions
Clinics and hospitals
Bree Collaborative
Many others
1.2.A.i: Decrease the rate of Opioid overdose deaths from 9.8 per 100,000 in 2015 to 9.0 in 2020
Strategies:
Naloxone distribution
Syringe service programs
Pharmacies
First responders
Clinics / ERs
Substance use disorder
providers
1.2.A.i: Decrease the rate of Opioid overdose deaths from 9.8 per 100,000 in 2015 to 9.0 in 2020
100 pharmacies
Over 1600 kits distributed
http://stopoverdose.org/section/find-naloxone-near-you/
Strategy:
Treating opioid use disorder
Traditional Opioid Use Disorder Treatment
Residential Detoxification
Inpatient Residential Treatment Transforming
Outpatient Counseling
Stand-alone Methadone Clinics
13,056
9,839
8,257 8,297
7,300
6,916
4,947 5,021
4,017
3,080
984
SOURCE: Provider One client Eligibility tables (HCA) & Client Outcomes Database (DSHS RDA).
Note: Excludes dual eligibles and persons with third-party liability; includes all Medicaid eligibles in
the year with Medication assisted treatment (MAT)
1.2.A.i: Decrease the rate of Opioid overdose deaths from 9.8 per 100,000 in 2015 to 9.0 in 2020
A long way to go
Treatment coverage for Medicaid clients with opioid use
disorder by Accountable Communities of Health, 2016
SW Washington Receiving methadone or
buprenorphine
Pierce
Not receiving methadone
Other* or buprenorphine
Olympic
North Sound
North Central
King
Greater Columbia
Cascade Pacific
Better Health
0 2000 4000 6000 8000 10000 12000 14000 16000 18000
Number of patients with OUD
Not
interested 56% medication treatment
20% 39% detox
Not sure 34% individual counseling
Very
8% for addiction
51%
Somewhat
21%
Strategies:
Native Americans
Public education campaigns, prevention & treatment
Cultural specific outpatient, residential and
Medication Assisted Treatment programs
Pregnant/Parenting Women
Parent Child Assistance Program (PCAP)
Outpatient, Residential, Hospital-based treatment
specifically for pregnant and parenting women
1.2.A.i: Decrease the rate of Opioid overdose deaths from 9.8 per 100,000 in 2015 to 9.0 in 2020
10 N=727
0
2000
2002
2004
2006
2008
2010
2012
2014
2016
Source: DOH Comprehensive Hospital Abstract Reporting System
Note: Includes infants born to mothers receiving appropriate treatment for drug use, receiving prescriptions for other health
conditions, or misusing drugs. Use of opioids, benzodiazepines, antidepressants, barbiturates and/or alcohol can result in
infant drug withdrawal. Excludes infants born with NAS after release from birth hospitalization.
Definition: 2000-Q32015 ICD9CM diagnosis code 779.5; Q42015-2016 ICD10CM diagnosis code P96.1
1.2.A.i: Decrease the rate of Opioid overdose deaths from 9.8 per 100,000 in 2015 to 9.0 in 2020
1
Washington State DOC violators in WA-STR1 Continuity of care
Partnerships & Grants
2
Washington State Prison releases to WA-STR1 Partnering with Medicaid
Targeted Response Clark & Skamania managed care plans to
to the Opioid Crisis Counties provide medication assisted
treatment (MAT) services
3
UW/Alcohol and Prison releases to L.J. Arnold Offer MAT services
Drug Abuse Institute King County with Foundation Provide overdose
South King County supervision prevention kits
requirements
4
National Governors DOC violators with National Measure MAT service
Association Center opioid use Governors availability
for Best Practices disorders in Association Conduct a pilot with a plan
to expand MAT services
Learning Lab Snohomish County Increase education and
outreach
Strategies:
Public awareness
campaigns
1.2.A.i: Decrease the rate of Opioid overdose deaths from 9.8 per 100,000 in 2015 to 9.0 in 2020
15%
10%
5%
0%
2006 2008 2010 2012 2014 2016
Prescriber Reports
The Department of Labor and
Industry developed an opioid
prescribing report for providers
treating injured workers.
Percentage of claims
prescribed high-dose opiods
Percentage of claims
prescribed concurrent opiods
and sedatives
Percentage of claims
prescribed chronic opiods.
1.2.A.i: Decrease the rate of Opioid overdose deaths from 9.8 per 100,000 in 2015 to 9.0 in 2020
500
400
300
200
100
0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Customer Focus
Assistance Needed
Increase treatment and prevention
Increase funding for treatment and reduce barriers for Medication Treatment
Expand the hub and spoke model across the state
Increase mobile Medication Treatment units
Increase funding for programs that provide linkage to treatment such as,
Community Prevention and Wellness initiative
Parent-Child Assistance Program