Opioid Call HistoryUtah Poison Control Center

Marty Malheiro, MS, CHES

Coordinator, Outreach Education

Introduction

• Misuse/abuse/overdose – far-reaching effects

• UPCC sees overdose in all ages– Intentional and unintentional

• Especially potent for children– “One Pill Can Kill”

Effects on the UPCC• These calls result in adverse and toxic

effects 20X more frequently

• Creates need for more ED referrals

• UPCC provides treatment recommendations– Higher acuity calls require increased staff time

for consultation

• Increased consultations with MEs office

Reasons for Pain Medicine Calls• Therapeutic errors – wrong med, double

dose– More common in 60+ age group

• Intentional misuse/abuse– Taking someone else’s med– Taking drug to get high– Taking multiple meds with similar ingredients

(Lortab® and Tylenol®)

• Concerns about withdrawal

Epidemiology of Opioid CallsUPCC Opioid Call History

0200

400600800

100012001400

16001800

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Year

# o

f C

alls

1,539

486

UPCC - Toxicall

Outcomes Of Opioid CallsOutcome % of Opioid ExposuresMinor effect 29.5

Moderate effect 14.1

Major or fatal outcome 6.1

No effect, not followed-non-toxic 34.4

Potentially toxic, but not followed 11.7

Unrelated effect 4.2

100.0

UPCC – Toxicall 2008

Opioid Call History Statistics<6 6-12 13-19 20-29 30-39 40-49 50-59 60+ Unk Age Total

Unintentionala 244 15 20 57 60 41 40 74 13 564

Intentionalb 0 6 98 228 154 103 50 31 19 689

Adverse Reactionc 2 4 13 47 42 19 15 23 4 169

Otherd 4 2 3 11 19 10 15 10 6 80

250 27 134 343 275 173 120 138 42

TOTAL 1,502

aUnintentional – unforeseen, unplanned event; i.e. child gaining access to a toxic substance, adult taking the wrong medbIntentional – misuse, abuse, suspected suicidecAdverse reaction - unwanted effect due to normal, prescribed, or recommended usedOther – include withdrawal and tampering

UPCC – Toxicall 2008

Opioid Calls by Age Group• 13-19 years

– 73% intentional (50% self-harm)– 13% severe or fatal outcome

• 20-59 years– 57% intentional (55% self-harm)– 18% therapeutic errors– 14% adverse reactions

• 60+ years– 22% intentional (57% self-harm)– 49% therapeutic errors– 17% adverse reactions

UPCC – Toxicall 2008

UPCCs Involvement• Medical Director is on the Steering

Committee– Consults with MEs office

• Outreach Coordinator is on Patient & Community Education work group– Participates on Medication Disposal group in

SL County• Include message in all outreach to never

hesitate to call UPCC – free and confidential

Hot Off the Press!!!

NSDUH Report

February 5, 2009

Nonmedical Use of Prescription Pain Relievers in the

Past Month, by Gender: Percentages, 2002 to 2007

NSDUH Report 2/5/09

QUESTIONS