The man who moves a mountain begins by carrying away small stones.

- Confucius

THE PROBLEM

• Three of four heroin addicts reported their addiction began through the abuse of opioids.

• Michigan ranks 10th nationally in per capita prescribing rates of opioid pain relievers and 18th in the nation for overdose deaths.

• In Michigan, opioid-related overdose deaths have tripled since 1999, and more than 1,700 people died in 2014.

• As heroin use has increased, so have heroin-related overdose deaths. Between 2000 and 2015, the rate of heroin-related overdose deaths more than quadrupled, and more than 12,989 people died in 2015.

OBJECTIVES

Identify roles of resources (federal / state / local)

Identify process efficiencies to ensure effectiveness

Discuss ideas for further improvements in addressing the opioid epidemic

STAKEHOLDERS AND RESOURCES

FEDERAL

Drug Enforcement Administration

Federal Bureau of Investigation

U.S. Attorney’s Office

Center for Disease Control

DOJ: Office of Justice Programs

Department of Health & Human Service: Substance Abuse

Mental Health Services Administration

STATE

Department of Health & Human Services

Department of Licensing and Regulatory Affairs

Prescription Drug Monitoring Programs (PDMPs)

Legislators

17-member Michigan Prescription Drug and Opioid

Abuse Commission

LOCAL

Schools

Doctors

First Responders

Hospitals

Treatment Professionals

Courts

Community Coalitions

Community Counseling

DRUG ENFORCEMENT ADMINISTRATION

DEA 360 Strategy

• Diversion Control

• Regulatory (manufacturers, pharmacies, practitioners)

• Criminal Investigation of Registrants via TDS

• Drug Take-Back (April 29th)

• Law Enforcement

• Coordinated actions against drug cartels and heroin traffickers

• Heroin Initiatives with LE counterparts

• Strike Forces

• Target Sources of Supply

• Community Outreach/Partners

• Discovery Education: www.operationprevention.com

• Boys Scouts & Girls Scouts

• Partnership for Drug-Free Kids: www.drugfree.org

• Community Anti-Drug Coalitions of America (CADCA)

• Boys & Girls Clubs: www.bgca.org

CENTER FOR DISEASE CONTROL AND PREVENTION

• What you can do to prevent Opioid Overdose Deaths

• Educate yourself and others

• https://www.cdc.gov/drugoverdose/index.html

• Patient and Partner Tools

• Opioid Basics

• Understanding the Epidemic

• Overdose Prevention

• Prescription Opioids

• Heroin

• Dangers of Fentanyl / Carfentanil

• Prevention for States funding program

• Guideline Information for Providers

• Guidelines for Prescribing Opioids for Chronic Pain

• Prescription Drug Monitoring Programs (PDMPs)

OFFICE OF JUSTICE PROGRAMS

• Funding Opportunities to Implement Community based Opioid Strategies

• Applications Due April 25, 2017

• Comprehensive Opioid Abuse Site-based Program:

• https://www.bja.gov/funding/CARA17.pdf

• Comprehensive Opioid Abuse Program Training and Technical Assistance (TTA) Program FY 2017 Competitive Grant

• https://www.bja.gov/funding/COAPTTA17.pdf

MI AUTOMATED PRESCRIPTION SYSTEM (MAPS)

• MAPS enables the practitioner to determine if patients are receiving controlled substances from other providers and to assist in the prevention of prescription drug abuse.

• Health professionals and law enforcement agencies have access to MAPS.

• Data from the Michigan Automated Prescription System shows that more than 21 million prescriptions for controlled substances were written in 2014, about four million more prescriptions than were written in 2007.

PROMISING STRATEGIES

• Increase the use of prescription drug monitoring programs to improve opioid pain reliever prescribing, inform clinical practice, and protect patients at risk.

• Consider policy options relating to pain clinics to reduce prescribing practices that are risky to patients.

• Evaluate state data and programs and consider ways to assess Medicaid, workers' compensation programs, and state-run health plans to detect and address inappropriate prescribing of opioid pain relievers, such as through use of prior authorization, drug utilization review, and patient review and restriction programs.

• Increase access to substance abuse treatment services, including Medication-Assisted Treatment (MAT), for opioid addiction.

• Identify opportunities to expand first responder access to naloxone, a drug used to reverse overdose.

• Promote and support the use of the CDC Guideline for Prescribing Opioids for Chronic Pain.

IMPROVEMENT DISCUSSION

• Schools

• Doctor

• Pharmacist

• First Responder

• Hospital

• Treatment Professional

• Policy/legislation changes

• Enforcement/Prosecution/Judicial

• Community Awareness/Counseling

DRUG ENFORCEMENT ADMINISTRATION

DEA Prescription Drug Abuse Hotline: 877-RX-ABUSE or 877-792-2873

313-234-4000

Follow us on Twitter @DEADetroitDiv

Tip Line: https://www.dea.gov/ops/submit.php