Opioid Overdose: Recently Released

Business Pulse: Opioid Overdose Epidemic

March 15, 2017: CDC Foundation launched an online resource, the “Opioid Overdose Epidemic,” intended to help employers reduce the negative impact of opioids on their workforce. The interactive infographic addresses lost workforce productivity due to opioids, the increased cost of opioid abuse and overdose as a result of healthcare and substance abuse treatment, and other challenges businesses face and how they can develop policies and programs to protect their employees. Also included are resources and an interview with Deb Houry, M.D., M.P.H., director of CDC’s Injury Center, and Mike Menkhaus, R.Ph., Enterprise Pharmacy Retail System project manager, The Kroger Co. The CDC Foundation is a nonprofit entity that advances the mission of CDC through public-private partnerships that protect the health, safety and security of our nation.

Integrating & Expanding Prescription Drug Monitoring Program Data: Lessons from Nine States

A promising strategy for addressing the U.S. opioid overdose epidemic is improving the use of prescription drug monitoring programs (PDMPs). The Substance Abuse and Mental Health Services Administration (SAMHSA) funded nine states to better integrate PDMP data into health systems and to initiate and increase interstate data sharing. The project was called PDMP Electronic Health Records (EHRs) Integration and Interoperability Expansion (PEHRIIE) and funded Florida, Illinois, Indiana, Kansas, Maine, Ohio, Texas, Washington, and West Virginia from 2012 to 2016. CDC conducted a process and outcome evaluation of the program; and in collaboration with Brandeis University, used a comparative case study to describe the implementation process, identify successes and challenges, and explore the program’s effects on the stated goals.

American Journal of Public Health: Recent Increases in Cocaine-Related Overdose Deaths and the Role of Opioids

Research has shown that cocaine use disorder was a significant risk factor for both heroin and prescription opioid use disorder. A recent article published in the American Journal of Public Health examines the role of opioids in the trend of cocaine overdose deaths from 2000 to 2015. Namely, the study shows how increased use of heroin and synthetic opioids is associated with the recent increases in cocaine overdose deaths. Key findings include:

• The percentage of cocaine-related overdose deaths involving any opioid increased from 29.4% in 2000 to 63.0% in 2015, with heroin or synthetic opioids (e.g., illicitly manufactured fentanyl) contributing to 81.5% of these deaths in 2015.
• Opioids, primarily heroin and synthetic opioids, have been driving the recent increase in cocaine-related overdose deaths. This corresponds to the growing supply and use of heroin and illicitly manufactured fentanyl in the United States. 

CDC MMWR: Methadone Prescribing and Overdose and the Associations with State Preferred Drug List Designations

Study looks at the relationship between how states’ prescribing policies relate to methadone overdose deaths. Specifically, this report looked at how methadone overdoses from 2007-2014 and State Preferred Drug List Policies related to Medicaid reimbursement for methadone for pain. Since methadone prescribing rates are higher among persons enrolled in Medicaid, strategies to reduce methadone prescribing might be able to reduce injuries and deaths in this population.

Pain Medicine: Increase in Drug Overdose Deaths Involving Fentanyl – Rhode Island, January 2012-March 2014

Rhode Island experienced a spike in overdose deaths involving fentanyl, this study assessed sociodemographic characteristics, substance use and abuse, and visitation of multiple prescribers and dispensers as risk factors of overdose deaths. The study concludes that illicit fentanyl deaths frequently involve other illicit drugs. The study shows importance of reviewing PDMP and substance abuse history before prescribing opioids. Key findings include:

• Those who died from illicit fentanyl were younger than those who died from other drugs.
• Of those who died, 35% filled an opioid prescription within 90 days of their death, where a third had a mean daily dosage of >100 MME.
• 29% of illicit fentanyl (and 10% of other drug) decedents filled prescriptions for buprenorphine, which is used to treat opioid use disorders.

Other articles and resources of interest:

• Journal of Women’s Health: CDC resources and programs that address injury deaths among US females
• Pain Medicine: Physician dispensing of oxycodone and other commonly used opioids, 2000-2015, United States
• CDC Vital Signs: Arthritis in America: Many adults with arthritis are prescribed opioids, yet other options for pain are safer. This issue includes an MMWR Early Release, a fact sheet, a media release, and a series of announcements. 
• A Substance Use Cost Calculator for Employers: A tool providing business leaders with specific information about the cost of substance use (including opioid and heroin addiction) in their workplace based on size of employee base, industry and state. Developed by the National Safety Council and Shatterproof in collaboration with an independent research institution, NORC at the University of Chicago.
• 2017 National Rx Drug Abuse & Heroin Summit: The largest national collaboration of professionals from local, state, and federal agencies, business, academia, treatment providers, and allied communities addressing the opioid crisis.