It has been a busy four months since the Arizona Department of Health Services (ADHS) submitted the Opioid Action Plan to Governor Ducey in September. The report on findings and recommendations was one of the requirements under the public health emergency declaration issued on June 5. The challenging work of reducing opioid overdoses has continued with a focus on implementing the fifty action items outlined in the plan, along with implementing the other deliverables of the public health emergency declaration.
We posted a new update on our progress since September. Some of the highlights include:
- We are nearing completion of the regular rulemaking process to finalize the new opioid prescribing and treatment rules for licensed health care institutions.
- On October 9 emergency rules went into effect to continue opioid-related reporting on an on-going basis. We are conducting regular rulemaking to adopt rules for opioid poisoning-related reporting.
- ADHS worked with the Arizona Prescription Drug Initiative Health Care Advisory Team to update the Arizona Opioid Prescribing Guidelines, originally published in 2014. The content of the guidelines was finalized in December 2017, and the final draft is posted at azhealth.gov/opioidprescribing. This voluntary, consensus document promotes patient safety and best practices if prescribing opioids for acute and chronic pain, and reflects a shift in pain care that avoids unnecessary exposure to opioids while addressing pain from a whole-person perspective.
- ADHS has provided 5,150 naloxone kits for 52 law enforcement agencies since June 2017. Agencies can request naloxone by completing the request form on the ADHS website
- A survey was conducted to gather feedback on the preliminary policy recommendations in the Opioid Action Plan.
- Actions taken to implement the Opioid Action Plan include launching taskforces to address improvements to the Controlled Substances Prescription Monitoring Program (CSPMP); regulatory issues; health profession curriculum; youth prevention; peer recovery support; and insurance parity issues. The CSPMP Taskforce issued an initial set of recommendations, and will continue to meet to discuss additional actions.
- The Governor’s Office of Youth, Faith, and Family developed new public service announcements that began airing in December and are scheduled to continue through 2018. Take a look at rethinkrxabuse.org to view the ads.
- A survey was conducted of Arizona’s jails and prisons to learn about existing programs or interest in using programs for opioid treatment or intervention. An analysis conducted by ADHS showed that people recently released from prison were 2.5 times more likely to experience an opioid-related hospitalization and 4.7 times more likely to experience an opioid-related death.
The progress report also includes a recent analysis of opioid data, which supplements the data that is posted to azhealth.gov/opioids on a bi-weekly basis. The recent data analysis reveals:
- Fatal opioid overdoses are most common among 45-64 year olds
- Chronic pain (e.g. lower back pain, joint pain, arthritis) is the most common pre-existing physical condition reported for those who had a verified opioid overdose
- Depression and anxiety are the second and third most common pre-existing health conditions reported for those who had a verified opioid overdose
- Heroin, alone or in combination with other drugs, was reported to be involved in 23% of verified opioid overdoses
- Oxycodone, morphine, and hydrocodone, alone or in combination with other drugs, were involved in 30% of verified opioid overdoses
- 64% of verified fatal opioid overdoses and 45% of non-fatal opioid overdoses involved polydrug use of at least one opioid and at least one other type of drug
- The number of opioid prescriptions filled per week in Arizona has declined since June
- About 40% of people who had a suspected overdose (between June 15 and December 31) had nine or more prescriptions for opioids filled during 2017
- 35% of people who had a suspected opioid overdose were prescribed opioids by 10 or more providers
We will continue to post new updates as they become available at azhealth.gov/opioids.