opiate epidemic - montgomery county, ohio · in 2015, narcan was administered 167 times demographic...
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Montgomery County, Ohio
OPIATE EPIDEMIC
Board of County Commissioners
City of Dayton Commission
Working Session
April 27, 2016
Overview of opiate epidemic data
Community health improvement plan
PRESENTATION
THE OPIATE EPIDEMIC
4,9515,382 5,118
0
1,000
2,000
3,000
4,000
5,000
6,000
2013 2014 2015
Number of jail bookingsMontgomery County, 2013-2015
7,145
7,862 7,900
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
2013 2014 2015
Number of drug chargesMontgomery County, 2013-2015
70.1%
29.1%
0.6%
0.2%
Jail bookings by race Montgomery County, 2013-2015
White
Black
Other*
Unknown
30.8%
69.2%
Jail bookings by sex Montgomery County, 2013-2015
Female
Male
Density of Jail Bookings
by Home Location
Montgomery County, 2013-2015
RESIDENCE MATTERS
Density
low
medium
high
Prescription
Opioids
54%
69%
41% 41%46%
31%
59% 59%
0%
10%
20%
30%
40%
50%
60%
70%
80%
2012 2013 2014 2015
Accidental poisonings by sex
Female Male
4142
111
70
0
20
40
60
80
100
120
2012 2013 2014 2015
Emergency department and inpatient visits Accidental poisoning
by other opiates and
related narcotics
hospital visits
Applies to: codeine, meperidine,
morphine, and opium
Montgomery County,
2012-2015
Rate of Other Opiates and
Related Narcotics
Accidental Poisoning
Hospital Visits
By Patient’s Home Location
Montgomery County, 2015
Rate per 100,000 people
0.0 - 3.3
3.4 - 9.6
9.7 - 22.4
22.5 - 32.6
32.7 - 45.6
45005 4500545066
45309
45315
45322
45325
45327
45337
45342
45344
45345
4535445371
45377
45381
4540245403
45404
45405
45406
45409
45410
4541445415
45416
45417
4541845418
4541945420
45424
45424
45426
45428
45429
45431
45432
45433
45439
45440
45449
45458
45459
Sources: Esri, HERE, DeLorme, TomTom, Intermap, increment P Corp., GEBCO,USGS, FAO, NPS, NRCAN, GeoBase, IGN, Kadaster NL, Ordnance Survey, EsriJapan, METI, Esri China (Hong Kong), swisstopo, MapmyIndia, © OpenStreetMapcontributors, and the GIS User Community
Heroin
Nationally, approximately 435,000
people were regular (past-month)
users of heroin.
Among people between the ages of
12 and 49, the average age of first
use was 28.
HEROIN OVERDOSES
4870
330
293
8 14
4827
0
50
100
150
200
250
300
350
2012 2013 2014 2015
Heroin accidental poisoning by hospital visit type Montgomery County, 2012-2015
Emergency Room Inpatient
HEROIN OVERDOSES
34%
42%39%
41%
66%
58%61%
59%
0%
10%
20%
30%
40%
50%
60%
70%
2012 2013 2014 2015
Hospital visits for heroin accidental poisoning by sex Montgomery County, 2012-2015
Female Male
HEROIN OVERDOSES
0
50
100
150
200
250
0-14 15-19 20-24 25-34 35-44 45-54 55-64 65 +
Ra
te p
er
100
,00
0
Rate of hospital visits for heroin accidental poisoning by age Montgomery County, 2012-2015
2012 2013 2014 2015
Rate per 100.000 people
0.0 - 6.6
6.7 - 33.6
33.7 - 69.7
69.8 - 120.0
120.1 - 193.3
Rate of Heroin Accidental
Poisoning Hospital Visits
By Patient’s Home
Location
Montgomery County, 2015
UNINTENTIONAL DRUG OVERDOSE DEATHS
NATIONAL
In many deaths, multiple drugs are present making
it difficult to identify which drug or drugs caused the death.
UNINTENTIONAL DRUG OVERDOSE DEATHS
OHIO
Lake
Erie Lorain
Ashtabula
Ross
Cuyahoga
Stark
Wood
Knox
Lucas
Darke
Pike
Licking
Scioto
Ottawa
Adams
Allen
Huron
Wayne
Gallia
Butler
Clark
Perry
Brown
Logan
Trumbull
Union
Seneca
Athens
Hardin
Henry
Meigs
Noble
Miami
Mercer
Franklin
Fulton
Belmont
Preble
Portage
Vinton
Putnam
Fairfield
Highland
Hancock
Carroll
Shelby
Monroe
Marion
Muskingum
Clinton
Medina
Richland
Holmes
Summit
Warren
Greene
Morgan
Madison
Morrow
Guernsey
FayetteWashington
Ashland
Pickaway
Coshocton
Geauga
Hocking
Williams
Jackson
Paulding
HarrisonDelaware
Tuscarawas
Defiance
Auglaize
Wyandot
Lawrence
Hamilton
Van WertColumbiana
Jefferson
Crawford
Mahoning
Sandusky
Champaign
Clermont
Montgomery
15.8
Death Rate per 100,000 persons
3.5 - 9.3
9.4 - 13.5
13.6 - 17.8
17.9 - 24.6
24.7 - 35.3
Fewer than 10 deaths
Unintentional Drug Overdose Deaths
2009-2014
UNINTENTIONAL DRUG OVERDOSE DEATHS
Drug overdose deaths have increased 104% from 2010 to 2015
Demographic Characteristics of Overdose Deaths in 2014
Average Age – 41.2 years Sex – Male (62%)
Level of Education – HS Graduate (73%) Race – White (89%)
Marital Status – Singe (44%), Divorced (31%), and Married (21%)
127 130
162
226
264 259
0
50
100
150
200
250
300
2010 2011 2012 2013 2014 2015
Case
s
Accidental Drug Overdose Deaths in Montgomery County 2010-2015
UNINTENTIONAL DRUG OVERDOSE DEATHS2014
Male62%
Female38%
White89%
Black11%
Single45%
Married21%
Divorced32%
Widowed2%
Sex Race
Marital Status
UNINTENTIONAL DRUG OVERDOSE DEATHS
28%26%
3%
58%
9%
44%
27%
52%
29%31%
4%
48%
41%37%
16%
51%
0%
10%
20%
30%
40%
50%
60%
70%
Alcohol Cocaine Methamphetamine Heroin IllicitFentanyl
Prescription Opioids
Anti-Depressants Benzodiazepines
2013 2014
Montgomery County: In 2013 and 2014, benzodiazepines and heroin
were the most commonly identified drugs involved in overdose deaths.
UNINTENTIONAL DRUG OVERDOSE DEATHS
Drug users may not know when illicit
fentanyl has been combined or substituted
with other commonly abused drugs,
such as heroin.
75 84
502
0
100
200
300
400
500
600
2012 2013 2014
Fentanyl-related accidental drug overdose deaths in Ohio, 2012-2014
DAYTON POLICE DEPARTMENTMULTI-YEAR OVERDOSE ANALYSIS
59 104 165 198
730494 369
509
159 462723
782
0
200
400
600
800
1,000
1,200
1,400
1,600
2012 2013 2014 2015
Dayton Police and Fire Departments Overdose Responses 2012-2015
Police Only Fire Only Both
948
1,060
1,257
1,489
UNINTENTIONAL DRUG OVERDOSE DEATHS
In 2015, Narcan was administered 167 times
Demographic Characteristics of Narcan Use
Average Age – 35 years Sex – Male (66%)
Youngest Age – 18 years Race – White (90%)
95% were administered Narcan and survived
3 24
7
19
13
20
15
21
27
21
15
0
5
10
15
20
25
30
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2015
Dayton Police Department Narcan Use by Month, 2015
52% Male
48% Female
93% White
6% Black
1% Asian and Native American
72 Referrals to Drug Treatment
1,334 Total Visits
308 Clients Served
15,202 Needles Exchanged
103 HIV Tests
6 Hepatitis C Test
Referrals offered for: clothing, food, housing, medical & dental
care, mental health, STD clinic, pregnancy
test, and Medicaid enrollment
From April 24, 2015 to March 25, 2016
Visits to Syringe Services Program
April 24, 2015 - March 25, 2016
Visits
1 - 13
14 - 34
35 - 51
52 - 87
88 - 377
CarePoint
Counts include visits by repeat clients
8% of clients live outside
Montgomery County.
31% clients live in zip
code 45403.
53% White
44% Black
3% Other Races
Treatment Services Offered:Screening, Assessment, Non-
Intensive and Intensive Outpatient
Counseling and Family Counseling
1009 Clients Served in FY 2016
Most Common Diagnosis
Alcohol Dependence
Cannabis Dependence
Opioid Dependence
23% of Clients are Opioid
Dependent
27% Female
73% Male
Prevention Services Offered:Classroom and Home Based
Education for Adults and Family
Members.
Accidental
Overdose
Deaths
Involving
Heroin -
from 2007
to 2015
COMMUNITY HEALTH IMPROVEMENT
PLAN
Montgomery County: A healthy, safe, and thriving community!
We believe that all residents of Montgomery County should have:
- equal access to resources that promote a healthy lifestyle
- an environment that promotes health and wellness
- social support and community connections
- knowledge about healthy choices and behaviors
HEALTH PRIORITIES
Priority 1 - Birth Outcomes
Priority 2 - Chronic Disease Prevention
Priority 3 - Behavioral Health
Regardless of the neighborhood or community, all Montgomery County
residents should have access to safe recreational facilities and healthy
food options. New policies and programs emphasizing chronic disease
prevention can “make the healthy choice, the easy choice”.
Integration of partners – mental health, substance
abuse, primary care, public health – is critical to meet the
behavioral health needs and ultimately the overall health
of Montgomery County residents.
Infant Mortality is the key, long-term indicator for birth outcomes as well as
for overall community health and well-being.
Birth Outcomes
Birth Outcomes
Neurodevelopmental Disorders
Infant MortalityMaternal, Infant, and Child Health
Chronic Disease Prevention
Chronic Disease
Chronic Disease
Tobacco Free
Living
Healthy Eating
Active Living
Food Access
Behavioral Health
Brain HealthIntegration of Physical and
Behavioral Health
Mental Health and Mental Disorders
Substance AbuseSubstance Abuse
MONTGOMERY COUNTY CHIP
MONTGOMERY COUNTY STRATEGIC PLAN
ODH STATE HEALTH IMPROVEMENT PLAN
HEALTHY PEOPLE 2020NATIONAL PREVENTION
STRATEGY
BEHAVIORAL HEALTH
Goal 1 - Ensure access to needed behavioral health
services at the right amount, at the right time,
for the right person, and in the appropriate setting.
Goal 2 - Increase integration of physical and
behavioral healthcare services.
Goal 3 - Enhance care coordination and
information sharing across
behavioral health and other
system partners.
BIRTH OUTCOMES
Goal 1 – Reduce preterm births.
Goal 2 – Reduce substance misuse in pregnant women and mothers of infants.
Goal 3 – Reduce the infant mortality racial disparity in zip codes:
45402, 45405, 45406, 45414, 45415, 45416, 45417, and 45426.
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