ADAI News

New Resources on Overdose Follow-up Programs in Washington

ADAI's Stopoverdose.org has new resources and information on Overdose Follow-up Programs in Washington state.

The recorded webinar and slides on “Overdose Follow-up Interventions: After Naloxone, What’s Next?” are now available -- find it under Webinars on the linked page. [note: in the recording, the slides aren’t synced to what’s being said for the first five minutes of the webinar, but it improves after that.]

You'll find new content for first responders about “Leave Behind” Naloxone, highlighting Tacoma Fire Department’s new program to carry naloxone (NARCAN^®) on their rigs.  View the TFD staff training video below.

The webinar and new content is just the beginning of the discussion about Overdose Follow-up in Washington State. Please contact Alison at the Center for Opioid Safety Education if you have ideas for topics to cover in future webinars or training, or other information that you would find helpful in planning programs in your community.  

Interviews & Webinars with ADAI Researchers

TOMORROW (Feb. 28, 12:00-1:00pm): The 2nd in a series of monthly webinars from ADAI's Northwest Addiction Technology Transfer Center (NWATTC) will feature psychologist Michelle Peavy, who will examine patient-centered care in an Opioid Treatment Program (OTP) setting.  Find out about future NWATTC webinars

ADAI Principal Research Scientist Caleb Banta-Green appeared on the KBTC TV program Northwest Now on Feb. 16, to talk about the epidemic of opioid use and overdose, and what can be done to stop the alarming addiction and death rate related to these drugs.  WATCH NOW
 

Dennis Donovan, ADAI Director, was interviewed by KING TV about the comparative risks of marijuana and heroin, and the fear that legalization will lead to increased use of marijuana. WATCH NOW

Beyond Brownies and Joints: Product Development and Advertising in the Legal Era was the topic of a webinar by ADAI Senior Research Scientist Bia Carlini, for the Washington Association of Prevention Coalitions and Prevention WINS.  VIEW on YouTube

Opioid Overdose Prevention Intervention in Acute Care

Along with the increase of opioid-related deaths seen all over the country, visits to hospital emergency departments (ED) and inpatient admissions related to opioid use have increased dramatically over the years, reflecting the increase in non-fatal overdose cases.

Hospital ED and acute care settings are potentially important settings to reach people vulnerable to opioid overdose that may not access healthcare in other settings, such as substance use disorder treatment centers or primary care.

A NIDA-funded clinical trial led by ADAI Principal Research Scientist Caleb Banta-Green tested an overdose prevention intervention for opioid users seen in the Emergency Departments of Seattle's Harborview Medical Center and the University of Washington Medical Center.  The intervention combined opioid overdose education, a take-home naloxone kit, and brief behavior change counseling.  The research team wanted to test the impact of the intervention on participants’ subsequent opioid overdoses, ED visits, and hospitalizations. 

The study found that the overdose prevention intervention had no statistically significant impact on subsequent overdoses, either positive or negative. This null finding is perhaps not surprising given the severity of medical and social problems of the population in terms of homelessness, drug use and other health and social issues. A brief, one-time intervention in acute care settings or subsequent to receiving acute care may not be sufficient to reduce serious overdose events.  Study participants also had very high rates of subsequent emergency department visits and hospitalizations, and warrant more intensive interventions.

Citation: Banta-Green CJ, Coffin PO, Merrill JO, Sears JM, Dunn C, Floyd AS, Whiteside LK, Yanez ND, Donovan DM. Impacts of an opioid overdose prevention intervention delivered subsequent to acute care. Injury Prevention 2018 (in press).

Read the published article (subscribers) or a final manuscript (free online to non-subscribers).

Washington State Syringe Exchange Health Survey 2017

A conservative estimate puts the number of people who inject illicit drugs (PWID) in Washington State at more than 33,000. A survey conducted by the UW Alcohol & Drug Abuse Institute at 18 syringe exchanges programs, representing approximately 80% of syringes exchanged annually in the state, profiles the health behaviors and health care needs and preferences of injection drug users in Washington.  The survey found that:

• Methamphetamine use among people who inject drugs appears to be increasing. Eighty-two percent (82%) reported using methamphetamine in the last three months compared to 69% in 2015.
• About half of people who used methamphetamine as their main drug were interested in reducing or stopping their stimulant use (47%).
• Most people who used heroin as their main drug were interested in reducing or stopping their opioid use (78%).
• The proportion of people who used opioids who had a naloxone kit more than doubled from 24% in 2015 to 59% in 2017 among those outside of King County; the increase was from 47% to 66% in King County.
• Syringe exchange participants have a wide and complex range of health concerns beyond substance use and face multiple hurdles and stigma when accessing health care.

The report was produced with support from the Washington State Department of Social and Health Services, Division of Behavioral Health and Recovery.  Read the full report at: http://adai.uw.edu/pubs/pdf/2017syringeexchangehealthsurvey.pdf

Related:

"Tackling the Opioid Crisis"  (Policy Brief, Gov. Jay Inslee, Jan. 2018)

"Can this drug use survey guide Washington policy?" (MyNorthwest.com, Jan. 19)

"Survey of needle exchange users shows meth usage up across Washington" (Spokesman-Review, Jan. 19)

Starts with One: Washington State Opioid Awareness Campaign

All Washingtonians have a role to play in protecting our families and communities from opioid misuse and abuse, and it starts with being informed.  The state's new Starts With One - Opioid Awareness Campaign will help to prevent opioid misuse and abuse and encourage safe storage and disposal of prescription pain medications by teaching:

• the dangers of prescription drug misuse and abuse
• how to safely store, use and dispose of prescription drugs
• how to respond to an opioid overdose

Last week in Spokane, Fox28 hosted a panel of experts discussing opioid misuse and abuse: Caleb Banta-Green (UW Alcohol & Drug Abuse Institute), Charissa Fotinos (WA Health Care Authority), Julia Havens from WA Division of Behavioral Health & Recovery, and Kristi Sharpe from the community organization Clarkston EPIC.

  

For more information about preventing opioid misuse and overdose:​

• Follow Starts With One on Facebook
• Washington Health Alliance/Bree Collaborative - Opioid Medication and Pain: What You Need to Know
• Washington Poison Center - Take Back Your Meds
• StopOverdose.org
• National Institute on Drug Abuse - Opioids
• Partnership for Drug Free Kids - Medicine Abuse Project
• SAMHSA - Opioids

Fentanyl Found Locally in Fake Opioid Pills

[Source: KOMO News] King County health officials are concerned that a bag of pills, found on a person believed to have died of an overdose, could result in a string of overdose deaths in Seattle.

On Monday, Public Health-Seattle and King County issued a statement about Fentanyl found in fake pills. The bag of pills looked like Oxycodone but were actually Fentanyl, the powerful drug blamed for hundreds of overdoses across the U.S.

“These pills look like Oxycodone 30 milligram pills; they look exactly like them,” said Caleb Banta-Green, with the University of Washington's Alcohol and Drug Abuse Institute.

“What we don’t know is what they’re being sold as, and what people think they’re buying."  Banta-Green said Fentanyl is hundreds of times more powerful than heroin. The drug can be found in a number of forms, including pills and powder.

Read and watch the full story on the KOMO News website.

Please share this Fentanyl Warning flyer.

More information at StopOverdose.org.

Overview of the Opioid Epidemic and Statewide Response, Webinar July 27, 1:30

"Overview of the Opioid Epidemic and Statewide Response" is the topic of webinar led by Caleb Banta-Green, MSW, MPH, PhD, principal research scientist at the UW Alcohol & Drug Abuse Institute. Participants will learn more about the statewide opioid response, the role of evidence-based medical treatments, and the multiple efforts to decrease mortality rates from opioid use by changing the way treatment is delivered.

The webinar is the latest in a series of "Transformation Talks," monthly webinars hosted by the Health Systems Transformation and Innovation team at the Washington State Department of Health. Topics cover a range of issues related to healthcare reform and health systems transformation efforts. These events are open to state agency staff, local public health, and partners statewide.

When: Thursday, July 27, 1:30-2:30 pm

Register here.

Download flyer

Recent Brief Reports from ADAI

Results of ADAI research are published in articles in peer-reviewed journals and presented at scientific conferences.  We also produce brief reports and summaries on a variety of topics, aimed at the wider audience of providers, policy makers, and the public.  These reports are supported by diverse funding sources.   

Funder: WA State Div. of Behavioral Health & Recovery (DBHR):

• Practical and Ethical Considerations in Providing Parent-Initiated Residential Treatment to Youth. Reviews relevant literature for group care for children and adolescents, residential treament for youth, and secure residential treatment in a juvenile justice context. No studies found on issues regarding absconding / elopment in SUD and COD facilities for youth vs. maintaining a therapeutic environment.
• Locked vs. Unlocked Facilities for Treating Youth with Substance Use Disorder.  Residential treatment facilities are frequently sought for adolescents with severe substance use and/or behavior disorders, yet it remains hotly debated whether residential care is superior to community-based care. Among residential treatment facilities, there is a question of whether locked or unlocked (i.e., secure or non-secure) units are better in terms of benefits or outcomes. This brief reviews the literature on this topic.
• Medication Safety: Online Resources. Annotated list of educational resources and materials on medication safety for various classes of drugs; describes audience, message, sponsor, and more.

Funder: I-502 for research on marijuana:

• Cannabis Use Disorder
• Screening and Assessment Tools for Cannabis Use Disorders
• Marijuana's Impact on Pregnant Women and their Children
• Vaping Marijuana

Funder: ADAI and other sources:

• Fentanyl Death Investigation in Four Washington State Counties.  Overdose deaths from fentanyl and fentanyl-analog drugs are increasing in the U.S. and elsewhere. This analysis focuses on the type of fentanyl substance, the possible source, the form/appearance, and how it was used. Findings will be used to inform public health educational messaging and possible improvements to death investigation procedures.

Heroin and Pharmaceutical Opioid Overdose: EMS Response

A new study by ADAI researcher Caleb Banta-Green and colleagues looked at whether Emergency Medical Services (EMS) data may provide insight into opioid overdose incidence, clinical characteristics, and medical response. Using data from a Seattle EMS service, the study compares heroin and pharmaceutical opioid overdoses from six alternating months in 2011.  While they are clinical similar, the study finds that heroin and pharmaceutical opioid overdoses are treated differently by responders.

Highlights:

• Emergency Medical Services data provided important insights into opioid overdose.
• Heroin was identified in 43% of cases, and prescription-type opioids only in 37%.
• Cases were clinically similar, yet heroin users were more likely to receive naloxone.
• Standardized surveillance of opioid overdoses could be valuable for public health.

Data collection was supported by a grant from the Robert Wood Johnson’s Public Health Law Research Program.

Citation: Banta-Green CJ, Coffin PO, Schoeppe JA, Merrill JO, Whiteside LK, Ebersol AK. Heroin and pharmaceutical opioid overdose events: Emergency medical response characteristics.  Drug & Alcohol Dependence 2017;178:1-6. https://doi.org/10.1016/j.drugalcdep.2017.04.021. See related reports from this project.

Summit on Opioid Epidemic in Washington, June 15-16, 2017

Washington State Attorney General Bob Ferguson will hold a two-day summit June on the opioid epidemic, convening law enforcement, medical professionals, prosecutors and public health experts.

“Opioids are devastating Washington families and communities, and overwhelming our safety nets,” Ferguson said. “This summit will bring together key stakeholders to identify next steps and solutions to this epidemic.”

When: June 15 (8:00am - 5:00pm) and June 16 (8:30am - 12:00pm)
Where: UW Kane Hall (6/15) and UW Husky Union Building (6/16)

Registration:  This summit is free and open to the public, with registration. Register online.

Who should attend? State, tribal, local and federal law enforcement and prosecutors’ offices, community leaders, and policymakers.

Speakers: Attorney General Bob Ferguson, Washington State Patrol Chief John Batiste, King County Prosecuting Attorney Dan Satterberg and State Health Officer Dr. Kathy Lofy. Multiple sessions will share best practices from around the country, from drug monitoring to health care fraud field operations.

The Attorney General’s Office planned the summit in partnership with the Washington State Patrol and the Washington Association of Prosecuting Attorneys. On October 7, 2016, Governor Jay Inslee signed an executive order requesting that the AGO, along with law enforcement and community partners, develop and recommend strategies to reduce the supply of illegal opioids in Washington state.

In 2015, 718 Washingtonians died from opioid overdose, more than from car accidents. The majority of drug overdose deaths — more than six out of ten — involve an opioid.

The opioid epidemic has impacted Washington unlike any other state in the region. According to the Centers for Disease Control and Prevention, Washington is the only Western state to see a statistically significant increase in drug overdose death rates between 2014 and 2015.

For more information on the upcoming opioid summit, please contact Kelly Richburg at [email protected].