drug overdose

Did Changes in Controlled Substance Prescribing Licensing Lead to Changes in Opioid Prescribing or Adverse Outcomes?

Unintentional fatalities because of prescription medications are an increasing problem in Utah and the United States. In response to this crisis of drug-related harm, the state government of Utah has undertaken several regulatory changes including promulgating guidelines for opioid prescribing and mandating that providers register to use the online portal for access to the Utah Controlled Substances Database (CSD), a registry of all filled prescriptions for schedule II-V drugs. This study aims to evaluate the impact of three regulations on prescribing patterns, use of the online system to access the CSD and adverse drug events.

Grant Number: 6369

Funding Date: Tue, 11/15/2011

Researching Institution: University of Utah

Researcher: Christina Porucznik, PhD, MSPH; Brian Sauer, PhD

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Reassessing the Effectiveness of Prescription Monitoring Programs

Prescription drug overdose deaths, mostly from opioid pain relievers, now outpace motor vehicle fatalities in most states. In about 35 states, electronic databases known as prescription monitoring programs (PMPs) are intended to reduce abuse of prescription drugs and overdose by tracking pharmacy dispensing and making data available to clinicians and law enforcement. This study will provide evidence-based information of effectiveness to administrators and inform policy decisions at the national level.

Grant Number: 6387

Funding Date: Tue, 11/15/2011

Researching Institution: University of North Carolina at Chapel Hill

Researcher: Nabarun Dasgupta, MPH; Corey Davis, JD, MSPH

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How can public health law support intervention in drug overdoses?

Drug overdose deaths have surpassed traffic fatalities in Washington State and 15 other states. This study will examine the legal intent, implementation and outcomes of a new Washington state law to support intervening in drug overdoses. The law includes a Good Samaritan component that provides legal immunity from drug possession charges for people who overdose or seek aid for another person’s overdose. It also allows the prescribing of an opioid antidote medicine (Naloxone) to drug users and their partners. Evaluation will be conducted on the development of the legislation and the impact of the law on Seattle area heroin users, bystanders, and police during overdoses as well as the impacts on community health outcomes.

Grant Number: 68396

Funding Date: Mon, 11/15/2010

Researching Institution: University of Washington

Researcher: Caleb Banta-Green, Ph.D. M.P.H. M.S.W.; Patrica Kuszler, M.D., J.D.

Results

Summary of Initial Findings

Passage of the “911 Good Samaritan Overdose Law” took five years, keys to passage included:

  • Framing the law as a public health issue, not primarily as a legal issue.
  • The emergence of prescription medicines (e.g. opiate pain medicines) as the drugs involved in a  majority of drug overdoses. This increased the perceived public health risks of overdose and broadened the populations, demographically and geographically, that could be helped by legislative action.
  • Keeping the scope of immunity narrow, just drug possession, was the only way to get support of law enforcement, prosecutors, and some legislators.

First responders’ and opiate users’ experience with overdose included:

  • Opiate overdoses are common---42% of opiate users and 62% of Seattle police reported being present at the scene of a serious opiate overdose in the prior year.  (Almost all opiate users surveyed at syringe exchange used heroin.)
  • Most paramedics had been at an overdose in the prior year and approximately 45 serious opiate  overdose victims (heroin or pharmaceutical) are transported by Seattle medics each month.
  • Police were at the scene of most overdoses for which 911 was called according to drug users and paramedics.
  • Arrests of overdose victims and bystanders were very rare according to drug users, paramedics, and police.

Impacts of Good Samaritan Law on planned behaviors:

  • 88% of opiate users indicated that now that they were aware of the law they would be more likely to call 911 during future overdoses. 
  • 62% of police surveyed said the law would not change their behavior during a future overdose because they would not have made an arrest for possession anyway, 20% were unsure what they would do, and 14% said they would be less likely to make such an arrest.

Information dissemination:

  • Funding for implementation of the law was not included in the legislation and no state agency was assigned responsibility for implementing the law.
  • Information dissemination has involved the limited distribution of written educational materials.
  • The website http://stopoverdose.org appears to be a frequently accessed source of information.

Caleb Banta-Green at the University of Washington

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