The Department's Focus On Addressing Overdose
Drug Overdoses are increasing rapidly throughout the nation, including right here in Pennsylvania. Therefore, it is no surprise that overdose touches our friends, family and community. The Department of Drug and Alcohol Programs (DDAP) is focused on addressing the overdose problem in Pennsylvania, while ensuring that our prevention programs are robust, well-resourced and evidence-based, and that all Pennsylvanians struggling with the disease of drug and alcohol addiction can get the level and duration of treatment and recovery supports they need to live a healthy and productive life.
What is the commonwealth doing to address the overdose problem?
Heroin and Other Opioids Workgroup: Similar to rising trends across the nation, overdose deaths in Pennsylvania have been on the rise over the last two decades. To strengthen and expand current initiatives, the Department called for a unified and concerted effort across all of state government to deal with these issues. All cabinet-level agencies and other state offices under the Governor’s jurisdiction were directed to recommend multi-disciplinary initiatives to effectively combat opioid abuse and the loss of life by drug overdose in the commonwealth.
Overdose Rapid Response Task Force
In an effort to directly address the overdose problem in Pennsylvania, DDAP created the Overdose Rapid Response Task Force (ODRRTF) as a diverse statewide group of individuals comprised of law enforcement, healthcare professionals, coroners, and government officials.
The task force is focused on improving methods of reducing overdoses by establishing rapid and reliable lines of communication about drug trends between emergency health care providers, law enforcement, and drug treatment providers. The task force will be doing the following:
- Determine particular overdose trends as a proactive/preventative measure;
- Determine what avenues can be established to communicate trends between different disciplines and state agencies (law enforcement, coroners, healthcare, treatment)
- Determine cross-system collaborative efforts between law enforcement, health and substance abuse providers for addressing identified trends/issues in a more robust fashion;
- Avert an upsurge in use of a particular trending substance;
- Prevent overdose deaths.
There are five workgroups that have been established and tasked with achieving particular objectives:
Coroners Workgroup: In addition to Methadone related deaths, coroners have agreed to report on all overdose deaths. A uniform report form to submit all types of overdose deaths has been finalized and reporting has commenced.
Health Department Epidemiologic Workgroup: This group is tasked with considering existing reporting systems from which overdose reporting information can best be obtained/reported that will potentially alert stakeholders of potential incidences requiring action. This information will be identified through overdose trends, visits to Emergency Departments, Emergency Medical Services, and reports to the Poison Control Centers. The DOH Workgroup was also assigned with informing the Task Force regarding PA’s standards for the administration of naloxone by emergency medical services. It is standard protocol for all ambulance companies to use naloxone in the case of overdose.
Treatment/Warm Hand-off Workgroup: The primary emphasis of this workgroup is to make sure that survivors of overdose receive immediate hand-offs to appropriate drug and alcohol services once they have been medically stabilized. An Overdose Policy Bulletin has been established and distributed to the county drug and alcohol directors (SCAs) via DDAP indicating that each county office must have a policy for dealing with overdose; overdose victims must be a priority for treatment assessment and SCAs must also send a list of assessment sites to emergency healthcare providers. Ongoing considerations of this workgroup include the use of Screening, Brief Intervention and Referral to Treatment (SBIRT), inclusion of drug and alcohol recovery support services in medical assistance reimbursement, Good Samaritan Legislation, etc.
Information Sharing Workgroup: This work group is addressing possible avenues that information pertinent to overdose prevention and response, use trends, etc. can be disseminated to stakeholders throughout the state (DDAP, DOH, SCAs, treatment providers, law enforcement, etc.) in a way that is timely, accurate and accessible.
Pennsylvania State Police are establishing a Homeland Security Information Network portal that will contain a location to post reports, requests for information, collaborations, etc. Participants having access to this portal (Task Force members and potentially other identified stakeholders) will be invited and vetted through the Department of Homeland Security representative. Information shared within this portal will then have the potential to be shared with other stakeholders across the state as necessary and appropriate.
Naloxone Workgroup: This workgroup has begun its review of overdose prevention, response strategies and legislation being utilized in other states. This includes Good Samaritan legislation and increased access to naloxone; this workgroup has made preliminary recommendations to the ODRRTF regarding both of these issues and discussion is ongoing. The task force has already started some preliminary information sharing and has the goal of creating a more effective system-wide method for information sharing among impacted constituencies, including government entities at the local, state and federal level. The federal Substance Abuse and Mental Health Services Association (SAMHSA) is also reviewing the ODRRTF program to see if it can be replicated as a national model.
Pennsylvania Drug Take-Back program
Introduced as a permanent statewide drug take-back program Pennsylvania Drug Take-Back program will provide up to 250 secure medicine return boxes throughout Pennsylvania which will allow individuals to dispose of unused and expired prescription and over-the-counter medication safely and anonymously.
The Pennsylvania Drug Take-Back program is a partnership between the Pennsylvania District Attorneys Association (PDAA), the Pennsylvania Department of Drug and Alcohol Programs (DDAP) and the Pennsylvania Commission on Crime and Delinquency (PCCD).
The Departments of Drug and Alcohol Programs and Health are co-chairing the Prescribing Practices initiative with the purpose of reducing prescription drug abuse and overdoses, while maintaining effective pain management. The group includes representation from all medical professionals, as well as their professional associations and regulatory agencies.
The focus of this group is to identify and find consensus on best and safest prescribing and pain management practices, and to identify ways that the stakeholders at the table (representing various state departments and private organizations) can most effectively promote those practices.
After the group’s first meeting, there appears to be a strong consensus in the group that the existing “Model Policy on the Use of Opioid Analgesics in the Treatment of Chronic Pain,” adopted by the Federation of State Medical Boards of the United States in July 2013, was the policy which this group should adopt and promote. This policy has been accepted by the American Pain Society and the American Academy of Pain Medicine. We are also working with the SAMHSA Regional Director, who has been putting us in touch with some of the stronger prescriber and dispenser training programs in our region.
Another goal of this group is to ensure not only that prescribers and dispensers are not only trained in best pain medicine practices, but that they also are trained in identifying drug abuse and addiction problems in their patients, and that they know where to refer them for treatment. At a minimum, prescribers and dispensers should have training in SBIRT (screening, brief intervention, referral to treatment), an evidence-based practice proving to be effective in reducing alcohol abuse and showing great promise with respect to drug abuse as well.
These Pennsylvania guidelines are now available for download: