P R OJ EC T L A ZA R U S I S A G R A N T -S U P P O RT ED P R O GR A M T H RO UGH T H E

JAC K S O N C O U N T Y D E PA RT M EN T

O F P U B L I C H EA LT H

Medication Safety

Who is Project Lazarus?•Nonprofit organization

•Provides training and technical assistance

•Using experience, data, and compassion we empower communities and individuals toprevent drug overdoses and meet the needs of those living with chronic pain

•Believes that communities are ultimately responsible for their own health and that everydrug overdose is preventable.

Project Lazarus Model

Overdose

• Defined:• Prescription Drug Misuse• Accidental Poisoning

• Who:• Patient misuse• Family/Friends sharing to self medicate• Recreational User• Substance Use Disorder/Treatment/Recovery

• Benzodiazepines • Xanax, Valium, Ativan

• Opioids • Morphine, methadone, hydrocodone, oxycodone

• Tranquilizers• Valium, Librium, Halicon

• Antidepressants• Celexa, Lexapro, Prozac

• Psychotropics and stimulants• Adderall, Ritalin, Depakote, Effexor

• Diabetes medication• Aspirin

Drugs involved in overdoses in Jackson County

Physical symptoms of Rx abuse

Behavioral signs of Rx abuse• Stealing, forging or selling prescriptions

• Taking higher doses than prescribed

• Excessive mood swings

• Increase or decrease in sleep

• Poor decision making

• Appearing to be high, unusually energetic or revved up, or sedated

• Continually "losing" prescriptions, so more prescriptions must be written

• Seeking prescriptions from more than one doctor

•Overdose deaths are surpassing motor vehicle deaths

•Preventable

•A concern for every community member

Why is it important?

DATA ATTRIBUTION AND DISCLAIMER: NC DHHS/DPH NC DETECT ED VISIT DATA WERE MADE AVAILABLE FOR THIS PRESENTATION BY THE NC DETECT DATA OVERSIGHT COMMITTEE. THE NC DETECT DATA OVERSIGHT COMMITTEE INCLUDES REPRESENTATIVES FROM THE NORTH CAROLINA DIVISION OF PUBLIC HEALTH IN THE DEPARTMENT OF HEALTH AND HUMAN

SERVICES, THE CAROLINA CENTER FOR HEALTH INFORMATICS IN THE DEPARTMENT OF EMERGENCY MEDICINE AT THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL, AND THE NORTH CAROLINA HOSPITAL ASSOCIATION. THE NC DETECT DATA OVERSIGHT COMMITTEE AND NC DETECT DO NOT TAKE RESPONSIBILITY FOR SCIENTIFIC VALIDITY OR ACCURACY OF THE

METHODOLOGY, STATISTICAL ANALYSIS, RESULTS, OR CONCLUSIONS PRESENTED.

11

Unintentional Poisoning Mortality Rates: North Carolina, 2001-2011

Citation: North Carolina State Center for Health Statistics. NC Health Data Query System. Retrieved April 24, 2013 from http://www.schs.state.nc.us/schs/data/query.html.

Crude rates per 100,000 person-years

CDC Policy Impact: Prescription Painkiller Overdoses

Source: CDC-www.cdc.gov/homeandrecreationalsafety/rxbrief/

ED visits for accidental poisonings*: Jackson and surrounding counties, 2008-2010

195

45

59

516

196

85

118

193

52

85

641

243

158

113

196

36

75

676

223

142

134

0 100 200 300 400 500 600 700 800

Swain

Macon

Jackson

Haywood

Graham

Clay

Cherokee

2010

2009

2008

Number of ED Visits

Number of prescriptions for controlled substances: Jackson and surrounding counties, 2008-2010

69,321

21,50317,054

130,342

72,079 69,479

33,111

72,028

24645

20675

132569

74706

67742

31807

73,676

27,676

24,175

150,171

74,329

71,050

34,145

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

2008

2009

2010

Nu

mb

er

of

pre

scri

pti

on

s

Chronic pain patients•Chronic pain patients at risk for overdose or death, especially when taking opioid pain medication

•Help is available for accidental overdoses

•Naloxone kits recommended for these patients

Addiction help and rehabilitation•Smoky Mountain Center – provides help with substance abuse, mental health. Access line available 24 hours/7days for help

1-800-849-6127

•Meridian Health Services-- creates services environments and relationships which instill hope, facilitate choice, foster wellness, promote healing and support individuals on recovery.

828-631-3973

•Barium Springs– provides a safe home through group homes, therapeutic foster care, and other services through the Reclaiming Youth Program

828-586-8958

•Clean Slate Coalition– provides safe, accessible, affordable housing for women in transition.

828-586-3939

What can you do to help?

•Take Correctly

•Store Securely

•Dispose Properly

•Never Share

Remember to:

Take Correctly•Read warnings on the label.

•Check the list of ingredients for things you may be allergic to.

•Know the expiration date.

•Don't skip doses -- know how much to take and how long to take it for.

•Know which foods or beverages to avoid while taking any medicine.

•Ask your health provider about side effects, and report any you experience.

•Never share medicines.

•Organize the medicines in your home.

•Never take or give anyone medicine in the dark.

•Keep a written record of medications each person is taking, including prescription drugs, over-the-counter medicines, and herbal and other dietary supplements.

Store Securely• Seniors can be abused/exploited for their medications.

• Some are taking meds out of “your” cabinet for personal use or to sell.

• Lock boxes available through Project Lazarus.

• Make sure medications of any type are not in plain sight or reach of children.

Dispose Properly

DO NOT

Flush Down the Toilet

If you do throw away in the garbage………..

Mix prescription drugs with an undesirable substance, such as used coffee grounds or kitty litter, and put them in impermeable, non-descript containers,

such as empty cans or sealable bags.

If you can’t get to a permanent drop site:Attend Pill Take Back Events

Dispose Properly

Permanent Drop Box LocationsAvailable in Jackson County

Jackson County Sheriff’s Office

399 Grindstaff Road, Sylva

(828) 586-8901

Available 8 a.m. through 5 p.m.

Monday through Friday

Never ShareDon’t be tempted to share your prescription drugs

to cut costs for yourself or someone else.

This is how improper doses are taken, potentially resulting in an overdose or death.

There are programs available, such as SHIIP, to help seniors find low cost prescriptions.

SHIIP =Seniors’ Health Insurance Information Program

Works to counsel seniors with Medicare beneficiaries and caregivers about Medicare, Medicare supplements, Medicare Advantage, Medicare Part D,

and long-term care insurance.

Contact Diane Parker at 631-8037

Adverse Drug Reactions•Approximately 80 percent of adverse drug reaction hospitalizations due to incorrect dosing

•Make sure each doctor knows what medications you take

•Use one pharmacy

•Before leaving the doctor’s office or pharmacy, be sure you understand dosing instructions

Areas of need in Jackson County•Increase knowledge of and access to Naloxone• Medicaid and other insurance providers cover Naloxone

• Continue training law enforcement on need for Naloxone

• Promote the Good Samaritan Law

•Overdose prevention training

•Open communication between patients, families, friends, and providers on prescription drugs

•Establish more pain support groups

•Seek out alternative ways to manage pain

•Promote use of medication logs

Final WordsResponsible medication management can lead to a healthier, safer community.

◦ Take medications correctly

◦ Store medications securely

◦ Dispose of expired, unused medications properly

◦ Never share

Questions?

This presentation brought to you by Project Lazarus, a grant-funded program of the Jackson County Department of Public Health.

For more information or to participate in Project Lazarus, call the health department at 587-8288 or email jcprojectlazarus@gmail.com.

Visit our website at www.jacksoncountyprojectlazarus.wordpress.com.

Thank you for your time and attention.