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2018 Population Health Dashboards Orange County, NC 3- SUMH18 Opioid and Other Drug Prescribing Sources: SCHS Mortality statistics (2015-16) and records (2012-2016), CSRS via NC DHHS (2015-16), CDC (2016) Data Considerations: The number and strength of prescriptions are correlated with age of patient and reason for prescription. Orange County has a younger population and also has a well-recognized hospital center that performs major procedures and may attract residents with chronic health conditions. Both of these factors may impact these measures. Unlike Opioid conditions, which increase with age, anxiety is most prevalent in people aged 30-44, so a larger population in this age group may affect this (although nationally they did not see Rx trends reflect along age trends they would expect, actually seeing increase in Rx with age). • Coordinating the state’s infrastructure to tackle the opioid crisis. • Reducing the oversupply of prescription opioids. • Reducing the diversion of prescription drugs and the flow of illicit drugs. • Increasing community awareness and prevention. • Making naloxone widely available. • Expanding treatment and recovery systems of care. • Measuring the effectiveness of these strategies based on results. Drug Prescribing Rates (2015-2016) Icon Current Proposed OC Target Previous Progress Peer NC US 2020 Target Number of Opioid Prescriptions per 100 Residents 52 NA 53 SAME 92 93 NA NA Strength of Average Opioid Prescription (MME)-54 NA 54 SAME 52 NA NA NA Number of Benzodiazepine Prescriptions per 100 Residents 30 NA 31 SAME 48 42 NA NA Number of Stimulant Prescriptions per 100 Residents 31 NA 30 SAME 26 27 NA NA Progress Orange County Trend Compare to In response to the Opioid epidemic, representatives of North Carolina and public health professionals from the injury and violence prevention branch and broader health community put together the North Carolina Opioid Action Plan. This plan, initiated in 2017, will run through 2021 and focuses on prevention, treatment, and recovery efforts to reduce mortality and morbidity related to drug use and overdose. As stated on the DHHS website, strategies of the plan are listed below, along with updated statistics on drug overdose reversals recorded in Orange County from 2013-2017. Responding to the Opioid Epidemic bB Significant change from previous that is positive, negative, or indeterminable (grey) No trend Trend cannot be assessed Performing better than Previous, Peer, NC, and US Performing better than two or three benchmarks Performing better than one or no benchmarks (Target value adds additional benchmark, if present) ↑↓Positive trend ↑↓Negative trend ↑↓Neutral trend 2015 Population Health Dashboards Disparity Present Negligible Disparity Performing better than four or more benchmarks Performing better than two or three benchmarks Performing better than one or no benchmarks Benchmarks include Previous, Peer, NC, US, and 2020 Target OC Targets represent proposed local goals Summary: Orange County is ranked #1 (best) in the state when it comes to the number of Opioid prescriptions (.52) or pills prescribed per resident (34.5) in 2016, which represents an average. This puts Orange County on par with the lowest quartile state averages in the US in 2014 (.52-.71). Regional neighbors are prescribing at similar rates, while we are doing slightly better than western peers (Buncombe), and much better than coastal ones (Brunswick). However, Orange County is ranked 75th on strength of Opioid prescription (54.2) per resident. This measure uses algorithms to translate all prescriptions to a single measure of MME (morphine milligram equivalents). The risk for overdose is directly associated with the use of multiple prescribers and daily dosages of >100 morphine milligram equivalents (MMEs) per day (CDC). For Benzodiazepines, Orange County is ranked 10th at .3 Rx/resident and 15.3 pills /resident. Unlike Opioid use, which increases with age, anxiety is most prevalent in people aged 30-44, so a larger population in this age group may affect this measure (although national Rx trends do not reflect along the age trends one would expect, actually seeing an increase in benzodiazepine Rx with age). Opioid and benzodiazepine prescribing rates have been stable over the past 6 years in Orange County. However, the stimulant prescribing rate has increased from 24 prescriptions per 100 residents to 30, placing Orange County 96th out of 100 counties.