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2018 Public Health Dashboards May 13, 2018 Executive Summary 2 | Page 2018 Public Health Dashboards: Executive Summary The following pages include a summary of the key take‐away findings from this year’s public health dashboards. There are 6 completed dashboards, available as separate documents. For additional FAQs on dashboard development, please also reference our Dashboard Companion Document. Substance Abuse and Mental Health Orange County saw significant increases in both Drug Overdose and Opioid Overdose mortality rates in 2016. However, it is important to remember that as a county with a small population, sizable fluctuation in rates from year to year is not unusual. It appears on several measures (alcohol, marijuana, and smoking cigarettes or e‐cigarettes), High School substance use decreased from 2015 to 2017 (CHCCS). Additionally, fewer students reported that they believed vaping is low in harm. However, more Orange County students report current marijuana use than NC or the US. Depression continues to be a common condition that close to 1 in 5 residents face, young and old. Opioid Use and Overdose The drug overdose mortality rate in Orange County has increased from 5.7 deaths per 100,000 residents in 2014 to 12.6 deaths per 100,000 residents in 2016. The rate of opioid overdose mortality has also risen from 3.6 deaths per 100,000 in 2014 to 6.3 deaths per 100,000 in 2016. The number of providers registered in the NC Controlled Substance Reporting System has risen in the past 5 years and estimated percent of providers using the system is comparable to peer counties. However, opioid medications are not the only drugs showing an elevated appearance as a cause of death in the last several years. Other synthetic narcotics, cocaine, and heroin also saw increases as contributors to overdose mortality in 2016. Orange County saw more than 400 ED visits related to Medication/Drug poisoning in 2017. More than a quarter of these were related to either opioids, heroin, or benzodiazepines (25.4%). Opioid and Other Drug Prescribing 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 average 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. Response to the Opioid Epidemic 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 include:  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.