Opioid

Opioid ODs have been rising globally and nationally. The death rate from ODs in the United States has increased 137% since 2000, including a 200% increase of OD deaths involving opioids1. The pilot project, a collaboration across 3 states, allowed information sharing with Syndromic surveillance (SyS) partners across jurisdictions, such as sharing a standard SyS case definition and verifying its applicability in each jurisdiction. This is a continuation of the work from an initial pilot project presented during the ISDS Opioid OD Webinar series.

Objective:

The objective is to develop a standard opioid overdose case definition that could be generalized nationally

Philadelphia is in the midst of a drug epidemic that killed 702 Philadelphians in 2015, 907 in 2016, and is on trajectory to kill 1,200 in 2017. Opioids are involved in the majority of fatal overdoses, contributing to 80% of overdose deaths in 2016. In 2016, the age-adjusted death rate for opioid-involved overdoses was 40.4 deaths per 100,000 residents, up from 17.9 deaths per 100,000 residents in 2010. Despite the epidemiologic work accomplished to date, gaps in knowledge still exist, especially for vulnerable populations such as those with serious mental illness or those who were ever incarcerated, homeless, or within the juvenile justice system. Matching individuals who died of an overdose across city systems could provide insight into missed opportunities for interventions. Findings will help inform policy for those systems that serve clients at highest risk for overdose.

Objective:

To match fatal overdose information across city data sources to understand which systems overdose decedents may have interacted with prior to their death

At the Governor’s Opioid Addiction Crisis Datathon in September 2017, a team of Booz Allen data scientists participated in a two-day hackathon to develop a prototype surveillance system for business users to locate areas of high risk across multiple indicators in the State of Virginia. We addressed 1) how different geographic regions experience the opioid overdose epidemic differently by clustering similar counties by socieconomic indicators, and 2) facilitating better data sharing between health care providers and law enforcement. We believe this inexpensive, open source, surveillance approach could be applied for states across the nation, particularly those with high rates of death due to drug overdoses and those with significant increases in death.

Objective:

A team of data scientists from Booz Allen competed in an opioid hackathon and developed a prototype opioid surveillance system using data science methods. This presentation intends to 1) describe the positives and negatives of our data science approach, 2) demo the prototype applications built, and 3) discuss next steps for local implementation of a similar capability.

Neonatal Abstinence Syndrome (NAS) rates have tripled for Missouri residents in the past three years. NAS is a condition infants suffer soon after birth due to withdrawal after becoming opioid-dependent in the womb. NAS has significant immediate health concerns and can have long term effects on child development and quality of life. The Missouri Department of Health and Senior Services (MODHSS) maintains the Patient Abstract System (PAS), a database of inpatient, emergency room, and outpatient records collected from non-federal hospitals and ambulatory surgical centers throughout the state. PAS records contain extensive information about the visit, patient, and diagnosis. When examining 2015 annual PAS data for NAS-associated discharges, Missouri analysts noticed a greater than 50% increase in discharges, even larger than anticipated in light of the opioid epidemic. Provisional 2016 data produced similar high rates, dispelling the notion that the trend was a transitional problem. In fact, provisional 2016 rates are 115% higher than NAS rates in 2015. In contrast, percentage change of opioid misuse emergency department visits (as defined by MODHSS) for Missouri women age 18-44 was +13% in 2015 and -12% in 2016.

Objective:

In this analysis we examine Missouri NAS discharge rates with special focus on the ICD-9-CM/ICD-10-CM transition and changes in code descriptions.

Like many other states in the U.S., Missouri has experienced large increases in opioid abuse resulting in hundreds dying each year and thousands of ED visits due to overdose. Missouri has two major urban areas, St. Louis and Kansas City and a few smaller cities, while the remainder of the state is more rural in nature. The opioid epidemic has impacted all areas in the state but the magnitude of that impact varies as well as the type of opioid used. Missouri Department of Health and Senior Services (MODHSS) maintains the Patient Abstract System (PAS) which contains data from hospitals and ambulatory surgical centers throughout the state. PAS includes data from ED visits including information on diagnoses, patient demographics, and other information about the visit. MODHSS also participates in the Enhanced State Surveillance of Opioid-involved Morbidity and Mortality project (ESOOS). One major aspect of this surveillance project is the collection of data on non-fatal opioid overdoses from ED visits. Through this collection of data, MODHSS analyzed opioid overdose visits throughout the state, how rates compare across urban and rural areas, and how those rates have changed over time.

Objective:

Compare rate changes over time for Emergency Department (ED) visits due to opioid overdose in urban versus rural areas of the state of Missouri.

Opioid overdoses are a growing cause of mortality in the United States. Medical prescriptions for opioids are a risk factor for overdose. This observation raises concerns that patients may seek multiple opioid prescriptions, possibly increasing their overdose risk. One route for obtaining those prescriptions is visiting the emergency department (ED) for pain-related complaints. Here, two hypotheses related to prescription seeking and overdoses are tested. (1) Overdose patients have a larger number of prior ED visits than matched controls. (2) Overdose patients have distinct patterns of pain-related complaints compared to matched controls.

Objective:

Identifying text features of emergency department visits associated with risk of future drug overdose.

Nationally and in Wisconsin, heroin is the leading cause of opioid related death and hospitalization. Opioids are commonly prescribed for pain. Every day, over 1,000 people are treated in emergency departments for misusing prescription opioids. In 2015, more than 15,000 people died from overdoses involving prescription opioids. Approximately, three out of four heroin users report having abused prescription opioids prior to using heroin. In Wisconsin from 2010 to 2014 the number of deaths involving any opioid increased by 51% and for heroin increased by 192%. Through the federal government funding and support Wisconsin has established a statewide tool to help combat the ongoing prescription drug abuse epidemic by providing valuable information about controlled substance prescriptions that are dispensed in the state. PDMP is continue to be among the most promising state-level interventions to improve opioid prescribing, inform clinical practice, and protect patients at risk.

Objective:

Using the Wisconsin Enhanced Opioid Surveillance System, the present study evaluates the heroin hospitalization risk among the opioid recipients using the Prescription Drug Monitoring Data (PDMP) with following specific objectives: 1. Evaluate the risk of heroin overdose hospitalization following the prescription of opioid. 2. Assess the time elapsed between last prescribed opioid and first heroin overdose hospitalization. 3. Identify the main predictors of heroin overdose hospitalization among prescribed opioid users.

Nearly 100 people per day die from opioid overdose in the United States. Further, prescription opioid abuse is assumed to be responsible for a 15-year increase in opioid overdose deaths. However, with increasing use of social media comes increasing opportunity to seek and share information. For instance, 80% of Internet users obtain health information online, including popular social interaction sites like Reddit (http://www.reddit.com), which had more than 82.5 billion page views in 20153. In Reddit, members often share information, and include URLs to supplement the information. Understanding the frequency of URL sharing and types of shared URLs can improve our knowledge of information seeking/sharing behaviors as well as domains of shared information on social media. Such knowledge has the potential to provide opportunities to improve public health surveillance practice. We use Reddit to track opioid related discussions and then investigate types of shared URLs among Reddit members in those discussions.

Objective:

We aim to understand (1) the frequency of URL sharing and (2) types of shared URLs among opioid related discussions that take place in the social media platform called Reddit.

Since 2008, drug overdose deaths exceeded the number of motor vehicle traffic-related deaths in Indiana and the gap continues to widen1. As the opioid crisis rages on in the United States the federal government is providing funding opportunities to states, but it often takes years for best practices to be developed, shared, and published. Indiana State Department of Health (ISDH) has developed a standard process for monitoring and alerting local health partners of increases in drug overdoses captured in Indiana’s syndromic surveillance system (ESSENCE). ISDH is launching a pilot project to encourage local partners to start a conversation about overdose response capabilities and planning efforts in their community. Other states have published articles about drug overdose syndromic surveillance (SyS) data being used to inform local public health action, however, the local overdose response activity details were vague 2,3. With the opioid crisis continuing to spiral out of control in the United States, it is imperative to work together as local, state, and national partners to find potential solutions to this crisis.

Objective:

The overall objective of this session is to discuss opportunities to use drug overdose syndromic surveillance (SyS) data to encourage action among local public health partners. After this roundtable discussion, participants will be able to:

• Identify opportunities to promote use of drug overdose SyS data to their health partners.
• Plan for potential drug overdose public health interventions.
• Develop relationships with roundtable attendees to continue the conversation and sharing of ideas about use of drug overdose SyS data.