County Report Addresses Prescription Drug Misuse

Poughkeepsie…Dutchess County Executive Marcus J. Molinaro has announced the Dutchess County Health & Human Services Cabinet has issued a special report “Confronting Prescription Drug Abuse in Dutchess County, New York: Existing and Proposed Strategies to Address the Public Health Crisis.” The report addresses the growing public health crisis of prescription drug use, misuse and abuse in Dutchess County, with more overdose hospitalizations and deaths than ever before being reported. Dutchess County has the highest number of admissions of 18-34 year olds to certified rehabilitation programs in the Mid-Hudson region. In 2012, there were 50 deaths as a result of accidental overdoses, with nearly 60% (33) involving prescription drugs. Year to date for 2013, 31 of 63 overdose deaths in Dutchess County have involved prescription drugs.

Adding to the concern about prescription drug use and abuse is the connection between prescription pain relievers and heroin use. The Substance Abuse and Mental Health Services Administration’s report “Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States” found that those who used prescription pain relievers medically, ages 12-49 were 19 times more likely to initiate heroin use. Heroin use is a rapidly escalating problem in Dutchess County, with the Dutchess County Drug Task Force reporting more than 30 non fatal heroin overdoses during the past month and the Medical Examiner’s office reporting 5 heroin deaths in the last two weeks.

County Executive Molinaro said, “This is a significant public health crisis that is not getting enough attention in the media or awareness in the community. Dutchess County Government is engaged in numerous efforts to combat the issue of prescription drug abuse and I am grateful to the work of our Health & Human Service Cabinet, under the leadership of Mary Kaye Dolan, for their recommendation on how to best coordinate a unified plan to comprehensively address this growing issue.”

Dutchess County Acting Commissioner of Health Dr. Kari Reiber, “Prescription drug abuse and the parallel problem of heroin use is a crisis situation for our region. People are dying from overdoses, and the problem far too often begins right in a home’s medicine cabinet with easy access to highly addictive pain medications and doctors who over prescribe. It is critical that people be aware of this problem, be watchful for signs of addiction and take steps to protect their families from the potential tragedy of an accidental overdose.”

The report identified key factors likely driving the increase in prescription drug abuse including:

• Widespread availability: overprescribing results in more availability and easy access in home medicine cabinets.
• Overprescribing: prescriptions for opioid analgesics increased by more than 175% from 1991 to 2010 nationwide.
• Misperceptions about the safety of these drugs: many assume these drugs are safe because they are prescribed by a doctor.
• Addictive potential: these drugs are highly addictive and can lead to illegal drug use such as heroin, which is cheaper.
• Inadequate prescription drug monitoring: addicted individuals often have several health care providers who do not communicate with each other, and fill their prescriptions at different pharmacies that do not have a common database.

The report outlines the current initiatives already underway in several county departments and in conjunction with community agencies to combat the growing problem of prescription drug abuse. The report also provides recommendations for greater coordination and enhancement of Dutchess County Government’s efforts to combat prescription drug abuse and provides a proposed work plan to move the recommendations forward.

Dutchess County Health & Human Services Cabinet Director Mary Kaye Dolan stated, “There is a great deal of work being done to address the issue of prescription drug abuse by various county departments and partner agencies. Our focus is bringing all of the players to the same table to identify what is being done and where gaps may be in our existing efforts so that we can best address them.”

The Dutchess County Health & Human Services Cabinet, which includes representation from the Departments of Health, Mental Hygiene, Community and Family Services, Planning & Development (including STOP-DWI), the Office for the Aging, Probation and Community Corrections, and Division of Veterans Services, outlined a draft work plan for key county and community stakeholders designed to enhance communications, coordinated activities, focus efforts with collective strategy for a cohesive, comprehensive response. Objectives outlined in the work plan include:

Improve physician prescribing practices and promote clinical guidelines;Raise greater awareness through public education campaign;Enhance data monitoring and sharing;Promote the disposal of excess opioids and other prescriptions drugs;Ensure access to and use of effective treatment for opioid dependence;Assess and advocate, if necessary, for change in public policy relating to opioids; and

Better partnering with law enforcement and other stakeholders.

Many of the current county efforts already focus on these objectives, such as the Dutchess County STOP-DWI program’s prescription medication disposal drop boxes available throughout the county. These drop boxes, in combination with the Resource Recovery Agency’s Safe Medication Disposal events, have collected well over 1,000 lbs of unwanted prescription medications year to date. Locations are available here

Last month, the Dutchess County Department of Health partnered with Hudson River HealthCare to host a special event for area physicians, pharmacists and dentists about New York State’s new I-STOP law which requires a patient’s complete controlled history be available to prescribers and pharmacists and requires real time input by pharmacists of all prescriptions at the time they are dispensed and requires prescribers to check the database before prescribing. Nearly 60 providers participated in the event to better understand their role in addressing prescription drug abuse and misuse. Planning is underway for another event in 2014.

The Dutchess County Department of Mental Hygiene (DCDMH) has been focusing on stronger prevention and intervention efforts to address prescription drug abuse through Local Governmental Plan for Mental Health, Chemical Dependency and Developmental Disabilities. DCDMH partners with the Council on Addiction Prevention and Education (CAPE) to provide a prevention effort addressing this growing problem of drug abuse. Among the initiatives are ongoing surveys for youth in grades 8, 10 and 12 to measure the risk and protection factors as perceived by young people about drug abuse. The surveys are currently underway in nine school districts throughout the county and are expected to be completed early in 2014 with results available later in the second quarter. CAPE has facilitated several community forums on the issue including a recent event in Wappinger Falls in late October at John Jay High School attended by over 100 people.

Dutchess County Department of Mental Hygiene Commissioner Dr. Kenneth Glatt said, “In 2014, Mental Hygiene will be implementing a broad-based, countywide prevention initiative aimed at those at risk for developing mental health and/or substance abuse disorder. Among our goals is to increase the community’s understanding of chemical dependency as a mental health issue and ensure people know about the resources we have available to help them, and expand on them to increase prevention and treatment options.”

The prevention initiative will be funded with $350,000 from the New York State Office of Mental Health, secured by New York State Senator Greg Ball. As part of the prevention initiative, DCDMH will begin “Mental Health First Aid” training for people throughout the community to learn how to help individuals who may be experiencing a mental health problem or crisis. A nationally recognized model, Mental Health First Aid training includes: risk factors and warning signs of mental health problems, information on depression, anxiety, trauma, psychosis, and addiction disorders; a 5-step action plan to help someone developing a mental health problem or in crisis and identifies where people can turn for help — local professional, peer, and self-help resources. Additionally, DCDMH will be introducing “Texting for Teens” – an alternative way to contact Dutchess County’s 24/7 HELPLINE, since teens often prefer to text rather than talk on the phone.

Legislature Assistant Majority Leader Angela Flesland said, “This report is an important step in addressing the critical issue of prescription drug abuse and corresponding heroin use, but there is a great deal more work to be done. I am grateful to the Health & Human Services Cabinet for their work on this draft work plan and am eager to work with County Executive Molinaro and the various departments to see it implemented as quickly as possible.”

The full Confronting Prescription Drug Abuse in Dutchess County, New York: Existing and Proposed Strategies to Address the Public Health Crisis” report can be found on the County’s website.

See an Overdose? Call 911 Immediately! Important information from the Dutchess County Department of Health about how the New York State 911 Good Samaritan Law protects those who help: