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INDIANA HEALTH DEPARTMENT RECEIVES $519,117 FOR OVERDOSE PREVENTION WORK IN AT-RISK COUNTIES
The Indiana State Department of Health (ISDH) has received $519,117 from the Centers for Disease Control and Prevention (CDC) to expand overdose prevention outreach in Indiana counties with high overdose rates. The award was announced on International Overdose Awareness Day, which aims to raise awareness of overdose and reduce the stigma of drug-related deaths. The funding will be used to provide education and training in naloxone use for first responders and lay providers, as well as technical assistance to local coalitions and increasing awareness of opioid prescribing habits. It also will help enhance data reports for counties to inform local efforts to combat overdoses. The award runs through Aug. 31, 2017.
The counties served by the new funding are Clark, Crawford, Delaware, Grant, Jennings, LaPorte, Marion, Morgan, Pulaski, Sullivan, Tipton and Washington. Blackford, Starke, Montgomery, Lawrence, Howard and Vanderburgh counties had already been receiving assistance through another grant.
“I am pleased that ISDH has an opportunity to help our most vulnerable counties prevent overdoses that can take terrible tolls on families and communities,” said State Health Commissioner Jerome Adams, M.D., M.P.H. “By helping at-risk counties assess their data in real time and educating them about naloxone and the role prescribing plays in this epidemic, we can make real progress in the fight against opioid abuse.”
In 2014, the most recent year for which final data are available, 452 individuals in Indiana died of drug overdoses involving opioids, and 2,822 people visited emergency departments due to opioid overdoses. Preliminary death data for 2015 indicates that 595 individuals in Indiana died of drug overdoses involving opioids that year.
INDIANA RECEIVES FUNDING TO HELP PREVENT OPIOID OVERDOSE DEATHS
INDIANAPOLIS—The Indiana State Department of Health has received a grant from the Centers for Disease Control and Prevention (CDC) to help prevent overdose deaths related to prescription opioids as part of the CDC’s Prescription Drug Overdose: Prevention for States program.
“As we have seen here in Indiana, opioid overuse is a problem that many people struggle with,” said State Health Commissioner Jerome Adams, M.D., M.P.H. “This funding will help us gather data to inform strategies on how to prevent opioid overdoses.” Dr. Adams is also a member of the Governor’s Task Force on Drug Enforcement, Treatment and Prevention, which was created by Governor Mike Pence to combat drug abuse and addiction in Indiana.
The CDC’s National Center for Injury Prevention and Control has expanded its Prevention for States program to an additional 13 states this year to help turn the tide on the prescription drug overdose epidemic. Funding will support enhancements to INSPECT, the Indiana prescription drug monitoring program at the Indiana Professional Licensing Agency; improvements to opioid prescribing practices, prevention efforts at the state and community levels to address new and emerging problems related to prescription drug overdoses and a partnership with the IU Fairbanks School of Public Health to evaluate opioid prescribing practices in Indiana. The Indiana State Department of Health will use this funding to expand the Indiana Violent Death Reporting System. The expansion will provide additional data regarding opioid overdose at the county level and will help inform prevention efforts and expand use of data for public health surveillance.
The Prevention for States program is a part of CDC’s ongoing efforts to scale up prevention activities as part of a national response to the opioid overdose epidemic. Prevention for States provides resources and support to advance comprehensive state-level interventions for preventing prescription drug overuse, misuse, abuse and overdose. For more information about Prescription Drug Overdose: Prevention for States, visit http://www.cdc.gov/drugoverdose/states/state_prevention.html.
Indiana State Department of Health Launches Website Showing Locations Where Life-Saving Naloxone Can Be Obtained
State health officials unveiled a new online registry that will connect those on the front lines of the battle against addiction with entities that can dispense a life-saving antidote for opioid overdoses.The Overdose Prevention Therapy-Indiana, or optIN, registry allows nonprofits, pharmacies, local health departments, addiction treatment facilities, correctional facilities and other entities to register as providers of naloxone, a non-narcotic medication that reverses life-threatening respiratory failure that is usually the cause of overdose deaths. Entities must obtain a prescription, or standing order, from a prescriber allowing them to distribute naloxone, provide training in the use of naloxone, instruct those who administer it to call 911 and provide a list of options for substance abuse treatment. Registered entities will also report the number of doses distributed to the state annually. The registry can be accessed at https://optin.in.gov/.
The registry was created to support entities that register to dispense naloxone to families or friends of someone at risk of opioid overdose. Aaron's Law, which Governor Mike Pence signed in April in honor of Aaron Sims of Indianapolis, allows healthcare providers to provide a standing order for naloxone to registered entities so they can dispense it to Hoosiers without a prescription. Aaron died of a heroin overdose in 2013 at age 20. According to the Centers for Disease Control and Prevention (CDC), drug overdoses are the leading cause of injury-related death for Americans ages 25 to 64. Indiana ranked 16th nationally for drug overdose deaths in 2013.
Naloxone is a Food and Drug Administration-approved medication and has been used for more than 40 years by emergency medical services personnel to reverse opioid overdose and revive people who might have died without treatment. It is not addictive, and although it is only effective at reversing overdoses of opioid drugs like heroin or prescription painkillers, it is not harmful if administered to someone who has not taken opioids. In March 2014, Indiana lawmakers granted immunity for first responders to use naloxone. Governor Pence has directed state agencies to raise the awareness of Aaron’s Law, which puts this life-saving tool in the hands of friends, family members and others closest to people at risk of an overdose.
What ICD-9-CM codes are used to identify inpatient & outpatient cases with drug overdose?
Inpatient and outpatient data are coded using ICD-9-CM. Poisoning by drugs, medicinal and biological substances is coded with ICD-9-CM diagnostic codes 960-979. Poisoning by analgesics, antipyretics, and antirheumatics is 965, with opiates and related narcotics as 965.0. For the subset of opiates and related narcotics, heroin code is 965.01 and methadone code is 965.02. Poisoning by sedatives and hypnotics is 967.
It is important to look at the data notes on prepared reports to ensure accurate comparisons across different sources. It is important to consult an ICD-9-CM coding book or website to identify codes for desired codes.
What ICD-10 codes are used to identify drug overdose deaths?
Drug overdose deaths are typically first identified through underlying cause of death coded on death certificate as drug overdose fatality or “acute drug overdose” (ICD-10 codes: X40-X44.9, X60-X64, X85, Y10-Y14.9). Then, drug-specific overdose deaths were identified through 10 contributory cause of death fields based on the appropriate ICD-10 codes. For instance, for specific-drug related deaths, heroin ICD-10 code is T40.1; opioid pain reliever codes are T40.2, T40.3, and T40.4; benzodiazepine code is T42.8; and cocaine code is T40.5.
It is important to look at the data notes on prepared reports to ensure accurate comparisons across different sources. It is important to consult an ICD-10 coding book or website to identify codes for desired codes. These recommendations are based on the guidelines from: Gabella BA, Proescholdbell SK, Hume B, et. al. State Special Emphasis Report: Instructions Drug Overdose Data. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2014.
Overdose: When a drug is swallowed, inhaled, injected, or absorbed through the skin in excessive amounts and injures the body. Overdoses are either intentional or unintentional. If the person taking or giving a substance did not mean to hurt themselves or others, then it is unintentional.
Misuse: The use of prescription drugs in a manner other than as directed.
Abuse: Continued use of illicit or prescription drugs despite problems from drug use with relationships, work, school, health, or safety. People with substance abuse often experience loss of control and take drugs in larger amounts or for longer than they intended.
Diversion: The use of prescription drugs for recreational consumption, such as diverting them from their original medical purpose.
Naloxone (also known as Narcan): A prescription drug that can reverse an opioid or heroin overdose if administered in time.
Poisoning: Injury or death due to the ingestion, inhalation, absorption through the skin, or injection of a drug, toxin, or other chemical such as gases and corrosives. Examples of poisonings include harmful effects resulting from exposure to alcohol, disinfectants, cleansers, paints, insecticides, and caustics.
Prescription Drug Monitoring Programs (PDMPs): State-run electronic databases used to track the prescribing and dispensing of controlled prescription drugs to patients.
Opioid: Derived from the opium poppy (or synthetic versions of it) and used for pain relief. Examples include hydrocodone (Vicodin®), oxycodone (OxyCotin®, Fentora®), methadone, and codeine.
Benzodiazepine: Central nervous system depressants used as sedatives, to induce sleep, prevent seizures, and relieve anxiety.
CDC: Centers for Disease Control and Prevention
DMHA: Division of Mental Health and Addiction
ED: Emergency Department
EMS: Emergency Medical Services
ICD-9- CM: International Classification of Disease- Ninth Revision – Clinical Modification
ICD-10: International Classification of Diseases – Tenth Revision
NAS: Neonatal Abstinence Syndrome
PDO: Prescription Drug Overdose
SAMHSA: Substance Abuse and Mental Health Services Administration
If you are interested in identifiable data, you must fill out both the ISDH Division of Trauma and Injury Prevention division data request form and the agency data request form.
If you are interested in de-identified, statewide data, fill out the division data request form and return it to the ISDH Division of Trauma and Injury Prevention. Please allow at least 3 business days for the request to be processed.
If you are interested in patient level data or variables that could lead to individual identification, it will need administrative approval. Please submit to the Division of Trauma and Injury Prevention:
All completed forms can be emailed to firstname.lastname@example.orgIndiana