Despite last year’s high water mark for opioid overdoses, data from the Pennsylvania Department of Health presented at a quarterly meeting Tuesday show that the state’s effort to reduce risky and high-dose prescription rates is working.
Members of the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP) board met virtually, which brought together staff from Gov. Tom Wolf’s administration and state health officials.
The ABC-MAP oversees multiple programs aimed at combatting opioid misuse in Pennsylvania, including an electronic database that allows healthcare providers to monitor their patients’ prescription history.
Ashley Bolton, director of the Office of Drug Surveillance and Misuse Prevention, said that in particular, the program’s Prescriber Education Initiative, which is offered to healthcare providers, was reducing the morphine milligram equivalents (MME) — the potency of the opioid dose — being prescribed.
“We’re finding that particularly among those that were prescribing greater than 50MME before the training, that they are having reductions after the training, which is very promising,” Ms. Bolton said during the meeting.
Ms. Bolton said the initiative also cut down on risky prescribing, which is seen when patients have an overlap in both opioid and benzodiazepine prescriptions.
The Prescriber Education Initiative has so far trained 13,536 individuals through in-person and virtual sessions, and 26,778 courses have been completed. Since the board’s last meeting in July, the initiative has trained a further 764 prescribers.
Ms. Bolton added that following academic sessions, the department has seen a decrease in the number of days that patients had overlapping prescriptions. Since the beginning of 2019, the percent of individuals with over 30 days overlap in their prescriptions has fallen close to 10%. Since the program began in 2016, that number has fallen 57%.
Other educational initiatives include opioid-related education for police, first responders, and correctional facility staff.
Ms. Bolton said that this September, the department saw its highest month of distribution of naloxone, a drug used to reverse opioid overdoses, to first responders.
The department announced two naloxone pilot programs, both alongside St. Joseph’s University in Philadelphia. One will train both the Department of Corrections and staff at multiple state correctional institutions, as well as state parole, alcohol, and drug agents. A second program will engage academy instructors within the state police.
The updates come as rates of opioid-related emergency department visits in Pennsylvania slowly return to levels slightly lower than what was seen pre-pandemic. When the pandemic hit, these hospital visits shot up to a little over 30% of every 10,000 visits, and remained high throughout the rest of 2020.
This fall, the rate has fallen back to 18.4%, the lowest it’s been since 2016.
According to Dr. Carrie Thomas Goetz, an epidemiologist with the Prescription Drug Monitoring Program Office, it is yet to be revealed whether overdose deaths have decreased as well — during the meeting, she said that there’s potentially been an increase in at-home overdose deaths that aren’t recorded by a hospital.
Among other trends, Dr. Goetz shared that the department has observed an increase in overdoses among people of color. In 2020, Pennsylvania’s Black population saw a 20% increase in overdose death rates compared to 2019, and a 64% increase compared to 2018.
Hispanics saw a 13% increase in 2020 from 2019, and a 23% increase compared to 2018. Other non-white races combined saw a 17% increase in overdoses in 2020.
Jared Shinabery, deputy secretary of Health Resources and Services, said the figures show the need to focus on minority and underserved populations. “Especially now that we’re really seeing the data shift in this direction.”
First Published: October 26, 2021, 9:46 p.m.
