Prescriber Licensing Discussion

Don asked us to post this string of comments he, Dr. Stephen Nelson, Rep. Daw, Rachel, and Kye had regarding prescriber licensing. I posted them as one large comment. Click on "comments" link to see the entire sequence of email comments.

SMART Management.

Comment on SMART's 2010 Budget Allotment

SMART members,Starting on October 1st we have a new allotment of $203,000 to fund our efforts until Sept. 2010. If you'd like to review and comment on SMART's budget, review the attachment - SMART's Board will approve all spending over $1,000. Please let me know if you agree/disagree with the way the budget is allotted by commenting on our blog or emailing me. Blog: http://smartutahcounty.blogspot.com/.

Budget Highlights

• 30% ($56,000)of our budget includes variable costs - meaning we can move the money around to fund whatever the coalition believes important (of course, evidence based).
  
• 70% ($144,250) of our budget includes fixed costs - meaning the costs cannot be changed. This includes salary for paid staff, rent, administrative expenses, etc.

You can view the budget details on the website at: http://sites.google.com/site/utahcountycoalition/budget

Thanks,

SMART Management

Report from Coalition Members Attending CADCA

Seven SMART coalition members (Greg, Leslie, Casey, Suzy, Taunia, Kye and Becky) attended the national Community Anti-Drug Coalitions of America (CADCA) conference in Kentucky, July 26th to the 31st. SMART members approved the funding of the trip with the stipulation that each attendee write a short report that focused on at least the following:

1. A short list of valuable information learned at the conference
   
2. Identify 1 to 3 ideas, from the list, that you'd like to help implement into coalition activities

Enjoy the reports.

SMART Management Team

Prescription Task Force Narrowing our Focus

During July coalition meeting we narrowed our focus down to the following general areas:

(1) Doctor Education (Addressing Provider Lack of Knowledge):

• Contracting with Health Insight to educate physicians directly
• Revising DOPL narcotic licensing test.

(2) Reduce Availability:

• Revising DOPL to allow better communication between law enforcement, and the health community
• Require doctors to run a DOPL report on all first time patients obtaining narcotics

(3) Community Norms:

• Create an education campaign like Clean out the Cabinet to change norms around prescription abuse and disposal

Do you agree with these recommendations? What would you add/remove? Add your comments to the blog. Please consider our one page fact sheets and recommendations at: http://sites.google.com/site/utahcountycoalition/data---what-we-know-1.

CRITERIA - this is hard to narrow down good ideas to a few our coalition can tackle. As you offer your suggestions consider the following (to obtain funding, each idea must pass this criteria test):

1. Is the strategy supported by the data we collect?
2. Is the strategy evidenced based? How do we know the strategy will reduce prescription abuse?
3. Is the strategy realistic considering the financial and human resources available to the coalition?
4. Does the strategy already exist or are other groups working to implement the strategy?

Thanks for your input!
SMART Management Team

It's Time to Brainstorm Solutions!

For the past year we have studied who, where, and why Utah County residents abuse prescription drugs and drive drunk (to view summary of data collected see: http://sites.google.com/site/utahcountycoalition/data-collection-workgroup).

Here is how you add your ideas - How do you think we could prevent future prescription and alcohol abuse in Utah County? Here are some options:

1. Post your ideas on this blog (please indicate if your idea is for prescription or alcohol)


2. Email Kye your ideas at mailto:mKyeN.UCADM@state.ut.us


3. We have already started a list of ideas on our website and will add your ideas to that list (to view ideas see: http://sites.google.com/site/utahcountycoalition/Home/strategies. I strongly encourage you to view this page.

The coalition will, in the next few months, invest coalition money in the ideas best calculated to reduce substance abuse. This is your community, money will be invested here, be part of the conversation.

Thanks for your input!

SMART Management Team

A little comic relief :)

New Prescribing Guidelines - How can we use them?

The Utah Department of Health released new guidelines Thursday designed to help reduce prescription drug deaths (according to a Deseret News Article)

Some of the key recommendations for medical providers include:

1. Give alternatives to opioids before prescribing them; start with something less potent first, particularly for acute pain.


2. Screen for risk of abuse or addiction before initiating prescription opioids


3. Use methadone rarely, if ever, to treat acute pain. Also, it should only be prescribed by those who know the risks and are prepared to carefully monitor patients who take it.

See article: http://www.deseretnews.com/article/705293368/New-rules-aim-to-stem-overdoses.html?pg=1

We have been conducting 12 different focus groups with community members. In each focus group members consistently said doctors (dentists and medical doctors) were contributing to the prescription drug abuse problems in Utah County by making these drugs easy to obtain and prescribing too many at one time.

Question for Coalition Memebers

• How can we utilize these guidelines to help reduce deaths in Utah County?
• How can we utilize the guidelines to educate the medical community?
• How can we utilize the guidelines to educate the public?
• Ofter any other general feelings about how these guidelines will curb overdose deaths.

NOTE: I (Kye) recently met with our partners in the North IHC Council, chaired by Mayor Heber Thompson. One of the IHC employees said he would give representatives of our coalition time on their monthly staff meeting - about 100 Utah County physicians come to those meetings.

Pharmacies need a Drug Take Back Program - Tell the DEA

The Drug Enforcement Administration (DEA) is seeking citizen feedback on making prescription drug disposal easier for consumers. Current federal law prohibits pharmacies from taking back prescription pain relievers. Federal law only allows law enforcement agencies (registered with DEA) to take back these drugs.

Research shows that individuals integrate health behaviors that are easy to implement with limited barriers. Currently the barriers surrounding the proper disposal of controlled drugs dispensed through a prescription are so significant that citizens are either (1) not disposing these harmful drugs – making them more available to abusers, or (2) citizens are disposing of the drugs irresponsibly in the toilet or in our landfills. The most environmentally friendly disposal method is incineration (method used by law enforcement and pharmacies).

SMART will be submitting the following recommendation to the DEA: "The DEA should, Rewrite DEA rules allowing pharmacies and hospitals to accept unused, outdated prescription pain relievers, thus reducing the significant barriers facing Utah County citizens to properly dispose of their prescription drugs."

AFTER THE DEA ALLOWS PHARMACIES TO TAKE BACK - THEN WHAT?
We need pharmacies and hospitals to support our effort of proper disposal. The Oregon legislature is currently considering a bill would require drug manufacturers to establish pharmaceutical take-back programs (for article see: http://news.opb.org/article/4479-bill-proposes-take-back-program-unused-consumer-drugs/.

SMART Utah County needs to follow Oregon's lead by working with legislators and pharmaceutical companies to reduce the availability of prescription drugs to abusers. We need representatives of these organizations working with us to reduce drug abuse. Do you agree?

Should we invest prevention dollars in central OR south county OR both?

Background - we need to solidify our target location. We've narrowed it down to central county (Provo, Orem area), OR south county (Springville City south) OR both. We have limited funds, (between $20,000 to $30,000) to invest in prevention messages by October 2009.

The Question You Need to Address on our Blog - Please read the section below and answer/comment on the following. Should we invest coalition moneys in comprehensive prevention messages in central, south utah county, or both?

If you look at percapita rates, south county is most impacted by drug use. If you look at overall numbers, central county is most impacted by drug use.

What we know about our target population - per the data we've collected (for data see: http://sites.google.com/site/utahcountycoalition/data-collection-workgroup) we have learned the following:

PRESCRIPTION NARCOTIC: we have identified Payson, Springville, Santaquin, Spanish Fork, Salem, Mapleton, and Provo as potential areas to target. Here’s why:

• Santaquin, Payson, Springville, Spanish Fork, and Salem (south county) –Southern county cities consistently rank high across all consequence data. These cities have the highest (all based on per capita) ER visits, treatment admissions, Medical Examiner death data, and shipments of prescription narcotics into their communities. Additionally, youth in Nebo School district use prescription narcotics at slightly higher rates than the other two districts.
  In short, prescription narcotics appear more available in these cities resulting in (1) higher use rates, (2) higher mortality rates (per capita) and (3) the highest, per capita, ER visits across Utah County.
  
• Orem and Provo (Central County) – Orem and Provo have 50% of total narcotic related deaths in Utah County (not per capita). Provo and Orem also have a significant portion of IHC ER visits. Comparatively, Provo and Orem have lower per capita rates. This presents the coalition with an interesting dilemma – do we focus on communities with the most per capita problems or the communities with the largest numbers overall?

ALCOHOL: we have identified Santaquin, Payson, Springville, Spanish Fork, and Provo/Orem as potential areas to target. Here’s why:

• Santaquin, Payson, Springville, Spanish Fork (south county)– these southern county cities consistently rank high across all consequence data. Specifically, these cities have the highest (all based on per capita) ER visits, treatment admissions, alcohol related motor vehicle crashes (ARMVC), the lowest EASY compliance rates, highest density of alcohol outlets, and youth in Nebo School district consume alcohol at slightly higher rates than other districts. In short, alcohol in these cities is more available than other cities in Utah County resulting in (1) higher use rates, (2) highest number of alcohol related motor vehicle crashes (per capita) and (3) the most residents involved in alcohol related motor vehicle crashes across Utah County.
  
• Orem and Provo (Central County) – Orem and Provo make up 50% of all ARMVC in Utah County; however, they have lower per capita rates than the cities listed above. Comparatively, Orem has more ARMVC problems than Provo.

How do you post a comment? - (1) just below this sentence (outside of white box) you'll find in red underlined text comments. Click thion comments. (2) In the new page, on the top right under "Leave Your Comment" - type your comments in the box. (3) After you complete comments either sign into your Google account and click "Publish Your Comment" OR if you do not have a Google account click "Anonymous" and then click "Publish Your Comment." If you use the Anonymous please place your name on top of the comment.

2009 PROPOSED SMART Strategic Plan

What is this plan? To accomplish great things as a coalition we must plan where we want to be by the end of the year. If we had time, we'd crank this out together as a coalition. To speed up the process, I've drafted a proposed strategic plan. It will require the efforts of the entire coalition to accomplish the goals. Please review and comment on what you'd like to add or remove from the plan. This document will guide our actions up to 2010.

How do you obtain the plan - I uploaded the document on our coalitions website click on this link (you'll find the document at the bottom of the page): http://sites.google.com/site/utahcountycoalition/Home.

Thanks for your feedback.