Research Question The main question looked at was

Research Question: The main question looked at was how present is the opioid crisis in Onondaga county compared to other counties in Central New York, and how much has it increased over time? Hannah Frank

Literature Review -40% of accidental deaths poisoning deaths have come from opioid analgesics drugs versus the 6% of deaths caused by heroin in 2006. Opioid deaths are not just a low income, urban problem. -Controlled Substance Act of 1970 - which is a federal law put into place to help end substance abuse and regulate other drugs, however states may add and are encouraged to additional regulatory requirements, such as PDMP. (Paulozzi and Stier 2010). -Dental prescriptions, opioid analgesics are one of the most commonly prescribed by dentists. Overall prescriptions of opioid analgesics decreased and prescriptions of non-opioids increased such as ibuprofen. These changes were noticeable after the implementing mandatory PDMP (Rasubala et al. 2015). -New York is making coordinated care easier “medical homes for their patients, able to deliver primary care, and specialists or referrals to specialists, all in one place Signed law that limits initial prescriptions for acute pain from 30 days to 7 days. 2016 the state also budgeted about 200 million to the Office of Alcoholism and Substance Abuse services to help combat addictions, such as adding to treatment centers, outpatient settings, medicated assistance, counseling and many other programs directly related to heroin, opioid and other substance abuse (Virtanen 2016). The federal government needs to increase coverage for no opioid pain medication which would take place in Medicare and Medicaid services (Kolodny, 2017).

Works Cited • Knopf, A. (2016). Lack of Medicaid reimbursement limits access to opioid treatment programs. Alcoholism & Drug Abuse Weekly, 28(40), 1 -3 • Kolodny, A. , & Frieden, T. R. (2017). Ten Steps the Federal Government Should Take Now to Reverse the Opioid Addiction Epidemic. JAMA: Journal Of The American Medical Association, 318(16), 1537 -1538. • Mulder, James (2017). Onondaga County Opioid Drug Deaths Drop 28 Percent in First Half of Year. Syracuse. com • Paulozzi, L. J. , & Stier, D. D. (2010). Prescription drug laws, drug overdoses, and drug sales in New York and Pennsylvania. Journal Of Public Health Policy, 31(4), 422 -432 • Rasubala, L. , Pernapati, L. , Velasquez, X. , Burk, J. , & Ren, Y. (2015). Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists. Plos ONE, 10(8), 1 -10. • Virtanen, Michael. “New York Sets 7 -Day Limit on Initial Opioid Prescriptions. ” Medical Xpress - Medical Research Advances and Health News, Medical Xpress, 22 June 2016,

Data Source • The data source used came from New York State Health Department • The data collected is between the years 2013 -2015 • The data looks at opioid deaths, heroin deaths, and pain reliever deaths and data from a Prescription Drug Monitoring Program • The rates used are per 100, 000 for the population

Data Analysis 1) Copy and paste entire NY state data from website (https: //www. health. ny. gov/statistics/opioid/index. htm) into excel spreadsheet 2) Find all data related to the region “Central NY” and highlight (repeat steps for all related data sets needed) 3) Copy and paste just Central NY data into new spread sheet 4) Highlight Data for “Heroin Related Deaths in Central NY” 5) Copy and Paste data into new spreadsheet and label it (Repeat this step so that in one spreadsheet you have data for heroin related deaths, opioid related deaths, and any pain reliever related deaths) So you have all data in one nice spreadsheet

Data Analysis Cont. • 6) After you have all copied and pasted into new spread sheet separate and label data based on its topic (ex. Heroin related deaths separated and labeled) • 7) After all are labeled highlight heroin related data chart and click create pivot table. (repeat this step for all data tables, 4 total) • 8) Highlight pivot tables and insert the first option for a 2 -column chart (repeat this step until you have four 2 column charts for each topic) • 9) After there are four charts click the “+” sign on each chart to correctly give title and correct axis labels

Findings Overdose by Just Heroin 45 27 23 30 25 21 20 Sum 2013 16 15 5 0 0 Sum of 2014 10 8 10 2 0 Cayuga 2 4 1 Sum of 2015 9 3 2 Cortland Madison Oneida Onondaga Oswego County Overdose by Any Pain Reliever 50 45 45 40 Deaths per 100, 000 • Any Pain Reliever- Many counties saw steady increase, while some such as Cayuga fluctuated and Oswego County actually saw a decrease in deaths. 35 Deaths per 100, 000 • Heroin Related Data- Onondaga County increased from 2013 from 23 deaths per 100, 000 up to 40 deaths per 100, 000 in 2015 indicating steady increase, similarly Cayuga, Cortland saw a steady increase over the two year span. Madison and Oneida, and Oswego county which did not have a steady increase but rather fluctuated between the two years. 40 40 34 31 35 30 23 20 25 20 15 10 5 0 2014 16 14 14 11 2013 5 4 4 0 3 5 7 9 8 Cayuga Cortland Madison Oneida Onondaga Oswego County 2015

Findings Overdose by Any Opioid 80 • Overdose by Any Opioid- After a two year period all counties had experienced increase, however over the two year periods Cayuga, Madison fluctuated while some stayed the same such as Oswego. Onondaga saw the biggest increase overall 70 70 56 Death per 100, 000 60 47 50 3636 40 Sum of 2013 30 20 17 12 5 10 0 17 0 Cayuga 5 8 18 1515 8 7 4 Cortland Madison Sum of 2014 Sum of 2015 Oneida Onondaga Oswego County Prescribed Opioid analgesics (PDMP) 500000 450000 300000 250000 Sum of 2013 200000 Sum of 2014 150000 Sum of 2015 100000 Sum of Average Population 50000 County w eg o Os ga da On on da ei iso ad M On n d an rtl Co yu g a 0 Ca • PDMP- The opioids prescribed stayed steady in most counties, and saw a slight decrease in Onondaga and Oneida County Prescription Rate per 1000 400000

Summary • Overall relating back to my question, I found that Onondaga County is experiencing the Opioid Crisis worse than other Central NY counties, and is steadily increasing over time. • This goes along with policy implications and that policy makers should create specific programs easily accessible to those in each county. • The new budget previously mentioned suggests that is what is happening, new facilities, and programs are being created, or expanded in areas that are needed. • Also this data is from 2015 and a current Syracuse. com article reports that as of October 2017 Onondaga County Opioid Related deaths have dropped 28 percent from last year, however it was noted it is too early to say if this trend will continue. (Mulder, 2017)