Rx bottle

An official Health Advisory from the Centers for Disease Control and Prevention (CDC) was recently released regarding an increase in fatal drug overdoses driven by synthetic opioids. A record increase in overdose deaths of 18.2 percent was reported from June 2019 to May 2020. The COVID-19 pandemic seems to have created a surge as the highest monthly increases were documented from March to May 2020.

Although overdose deaths across the Dakotas are lower than the national numbers (38 North Dakota deaths and 86 in South Dakota during 2019), both states are working to combat issues of opioid misuse and overdose through quality improvement initiatives.The Avoid Opioid South Dakota web site shows opioid deaths in South Dakota have steadily increased since 2012 and unintended overdose is a risk for anyone who takes prescription opioids.

Recognizing emergency departments as frontline providers, the South Dakota Department of Health assessed existing practices and identified key recommendations to advance overdose prevention and reduction efforts. An emergency department toolkit is being developed to provide evidence-based information on best practices and model policies for emergency department to consider, adapt and use to support overdose prevention and treatment and reduce drug-related harm.

Increase in Fatal Drug Overdoses Across the United State Driven by Synthetic Opioids Before and During the COVID-19 Pandemic

The CDC made the following recommendations for combatting the growing overdose death rates:

  1. Expand the provision and use of naloxone and overdose prevention education
  2. Expand access to provision of treatment for substance use disorders
  3. Intervene early with individuals at the highest risk for overdose
  4. Improve detection of overdose outbreaks due to fentanyl, novel psychoactive substances (e.g., fentanyl analogs), and other drugs to facilitate an effective response

“We have been bringing together subject matter experts to provide guidance in the development of emergency department model policies, resources and tools,” shared Laura Streich, MPA, opioid program director for the South Dakota Department of Health. “Our focus areas include screening, intervention, treatment, use of the prescription drug monitoring program (PDMP), naloxone distribution, and patient/provider education.”

North Dakota’s innovative Opioid and Naloxone Education (ONE) Rx program equips pharmacists with tools to screen for opioid use disorder, identify patient needs and provide counseling and support to assist them in safely using prescribed opioids.

“The project has had a great impact on pharmacists and patients,” shared Heidi Eukel, PharmD, associate professor at the North Dakota State University (NDSU) School of Pharmacy. “At-risk patients are provided with critical interventions like naloxone, misuse education, and community support referral. Medication disposal and the risk of misuse are pearls that every patient receiving an opioid medication should receive.”

The Great Plains Quality Care Coalition will be working to improve behavioral health outcomes and decrease opioid misuse. Those interested in learning more about expanding the ONE Rx program across the Dakotas or participating in the emergency room toolkit developed are encouraged to reach out to quality improvement advisors, Jayme Steig, PharmD, RPh, or Stacie Fredenburg, for more information.