MHA News Now

Town Hall Meeting in Brandon Discusses Opioid Addiction

Pictured are (l to r) Daisy Carter, Executive Director of the National Council on Alcoholism and Drug Addiction, Central Mississippi; Dr. Scott Hambleton, Mississippi Physician Healthcare Program; Trey Crawford, pharmacist and owner of Diket’s Professional Drugs; Michael Jordan, State Opioid Treatment Authority with the Department of Mental Health; Bryan Bailey, Rankin County Sheriff; Marshall Fisher, Commissioner of the Department of Public Safety; and Steve Parker, Deputy Director of the Mississippi Board of Pharmacy.

A town hall meeting in Brandon on May 23 addressed the growing impact of opioids in communities across the state. The meeting was hosted in a partnership with the Department of Mental Health, the Bureau of Narcotics, the Board of Pharmacy, and the Jackson Division of the FBI.

It is one of several that will be taking place throughout the state in the coming months. A panel discussion at the meeting also included a physician, a pharmacist, and Rankin County Sheriff Bryan Bailey, but the featured speaker of the night was Aden Giles, a Jackson metro area resident who shared how her family and her life had been tragically impacted by addiction and opioids.

First though, Lt. John Harless with the Mississippi Bureau of Narcotics made sure attendees knew just how large of a problem opioid addiction has become as it has worked its way into the lives of Mississippians and Americans, leaving a trail of broken people and families in its wake.

“I’m about to start my twentieth year with MBN,” Lt. Harless said. “When I started, heroin was something that maybe we saw a little bit of back in the ‘70s. When I was trained, nobody told me we’ve got to get ready to see heroin. We were dealing with the crack epidemic, and then we dealt with the meth labs, but illegal opioids are growing, and they continue to grow.”

Heroin is the most common illegal opioid, but that’s not the limit of the current problem. The problem ranges from prescriptions like hydrocodone and oxycodone to powerful synthetics like fentanyl, and even to newer synthetic drugs that have popped up. One such synthetic is known as U-47700, which first showed up in Mississippi in Rankin County not long before this town hall meeting.

Mississippi has the fifth highest rate of hydrocodone prescriptions in the country, Lt. Harless said. In Rankin County, there were 14 overdose deaths from 2013 through 2016, with 11 of those caused by prescription drugs.

Michael Jordan, State Opioid Treatment Authority for the Department of Mental Health, said that a recent survey of high school students showed it was easier for them to get a narcotic than it was to get alcohol.

“Think about that. It’s staggering. This is not a national problem. It’s not a Mississippi problem. It’s a community problem,” he said. “Together we can make an impact on the lives of Mississippians.”

The most powerful presentation of the night was from Aden Giles, a resident of the Jackson metro area who spoke about how she and her family have been impacted by opioid addiction. While she struggled with alcohol and drugs for much of her adult life, her son Mitch grew up to face struggles of his own with an addiction to opioids.

Her addiction led her to lose everything she said she cared about – relationships with her siblings, her parents, and her job. A little more than two years ago, she decided to enter treatment. While she was beginning recovery, her son’s addiction began to get worse.

It didn’t happen right away, but he eventually began to turn his life around. He became known as the poster child for recovery in his treatment program. In one letter Giles read from, her son wrote her to thank her for the life she had given him, and talking about his hopes for a life in recovery. He was happy to be brought back together in sobriety.

Months went by until one day Mitch saw one of the people he used to get drugs from. Several hours later, his family was notified that Mitch had died of an overdose.

“I couldn’t believe it. I was shocked,” Aden said. “But you know, I’ve never been angry with him relapsing and being weak at that moment, because every alcoholic and drug addict knows that thought comes across your mind every so often.”

She would never give up the six months she got to spend with her son in recovery, she said. It was six months of happiness she and Mitch would have never had. Her own recovery has brought back the relationships she had lost with the rest of her family. It has shown her a life that she never knew was out there.

“As they tell me all the time, just stick around until the miracle happens,” she said. “And it happened to me.”

Opioid Town Hall Meeting in Brandon

Attached below is a flyer for the first of several town hall meetings across the state to discuss the impact of opioid abuse in Mississippi. The first town hall meeting will be in Brandon at the Civic Center on May 23 at 6:30 p.m. 

Download DMH-impact-of-opioids-flyer

WEBINAR: Restraints - CMS & Joint Commission: Similarities & Differerences

Restraints remain a challenging procedure. This is one of the few areas where the Joint Commission (TJC) and CMS vary greatly.

If your organization uses The Joint Commission Accreditation for Deemed status, there is good news. You follow ONLY the CMS requirements for restraints and they are much more reasonable.

On April 18, the Mississippi Hospital Association will host Restraints - CMS & JC: Similarities & Differerences from 10 a.m. until 11:30 a.m. This webinar is for all clinical personnel in organizations who use TJC accreditation for deemed status and want to finally master these requirements.

Sandra M. McRae, BSN, RN, MPH, LHRM, will be the instructor. During the webinar, Ms. McRae will review the CMS requirements for violent and non-violent restraints, discuss the use of protocols in non-violent restraints, and compare the difference between TJC and CMS requirements of restraints.

This program has been approved for 1.8 contact hours by the Iowa Board of Nursing Approved Provider Number 339. Completion of offering required prior to awarding certificate.

This webinar is open to MHA members and non-members. Register online here. If you need help registering, you can chat with us online or contact Anasthia Johnson at ajohnson@mhanet.org.

April is Autism Awareness Month

April is Autism Awareness Month. While the word “Autism” is recognized by many people in our community, very few actually know anything about this disorder. Canopy Children’s Solutions, a leading provider of autism therapy and behavioral health solutions, wants to transform “awareness” into understanding to help support the more than 10,000 Mississippi children diagnosed with Autism Spectrum Disorder.

How can you help? Below is a list of awareness activities Canopy is promoting during the month of April or you can learn more by visiting mycanopy.org. For individuals, organizations and businesses who opt into participating, we will provide you with materials that will help not only bring awareness to Autism, but education and understanding of this complex disorder. This information can be used on email blasts, marquee signs, internal digital boards, receipts, social media and more as a way to promote autism awareness and education. We will also aid in promoting your organization’s participation on our website and through extensive social media campaigns.

Why is it important to support Autism awareness? Currently, there are more than 10,000 children in Mississippi on the autism spectrum. The Centers for Disease Control and Prevention estimates 1 in every 68 children receives this diagnosis, and 1 in every 42 boys. In 2002, the rate was 1 in every 150. Families who may face these challenges need to know about effective therapies available for children in Mississippi and communities should know the important role their support of those families and children is and understanding the struggles they face.

For more information, contact Kym Williams, director of public relations for Canopy Children's Solutions, at 769-777-1010 or kym.williams@mycanopy.org.

Download Autism Awareness 2017

Feedback sought on Joint Commission Pain Assessment and Management program

The Joint Commission seeks feedback on the proposed requirements for Pain Assessment and Management for Hospitals. Comments will be accepted until February 20, 2017. The accreditor hopes that by aligning its requirements with existing best practices, it will be able to better promote patient safety and quality of care.

CDC: Overdose deaths from synthetic opioids up sharply last year

The rate of overdose deaths from synthetic opioids other than methadone increased 72.2% in 2015, likely driven primarily by illicitly manufactured fentanyl, according to a new report from the Centers for Disease Control and Prevention. The overdose death rate from methadone fell by 9.1%. The overdose death rate from heroin rose 20.6% in 2015, while the rate from natural and semisynthetic opioids rose 2.6%.

Deaths involving heroin and synthetic opioids other than methadone increased across all demographic groups and regions.

[ via AHA News Now ]

FDA’s opioids action plan: A midyear checkup

Learn what FDA has been doing to implement a multipart opioids action plan from Robert M. Califf, M.D. "As FDA works to address the opioid epidemic of abuse, misuse and addiction, it’s valuable to see firsthand some of the ways the crisis is affecting our communities. This summer, I toured areas hard-hit by the opioid crisis in Tennessee, West Virginia and Kentucky, visiting with survivors of opioid addiction and overdose as well as community activists, government officials, and health care providers, all of whom are working diligently and creatively to address and overcome this crisis."

Department of Mental Health announces Mississippi Suicide Prevention Plan

The Mississippi Department of Mental Health (DMH) has released its first state plan for suicide prevention, making an important step in efforts to prevent the loss of lives by suicide in Mississippi.

Though the agency and its partners in the community have worked for years at suicide prevention efforts and to fight the misconceptions of mental illness, the Mississippi Suicide Prevention Plan marks the first time a comprehensive plan has been formalized and adopted. It is available on the DMH web site. Its release in September carries special significance as September is Suicide Prevention Awareness Month.

“Whether we realize it or not, many of our friends and neighbors have been affected by suicide or mental illness,” DMH Executive Director Diana Mikula said. “Suicide affects people across all ages, races, and backgrounds, but through collaboration, sharing resources, and working towards common goals, we can prevent the tragedy of suicide.”

The plan contains three core sections: Assessment, Capacity, and Goals and Objectives. The Assessment section addresses demographics and trends in the mental health field. The Capacity section examines resources that are currently available to help address suicide. The Goals and Objectives section are the specific targets DMH is working towards with the plan.

Also included throughout the plan are a series of stories written by people who have been affected by suicide, either as loved ones or friends of someone who took his or her own life, or as people who have attempted suicide or had suicidal thoughts themselves. Though some names have been changed, they are all the experiences of Mississippians who have faced tragedy.

Mississippi Board of Mental Health member Teresa Mosley shared her own personal experiences in the story, telling of the loss of her daughter Elisabeth.

“There was such a stigma attached to suicide and I wanted to share Elisabeth’s story in an attempt to start a conversation with individuals whose lives had been touched by this tragedy,” she writes in her story in the plan.

She said that unless someone is a suicide survivor, others have no idea how it feels to lose someone to the tragedy of suicide.

“When studying suicide, we like to look at statistics,” Mosley said. “However, those statistics don’t really make it real. It’s real when you love one of the numbers.”

Suicide is the 12^th leading cause of death overall in Mississippi, but among people aged 10 to 24-years-old, it is the third leading cause of death. Suicide rates also increase with age, and older adults have the highest suicide rates.

The plan’s four goals hope to address those statistics, leading to greater coordination of suicide prevention activities, increase partnerships between public and private organizations, and promoting and improving mental health literacy and attitudes about mental health.

Mississippi’s First Lady, Deborah Bryant, shared a letter in the plan mentioning how she had been affected by suicide.

“I have seen first-hand the effect that suicide has on people’s lives, and my hope is that we do all we can to prevent unnecessary deaths by suicide,” she said.

She also notes that suicide affects people in all walks of life.

“People from all populations – young adults, military, older adults, males, and females – will be impacted by the goals and objectives in this Plan. An integrated and coordinated effort is essential to prevent suicide attempts and deaths, and to save the lives of those we love,” she wrote.

One thing all Mississippians should be aware of now is the National Suicide Prevention Lifeline. DMH is the statewide provider for this lifeline in Mississippi, and the line is staffed 24 hours a day, seven days a week. It can be reached at 1-800-273-8255. DMH also operates a toll-free helpline available at all hours by calling 1-877-210-8513.

Anyone who feels they need help, or who knows someone who appears to need help, is encouraged to call one of those numbers any time of the day and any day of the week. All calls are confidential and help is available at all times.

The Mississippi Suicide Prevention Plan is available on the DMH web site, www.dmh.ms.gov, located in the Resource Library.

Clinton Proposes Plan to Address Mental Health Treatment

Hillary Clinton rolled out a comprehensive plan to address millions of Americans coping with mental illness, pointing to the need to fully integrate mental health services into the nation's health care system. Clinton's campaign released a multi-pronged approach to mental health care on Aug. 29, aimed at ensuring that Americans would no longer separate mental health from physical health in terms of access, care and quality of treatment.

Read more here.

Influx of Fentanyl-laced counterfeit pills and toxic Fentanyl-related compounds further increases risk of Fentanyl-related overdose and fatalities

Health care professionals, first responders, medical examiners and coroners are being updated to new developments that have placed more people at risk for fentanyl-involved overdoses from IMF and may increase the risk of non-fatal and fatal overdose. These developments include the following: (1) a sharp increase in the availability of counterfeit pills containing varying amounts of fentanyl and fentanyl-related compounds (e.g., labeled as Oxycodone, Xanax, and Norco), (2) the potential for counterfeit pills containing fentanyl and fentanyl-related compounds to be broadly distributed across the United States which could impact states not previously impacted by IMF and persons using diverted prescription pills (i.e., licit drugs diverted for illicit purposes and involves the diversion of drugs from legal and medically necessary uses towards uses that are illegal and typically not medically authorized or necessary) the widening array of toxic fentanyl-related compounds being mixed with heroin or sold as heroin, including extremely toxic analogs such as carfentanil, and (4) continued increases in the supply and distribution of IMF.

In July 2016, the Drug Enforcement Administration (DEA) issued a nationwide report indicating that hundreds of thousands of counterfeit pills have been entering the U.S. drug market since 2014, some containing deadly amounts of fentanyl and fentanyl analogs. Traditionally, fentanyl and fentanyl analogs in the illicit market have been mixed into heroin or sold as heroin, often without the knowledge of the consumer, and have primarily impacted areas where white powder heroin is prevalent, including the Northeast, Midwest, and Southeast regions of the United States.

The influx of counterfeit pills, which closely resemble oxycodone, Xanax, and Norco, has increased the chance of fentanyl-involved overdoses among persons misusing prescription opioids or benzodiazepines who seek diverted medications on the illicit market, in addition to persons who inject, sniff, or snort drugs. Persons who misuse prescription pills are geographically widespread; thus, the potential risk for fentanyl overdose has spread beyond those regions previously known to be impacted by IMF, and could intensify the impact in regions already affected by IMF.

The supply, distribution, and potency of illicitly manufactured fentanyl and fentanyl-related compounds in the U.S. drug market is evolving. Carfentanil, an extremely potent fentanyl analog, has been detected in at least one state and is currently being investigated as a possibility in a few other locations.

Designed in 1974, carfentanil was previously used exclusively for veterinary use with large animals and is not approved for use in humans, as it has been shown to be 100 times more potent than fentanyl in animal studies. Other fentanyl-related compounds have been reported by the DEA National Forensic Laboratory Information System (NFLIS), which systematically collects drug identification results from drug cases submitted for analysis to forensic laboratories (referred to as drug submissions).

From 2014 to 2015 the number of drug submissions testing positive for acetyl fentanyl increased substantially, rising from 463 in 2014 to 1,870 in 2015, and in 2016, NFLIS reported increasing drug submissions testing positive for furanyl fentanyl (244 drug submissions from January to July 2016). States should be vigilant about the possibility of highly toxic fentanyl-related compounds becoming available in the illicit drug market, as well as other highly toxic synthetic opioid derivatives, such as U47700.
 

NFLIS has reported that the overall supply of illicitly manufactured fentanyl appears to have substantially increased from 2014 to 2015, with the number of drug submissions testing positive for illicitly manufactured fentanyl doubling during this period (from 5,343 to 13,882). The number of states reporting more than 100 fentanyl submissions also increased during this period from 11 to 15 .

Recently, according to NFLIS and National Seizure System (NSS) reports, the amount of fentanyl seized in the United States has nearly doubled; from October 2014 to September 2015, federal, state, and local law enforcement agencies seized a total of 167.7 kilograms of fentanyl, and through June, 2016, they seized 363.8 kilograms of fentanyl. CDC suggests the following actions in response to the increased risk of fentanyl overdose from IMF due to the influx of fentanyl-laced counterfeit pills, the widening array of highly toxic fentanyl-related compounds, and the continued expansion and geographic spread of the IMF supply:  

• Multiple dosages of naloxone may need to be administered per overdose event, because of fentanyl’s increased potency relative to other opioids. Orally-ingested counterfeit pills laced with fentanyl may require prolonged dosing of naloxone in the ED/hospital setting due to a delayed toxicity that has been reported in some cases.
• Facilitate access to Medication-Assisted Treatment (MAT). MAT is a comprehensive approach to addressing the needs of persons with opioid use disorders that combines the use of medication with counseling and behavioral therapies.  Providers should discuss treatment options with persons who have an opioid use disorder, and persons who have experienced an opioid-related overdose once they are stabilized.

For more information:     

CDC Health Advisory: Recommendations for Laboratory Testing for Acetyl Fentanyl and Patient Evaluation and Treatment for Overdose with Synthetic Opioid  

SAMHSA Opioid Overdose Toolkit