Happy Monday! Here is your

 NCMS Morning Rounds.

July 22, 2019

DATA DIVE: Drug Overdose Deaths Decline Nationally

Preliminary statistics from the Centers for Disease Control and Prevention (CDC) show that total drug overdose deaths nationally declined by about 5 percent last year, the first drop since 1990. The decline is attributed to a dip in deaths from prescription opioid painkillers, the medicines that set off the epidemic of addiction that has lasted nearly two decades. Fatal overdoses involving other drugs, particularly fentanyl and methamphetamine, however, continued to rise.

In The New York Times article on the CDC’s release of the numbers, Andrew Kolodny, MD, the co-director of opioid policy research at Brandeis University, is quoted as saying: “There’s nothing to celebrate, because the death toll is still very high.” The article goes on to state the 68,000 overdose deaths in 2018 exceeded the nation’s peak annual deaths from car crashes, AIDS or guns.

The CDC data did not include deaths caused by infectious diseases related to intravenous drug use like hepatitis C and endocarditis.

The NC Department of Health and Human Services Division of Public Health, however, just released data for the state on fatal and nonfatal overdoses and infectious complications of drug use. Between 2010 and 2017, the incidence of acute hepatitis C increased by 350 percent statewide. Increases also were seen in acute hepatitis B and drug-associated endocarditis.

The NCDHHS report includes data for all 100 counties in the state and concludes that:

“All counties in North Carolina continue to experience significant morbidity and mortality associated with the opioid epidemic. Most indicators, particularly the infectious outcomes, are continuing to increase statewide. This assessment identified that the western Appalachian counties are continuing to experience the highest burden of overdose and infectious disease outcomes, but new regions of the state have been identified in the highest burden quartile. Expanding Syringe Exchange Programs, particularly to all counties in the highest quartile, may reduce morbidity and mortality.”

In another interesting data set, The Washington Post combed the US Drug Enforcement Agency’s data to find the number of opioid pills per person distributed in North Carolina by county, opioid related deaths, as well as the top manufacturers and distributors of those drugs from 2006-2012. See that data (free registration is required).

Experts quoted in The New York Times article say there has been a steady increase in access to methadone, buprenorphine and naltrexone, medications use to treat opioid use disorder. The NCMS Foundation’s Project OBOT is helping to train physicians to provide Medication Assisted Treatment (MAT) and to coordinate patient care and reduce barriers to the successful treatment of Opioid Use Disorder. Learn more about Project OBOT.

NCMS Weekly Legislative Summary

Legislators are still in Raleigh trying to wrap up this long session by finding the necessary votes to override the Governor’s veto of the budget and/or pass a stop gap funding bill that will allow the state to continue to draw down federal money allowing a multitude of state programs to continue without a state spending plan in place.

As of the end of last week, it remained to be seen whether the House or Senate version of the stop gap funding proposals would prevail. And it was unknown whether the House had the additional democratic votes necessary to override Governor Cooper’s budget veto. An attempt to pass legislation viewed by the NCMS and others as a compromise to the Governor’s push for Medicaid expansion and a possible way to solve the budget deadlock, HB655 – NC Health Care for Working Families, also remains in limbo at this point. This week may see movement on these issues.

In other news from the General Assembly, several bills we’ve been tracking have progressed, including:

HB 126 – Amend Certificate of Need Laws This proposal has generated much heated debate among legislators and stakeholder groups and has gone through at least 10 versions in the process. Read the detailed bill summary on our blog to understand the many facets of this legislation. The House passed the bill back on July 2 and it made it through the Senate Rules Committee last week.

HB 228/SB 178 – Modernize NC Medical Board Laws This bill may yet make it over the finish line this session. The House passed the proposal on June 12 and it has been slowly making its way through Senate committees, finally passing the Senate rules committee last Tuesday. The many technical changes and other provisions in this legislation are detailed in our bill summary.

Watch your NCMS Morning Rounds for updates this week about the budget and possible adjournment. In the meantime, check out our Legislative blog for information on all the health care related legislation we’ve been watching this session.

NCPHP – New Name; Same Acronym

Last Friday, the North Carolina Physicians Health Program (NCPHP) changed its name to the North Carolina Professionals Health Program (also NCPHP). The new name better reflects all of those served beyond physicians such as physician assistants, perfusionists and anesthesiology assistants. Over the years, the program has added veterinary medical professionals in 2004 and pharmacy personnel in 2016.

NCPHP helps medical professionals by addressing their mental health, substance use or behavioral issues affecting their ability to provide appropriate medical care. NCPHP has served over 3,000 medical professionals across North Carolina by encouraging their well-being and recovery through compassion, support, accountability, and advocacy.

The NCPHP’s legal name will remain the North Carolina Physicians Health Program.

In the News

Here are two recent articles on climate change and health:
Has Your Doctor Talked to You About Climate Change?, NPR, 7-13-19
Climate Grief’: Fears About the Planet’s Future Weigh on Americans’ Mental Health, Kaiser Health News, 7-18-19

Learning Opportunity

With Medicaid managed care open enrollment underway, you may want to brush up on everything you need to know. Access both the state’s upcoming training on Thursday, July 25, that focuses on care management for long-term services and support as well as the previous Medicaid Managed Care Trainings here.