DPH to Distribute Overdose Reversing Medication Naloxone March 9, 2019 in Georgetown

GEORGETOWN (March 1, 2019) – In an effort to reduce the number of individuals dying from drug overdoses in Delaware, the Division of Public Health (DPH) will hold Community Naloxone Distribution events in each county throughout the month of March. DPH will distribute free naloxone kits to members of the general public from 10 a.m. to 2 p.m., on Saturday, March 9, 2019, at Delaware Technical Community College, Owens Campus, 21179 College Drive, Georgetown, DE 19947. The distribution event will be held in the Theater Lobby and Rooms 344A/B in the Arts and Sciences Center. DPH is holding its first distribution event Saturday, March 2, 2019, in coordination with the atTAcK addiction 5K race in New Castle.

In addition, a third distribution event will be held in Kent County, from 5:30 p.m. to 8:30 p.m., Wednesday, March 20, 2019, at Delaware Technical Community College, Terry Campus, 100 Campus Drive, Dover DE 19904, Corporate Training Center Rooms 408 and 412.

Each naloxone kit will contain two doses of naloxone, and members of the community who attend these events will receive one-on-one training on how to administer the overdose-reversing medication. The Division of Substance Abuse and Mental Health (DSAMH) also will have representatives on hand to answer any questions about access to treatment for those struggling with substance use disorder.

“It is critically important for family and friends of loved ones struggling with addiction to have access to naloxone,” said DPH Director Dr. Karyl Rattay. “The data are telling us that 80 percent of overdoses happen in a residence. If family or friends of someone overdosing have naloxone immediately accessible, it can mean the difference between life or death for that person.”

Within three to five minutes after administration, naloxone can counteract the life-threatening respiratory depression of an opioid-related overdose and stabilize a person’s breathing, which buys time for emergency medical help to arrive. DPH recommends calling 9-1-1 immediately if you find someone in the midst of a suspected overdose, starting rescue breathing, and then administering naloxone. Naloxone is not a replacement for emergency medical care and seeking immediate help and follow-up care is still vital.

There were at least 291 deaths last year in Delaware from suspected overdoses. Tragically, the final number is expected to exceed 400 after all toxicology screens are finished (they take six-eight weeks) and final death determinations are made on outstanding cases by the Division of Forensic Science. The Centers for Disease Control and Prevention ranked Delaware as number six in the nation for overdose deaths in 2017.

In 2018, first responders administered 3,728 doses of naloxone, compared to 2,861 in 2017, a 30 percent increase.

Funding for the Community Naloxone Distribution Initiative comes from state funding built into DPH’s budget for the first time in state fiscal year 2019, thanks to the advocacy of Lt. Governor Bethany Hall-Long and the Behavioral Health Consortium. In October, DPH also announced the agency was awarded federal funds to support the purchase of naloxone and other programs for first responders.

Community access to naloxone has increased significantly since 2014 when legislation was enacted making it available to the public. In 2017, Governor John Carney signed additional legislation ensuring pharmacists had the same legal protections as doctors, peace officers and good Samaritans when dispensing the medicine without a prescription.

Information on community training and pharmacy access to naloxone, along with resources regarding prevention, treatment and recovery are available on HelpIsHereDE.com.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


DHSS Secretary Dr. Kara Odom Walker Elected to Prestigious National Academy of Medicine

NEW CASTLE (Oct. 15, 2018) – Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a board-certified family physician, has been elected as a member of the prestigious National Academy of Medicine (NAM), Academy President Victor Dzau announced today during the organization’s annual meeting in Washington.

Secretary Walker is one of 75 new members this year from across the country and 10 international members. Membership in the National Academy of Medicine is considered one of the highest honors in the fields of health and medicine, and recognizes individuals who have demonstrated outstanding professional achievements and commitment to service.

“I congratulate Dr. Walker on being elected to the National Academy of Medicine,” Governor John Carney said. “Dr. Walker uses her problem-solving, outreach and leadership skills to take on such complex issues in our

state as the opioid epidemic and the rising growth in health care spending. She doesn’t back way from these issues. She leans in, bringing people together, using data and other resources to assess situations, and changing systems to better serve the people of our state.”

Secretary Walker was sworn in as Cabinet Secretary for DHSS in February 2017, leading the principal agency charged with keeping Delawareans healthy, ensuring they get the health care they need in a fast-changing world, and providing children, families and seniors with essential social services including food benefits, disability-related services, and mental health and addiction treatment. She oversees one of the largest departments in Delaware’s government with an annual budget of more than $2 billion. As Cabinet Secretary, her priorities include:

• Slowing the growth of health care spending, increasing the transparency of health care costs and improving patient outcomes.
• Bolstering the state’s response to the opioid epidemic with increased resources for treatment, harm reduction and prevention.
• Reducing gun violence in Wilmington by meeting the social services needs of high-risk young people and their families.
• Maintaining a strong safety net for those in need.
• Providing more community-based services for seniors, people with disabilities and individuals who are homeless.

Prior to being nominated to head DHSS by Governor Carney, Secretary Walker worked as the Deputy Chief Science Officer at the Patient-Centered Outcomes Research Institute (PCORI), a nonprofit, nongovernment organization in Washington that is authorized by Congress to improve evidence available to help patients, caregivers, employers, insurers and policymakers make informed health care decisions. She managed the Institute’s research investments, which totaled $1.6 billion in 2016, toward a planned total of $2.5 billion by 2019.

“Those of us who had the great pleasure to work with Kara during her four and a half years at PCORI are thrilled with her well-earned election to the National Academy of Medicine,” said Joe V. Selby, MD, MPH, Executive Director of the Patient-Centered Outcomes Research Institute. “It recognizes the diligent work and exceptional contributions she’s made at every stop throughout her training and career. She brings tremendous knowledge and insight to the Academy as it pursues its mission of improving health for all.”

Background in teaching, serving

Secretary Walker formerly taught Family and Community Medicine at the University of California, San Francisco, as an Assistant Clinical Professor, and has worked with several national organizations to advocate for health equity and for access to quality health care in minority and underserved populations, including the National Medical Association, the Student National Medical Association and the American Medical Association. Dr. Walker has been recognized for leadership by Harvard Business School’s Program for Leadership Development, the American Medical Association and the National Medical Association.

Kevin Grumbach, MD, the Hellman Endowed Professor and Chair of the University of California, San Francisco (UCSF) Department of Family and Community Medicine, nominated Dr. Walker for the honor. “Dr. Walker’s election to the National Academy of Medicine recognizes her career-spanning roles as a family physician and community health leader in academic medicine, the Patient-Centered Outcomes Research Institute, and state government who has championed health equity and consumer and community engagement,” Dr. Grumbach said. “In her current role as Cabinet Secretary at the Delaware Department of Health and Social Services, she has addressed social determinants of health by making Delaware a state with one of the highest percentages of eligible families enrolled in the Supplemental Nutritional Assistance Program and fathers paying child support, and by launching new community-based violence prevention programs. She has rapidly emerged as one of her generation’s most influential family physicians.”

A Caravel Academy high school graduate, she earned her bachelor’s degree in chemical engineering from the University of Delaware and her medical degree from Jefferson Medical College in Philadelphia. She has a Masters of Public Health from the Johns Hopkins School of Public Health and a Masters in Health Services Research from the University of California, Los Angeles, School of Public Health, where she also completed a post-graduate fellowship in the Robert Wood Johnson Clinical Scholars program. As a family physician, Dr. Walker has provided direct patient care in many primary care settings, including those for uninsured and underserved populations. She has published research papers on physician workforce issues, health care organization and delivery.

“The College of Engineering at the University of Delaware would like to congratulate Dr. Walker for her well-deserved election to the National Academy of Medicine,” said Levi T. Thompson, Dean of UD’s College of Engineering and an alumnus of UD’s chemical engineering program. “Her studies in chemical engineering at UD were the starting point of an educational journey that prepared her well to tackle grand challenges in health and public policy. Now, she is using her skills and knowledge to improve the health, safety and quality of life for people in Delaware and across the nation. We could not be more proud of Dr. Walker and look forward to her continued successes.”

The National Academy of Medicine, established in 1970 as the Institute of Medicine, is an independent organization of eminent professionals from diverse fields, including health and medicine; the natural, social and behavioral sciences; and beyond. It serves alongside the National Academy of Sciences and the National Academy of Engineering as an adviser to the nation and the international community. Through its domestic and global initiatives, the Academy works to address critical issues in health, medicine and related policy, and inspire positive action across sectors.

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The Department of Health and Social Services is committed to improving the quality of life of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.


Johns Hopkins Team Releases Major Recommendations for Strengthening Delaware’s Substance Use Disorder Treatment System

NEW CASTLE (July 24, 2018) – Following a 14-month review of Delaware’s opioid use disorder treatment system, a research team from the Johns Hopkins Bloomberg School of Public Health and the Bloomberg American Health Initiative today recommended four major strategies to achieve the state’s goal of a system of care that is accessible, evidence-based, individualized, comprehensive and accountable.

Brendan Saloner, PhD, an assistant professor at the Johns Hopkins Bloomberg School of Public Health, presented the findings today at a meeting of the Behavioral Health Consortium at Buena Vista. The report proposes four major strategies for the state to meet its treatment vision:

  • Increase the capacity of the treatment system.
  • Engage high-risk populations in treatment.
  • Create incentives for quality care.
  • Use data to guide reform and monitor progress.

In April 2017, Department of Health and Social Services Secretary Dr. Kara Odom Walker asked a team of researchers and clinicians from the Johns Hopkins Bloomberg School of Public Health to conduct the review by meeting with state officials representing multiple agencies, behavioral health organizations, treatment providers and patient advocates, and by studying data on Delaware’s epidemic, available literature, and the experiences of other states and localities.

“Families across the state have urged me to make changes to our public addiction treatment system,” Governor John Carney said. “This Johns Hopkins report is an important step forward in building a stronger treatment system so we can help more people get the access to care they need.”

“The recommendations from the Johns Hopkins team gives us a solid foundation in data, evidence and experiences from which to strengthen the opioid use disorder treatment system in our state,” said Secretary Walker, a board-certified family physician. “With almost one Delawarean dying each day from overdoses and thousands of more individuals and their families impacted by this epidemic, we need to meet people whenever and wherever they are ready for the most effective treatment we can provide.”

In 2017, 345 Delawareans died from overdoses, according to the Division of Forensic Science (DFS). That total was up about 12 percent from 2016. In 2016, the report says, Delaware’s overdose rate tied for ninth (with Rhode Island) among all states at 30.8 deaths per 100,000. Through July 23 of this year, 145 people have died from suspected overdoses in Delaware, according to DFS.

“This report really helps to identify those priority areas we need to address to fix our broken system of treatment in Delaware,” said Lt. Governor Bethany Hall-Long. “These recommendations support the action items included in the Behavioral Health Consortium’s Three Year Action Plan. Implementing these recommendations will allow us to better serve our population and meet their needs most effectively.”

“We deeply appreciate the thoughtful recommendations from the Hopkins/Bloomberg Team to help us strengthen our response to this critical public health epidemic,” said Division of Public Health Director Dr. Karyl Rattay. “The recent passage of an Overdose System of Care bill will help us fulfill the recommendation to engage high-risk populations into treatment, through the creation of a statewide system to ensure that consistent, humane, evidence-based treatment and care is available and provided to those requiring acute management for overdose or substance use disorder.”

The Overdose System of Care will involve establishing consistent EMS and emergency department protocols to improve acute response, initiate medication-assisted treatment to manage withdrawal, and rapidly engage individuals into SUD treatment. Additionally, the bill enables the establishment of stabilization centers, which could provide medical management for individuals who have overdosed or who require acute management of SUD. The ultimate outcome of system implementation is a reduction in morbidity and mortality and improved engagement into SUD treatment.

In embracing another recommendation of the Johns Hopkins report, DHSS’ Division of Substance Abuse and Mental Health (DSAMH) will begin contracts this summer with providers to increase access to care, peer support and effective treatment for individuals living with substance use disorder. In addition to meeting individuals’ treatment needs, the new centers also will address needs for medical care, housing, vocational opportunities, education and other wraparound services.

“We need to treat each person with an opioid use disorder as a whole person,” DSAMH Director Elizabeth Romero said. “At the new centers, we will use certified recovery peers to help individuals navigate their way through both the treatment and the social services worlds. Being able to talk with someone with a similar lived experience will help individuals suffering from opioid use disorder to better coordinate their services and maintain their engagement with treatment.”

“Delaware’ leadership recognizes that the rising tide of overdoses is a public health crisis,” said Joshua Sharfstein, MD, Professor of the Practice and the Director of the Bloomberg American Health Initiative at the Johns Hopkins Bloomberg School of Public Health. “We are pleased to help the state save lives by expanding access to treatment.”

The Johns Hopkins report, available on DHSS’ website, includes details on each of the four strategies:

  • Increasing treatment capacity: Recommendations include DHSS’ Division of Substance Abuse and Mental Health (DSAMH) implementing a Centers of Excellence-type program to provide rapid intake and assessment, treatment, peer services and access to chronic disease management; DSAMH creating an online inventory of all credentialed treatment providers; DHSS leading a campaign to increase the number of providers who prescribe buprenorphine; and DHSS developing a plan to support housing and employment for individuals in recovery.
  • Engaging high-risk populations in treatment: Recommendations include the Department of Correction offering opioid use disorder treatment that includes all FDA-approved medications to all individuals in detention facilities; the state upgrading the three existing withdrawal management centers; and DHSS setting standards for hospital provision of SUD treatment for medication-assisted treatment and the use of peers.
  • Creating incentive for quality care: Recommendations include DSAMH reviewing its current rates to ensure there is adequate and consistent reimbursement for high-quality care; DHSS’ Division of Medicaid and Medical Assistance (DMMA) ensuring that current value-based payment initiatives applied through Managed Care Organizations (MCOs) are extended to opioid use disorder treatment; and DHSS, in partnership with other state agencies, developing a compliance strategy.
  • Using data to guide reform and monitor progress: Recommendations include DHSS developing a dashboard that collects and publicizes statewide data on treatment capacity, utilization and quality indicators; DHSS overseeing a linkage project that brings together multi-agency data for understanding system effectiveness and identifies opportunities for improvement; and DHSS evaluating program and policy changes and rapidly disseminating findings to facilitate continuous improvement.


Delaware Health Officials Issue Warning after 2 Deaths Involve Same Stamp on Packets of Heroin

Secretary Kara Odom Walker participates in a press conference about the opioid epidemic in Delaware.

NEW CASTLE (May 28, 2018) – Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker is warning people in active substance use in Delaware that two people have died from suspected overdoses in a 24-hour period that involve heroin packets with the same stamp. DHSS is not identifying the stamp so people will not seek out the drug.

“If you are in active use, we urge you to seek treatment immediately,” Secretary Walker said. “Call DHSS’ 24/7 Crisis Hotline or seek help at the nearest police department, hospital or medical provider. If you continue to use substances, have the overdose-reversing medication naloxone with you because the risk for death is increased. Our first priority is to reduce harm and to save your life or the lives of others.”

By calling DHSS’ 24/7 Crisis Services Hotline, individuals in active use or their loved ones will be connected to trained crisis professionals who can discuss treatment options. In Kent and Sussex counties, the number is 1-800-345-6785. In New Castle County, the number is 1-800-652-2929. Individuals and families also can visit DHSS’ website, www.HelpIsHereDE.com, to find addiction treatment and recovery services in Delaware or nearby states.

In Delaware, there have been 106 deaths from suspected overdoses through May 27 of this year, including three since Friday, May 25, according to preliminary reports from the Department of Safety and Homeland Security’s Division of Forensic Science. The two deaths involving the same stamp occurred Thursday, May 24, and Friday, May 25. Of the 106 total deaths for 2018, 71 have been in New Castle County, 22 in Sussex County and 13 in Kent County, The youngest person who died was 19; the oldest 74.

Elizabeth Romero, director of DHSS’ Division of Substance Abuse and Mental Health, encouraged individuals in Delaware to call 911 if they believe someone is overdosing. Under Delaware’s 911/Good Samaritan Law, people who call 911 to report an overdose and the person in medical distress cannot be arrested for low-level drug crimes.

“When someone overdoses from an opioid, naloxone must be administered within minutes,” Romero said. “That’s why it’s so important for people to call 911 immediately. We also urge people to have naloxone on hand if they have a loved one suffering from addiction. Naloxone saves lives.”

If a user has ingested fentanyl or a drug laced with fentanyl, time is critical because the powerful opioid quickly affects the central nervous system and the brain. Users often have trouble breathing or can stop breathing as the drug sedates them. If someone is too drowsy to answer questions, is having difficulty breathing, or appears to be so asleep they cannot be awakened, call 911 immediately and administer naloxone if you have the medication.

Naloxone, the overdose-reversing medication carried in Delaware by community members, paramedics and some police officers, can be administered in overdoses involving fentanyl. Because fentanyl is more potent than heroin or opioid painkillers, multiple doses of naloxone may be needed to reverse an overdose. In 2017, Delaware paramedics and police officers administered naloxone 2,714 times in suspected overdose situations to a total of 1,906 patients.

Overdose deaths continue to increase in Delaware. In 2017, 345 people died from overdoses, up 12 percent from the 308 people who died in 2016, according to the Division of Forensic Science. Of the 345 overdose deaths last year, 210 – or about six out of 10 – involved fentanyl. That number was almost double the 109 fentanyl-related deaths in 2016.

 


Delaware Files Lawsuit Against Opioid Industry

Suit Seeks To Hold Manufacturers, Distributors and Retailers Responsible for Cost, Impact of Prescription Opioid Epidemic

On behalf of Delawareans, Attorney General Matt Denn filed suit Friday against some of the nation’s largest manufacturers, distributors, and retailers of prescription opioid drugs, alleging that their failures to meet their legal obligations have fueled an opioid addiction epidemic that is devastating individuals, families, and communities across Delaware.

The lawsuit seeks to hold them financially responsible for the harm they have caused to the State and its citizens and to require them to change their conduct to help end the epidemic.

“Opioid manufacturers misrepresented the addictive nature of their products. They, along with national opioid distributors and national pharmacies, knew that they were shipping quantities of opioids around the country so enormous that they could not possibly all be for legitimate medical purposes, but they failed to take basic steps to ensure that those drugs were going only to legitimate patients,” Attorney General Denn said. “These companies ignored red flags that opioids were being diverted from legitimate channels of distribution and use to illicit channels. The failure of these corporate defendants to meet their legal obligations has had a devastating impact on Delawareans.”

Delaware’s lawsuit cites statistics showing that, each year, more than 50 opioid pills are shipped into Delaware for every man, woman, and child in the state. When limited to persons – including those who received prescriptions for a week or less following minor medical procedures – who actually have used opioids, the estimated number is 440 pills per person per year.

The manufacturer defendants named in Delaware’s lawsuit are Purdue Pharma and Endo Pharmaceuticals. The distributor defendants named in the lawsuit are McKesson, Cardinal Health, Amerisource Bergen, Anda Pharmaceuticals, and H.D. Smith. The retailer defendants named in the lawsuit are CVS and Walgreens. Other defendants may be named in the future.

“The filing of this suit is an important step in what will likely be complex and time-intensive litigation against sophisticated national corporations,” Attorney General Denn said. “But these defendants must be held accountable for the damage that they have caused to our state and its citizens.”

The lawsuit, filed in Delaware Superior Court’s Complex Commercial Litigation Division, can be found here.