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Home My WebLink About12/17/2024 03.D. Discussion with community service providers relating to opioid epidemicItem No. 3.D. For Meeting of: December 17, 2024 ITEM TITLE:Discussion with community service providers relating to opioid epidemic SUBMITTED BY:Sara Watkins, City Attorney BUSINESS OF THE CITY COUNCIL YAKIMA, WASHINGTON AGENDA STATEMENT SUMMARY EXPLANATION: At a prior City Council meeting, the City Council requested a second roundtable discussion regarding the services available in the community from community service providers working with people with opioid use disorder/substance use disorder. Agenda: 1. A brief summary of the services provided by your organizations or your interest in how the community addresses opioid use disorder. (15 minutes) 2. Dr. Caleb Banta-Green and Mandy Owens to talk about their work at UW Addictions. (15 minutes) 3. What are you seeing that is new from the last year (or approximately the last time you spoke in front of City Council if you were at the previous roundtable). 4. Is there new funding or resources that have come available in the last year? 5. Have you been subject to new restrictions and how has that affected your ability to serve the community suffering from opioid use disorder? Time permitting, a discussion of the current gaps in service, or areas where services need to expand to meet demand. Participants: Dr. Gillian Zuckerman, Comprehensive Healthcare Dr. Jocelyn Pedrosa and Annette Rodriguez, YNHS Cassidy Leslie, Triumph Treatment Melissa Sixberry, Yakima Health District Lisa Davisson and Katherine Saluskin, Yakama Nation Megan Tweedy, Community Leader Dr. Caleb Banta-Green and Mandy Owens, PhD, University of Washington Addictions, Drug & Alcohol Institute ITEM BUDGETED: STRATEGIC PRIORITY 24-25: A Safe and Healthy Yakima RECOMMENDATION: ATTACHMENTS: 99 Distributed at Meeting: LL.2__Item#� Addressing Opioid Use Disorder at YNHS December 17,2024 1 Our OUD Population 11/1/2023-10/31/2024 • 45.7% unhoused • 460 patients seen in with OUD • Of unhoused,47.6%are living • 55%between ages 25-44 years old on the street • 11%are in Permanent • 53%assigned male at birth Supportive Housing • Race: 84.3%White • Ethnicity: 70.4% Non-Hispanic or Latino Our OUD population looks very similar this year as it had last year. 11/2023 stats: 455 patients seen in 2023 with OUD 58% between ages 25-44 years old 58% assigned male at birth Race: 85.5%White Ethnicity: 73.6% Non-Hispanic or Latino 41 .5% unhoused Of unhoused, 46.5% are living on the street 14% are in Permanent Supportive Housing 2 2024 OUD Diagnosis (patients may be included in more than one category) ■'MH6M;,..... �82.A4°k ■Farm rYNNSM000 26.6^n ■Met tuE ore 0ae wane. ■MOUD flaawn crr 60,1.1 •h in e 62.16' In 2024 we saw 365 patients with a diagnosis of OUD. Most are receiving treatment for their OUD, either at our organization or elsewhere. Our goal is to engage w/those not receiving treatment, and re-engage those who may have interrupted treatment. 3 Total Sum of 8 of Pts U Narcan given Narcan Doses 2022 1 1 Qtr2 1 1 2023 12 23 We're Qtrl 1 1 Qtr2 7 15 Responding Qtr3 2 5 to More Qtr4 2 2 2024 18 39 Overdoses Qtrl 2 6 Qtr2 5 9 Qtr3 1 2 Qtr4 10 22 Number of naloxone doses by incident report. We've been alerted to individuals found unresponsive around our sites,and have resuscitated overdosed individuals with the opioid reversal agent, naloxone (brand name Narcan). 4 Naloxone Prescriptions ae . We've been trying to increase efforts to get naloxone in the hands of patients or their loved ones. 5 Access to MOUD DEDICATED APPOINTMENT INTAKE CONDUCTED BY DEDICATED YNHS PHONE PARTNERSHIP WI YNHS NEWPARTNEPSHIP'MTH SLOTS FOR MOUD SUBSTANCE USE EXTENSION FOR NON- OUTREACH,HOUSING, SCALA-NW DISORDER PROFESSIONAL URGENT MESSAGES AND MEDICAL RESPITE On any given week we have about 140 appointment slots among 10 medical providers earmarked for MOUD appointments. Our SUDP can start applying their skills from the very beginning The dedicated phone line eliminates barriers to receiving help for non-urgent needs A roof over your head provides comfort during the difficult stages of induction/withdrawal SCALA-NW is a program from the WA State Healthcare Authority that helps hospitals and Eds initiate treatment for OUD and connects patients to follow up primary care We now have an Internal Medicine physician at NC w/special training and expertise in treating substance use disorders and HIV YNHS is also a naloxone distributor 6 Whole Person Care Focus on Efforts to Treat Hepatitis C As we met these individuals , the impact of providing whole person care became very apparent. Substance use disorders, infectious disease , and mental health disorders often go hand-in-hand, and all are public health issues that need to be addressed. Most patients in the US and Europe acquired hepatitis C through IV drug use or blood transmission. In the US IV drug use w/ needles or paraphernalia contaminated w/ HCV is the most commonly identified source of acute hep C infection Other modes of transmission: organ transplantation, using contaminated equipment for procedures, other pokes/piercings, sexual transmission, perinatal . You don't have to be using drugs to get hep c. Hepatitis C Patients Initiating Hep C Cure Rate Treatment by Year 26 21,27% 18 ■:: 18 ■`.:;':: 14 57,73% 8 2022 78 patients have initiated treatment for hepatitis C at YNHS. Of those, 73% have been cured. 8 Hep C cured and SUD status 23,40% ■ 34,60% Most of the patients cured of Hep C have substance use disorders 9 Hep C cured and SUD status 13,23% 21,37% ■>_... • 23,40% Among these patients, 23% are in SUD remission 10 c7 3 0 ri:: :.: 41 - Of the 57 cured, 41 are housed, 6 are in Permanent Supportive Housing,4 are on the Street, 3 are in Shelters, 2 are Doubling Up, and 1 is in Public Housing 11 Hepatitis C 25 MOUO Teaimer et INNS 11 MOUO treatment EUewNna 5 41 patients initiated Hep C treatment at YNHS in 2023-2024. Of those, 25 (61%) have a SUD Dx. 11 of those have been involved with MOUD Tx at YNHS and an additional 5 have received MOUD Tx elsewhere 12 Distributed at Meeting: Continuum of Care for Opioid Misuse Di Di Prevent Treat Opioid use disorder Improve function & inappropriate Reduce morbidity & mortality initiation of Manage pain & opioids Overdose opioids safely Infectious disease Populations Populations Populations General public Substance use disorder (i.e. Addiction) Substance use disorder (i.e. Addiction) Prescribers Pain Pain Patients People who use opioids/Family/Friends/Social networks Youth Interventions Police/Fire/EMS Medications for opioid use disorder Interventions Psycho-social/counseling Interventions Supply reduction Behavioral/Contingency management Medications for opioid use disorder Law enforcement Social/recovery support/AA-NA Health care/Pain management Prescribing practices Health care/Pain management HIV/HCV treatment meds Pain management practices Complementary health Housing/Supportive housing Lock boxes Housing/Supportive housing Overdose education & Naloxone Rx disposal Harm reduction/safer use supplies/education & counseling Prescription Monitoring Settings Medical Settings Demand reduction • Clinic Medical Education • Hospital/ED • Clinic • Health beliefs • Pharmacy • Hospital/ED • Medication beliefs Community agencies • Pharmacy • Pain/Stress coping • Public health Community agencies • Social services • Public health Settings • Homeless services • Social services Medical care/Pharmacy • Supportive housing • Homeless services Schools • Harm reduction program • Supportive housing Homes Drug treatment programs • Harm reduction program Social media Drug court Drug treatment programs Jail / Prison Drug court Community- First responders Jail / Prison Community- First responders „e.4 I� IDA' � UNIVERSITY of WASHINGTON Developed by https://adai.uw.edu/cedeer/contact Caleb Banta-Green calebbg(ciluw.edu updated 12/16/2024 ADDICTIONS.DRUG 8 Srhool of Medicine ' .3,- A,CONOI INStIiUiF What's next? Your preferences About OUD fart* p Learn more about OUD Setting: What is opioid use disorder? and how to use this brochure: Dosing frequency: Opioid use disorder(OUD) is a medical learnabouttreatment.or •• 9 condition. People with the condition are 7 1 1), 41.- Clinic visit frequency: physically dependent on opioids and have '....,•••....... r' brain changes that affect their thinking, Connect to medication Counseling: priorities,and relationships.. 1 options near you: "'�,, warecoveryhelpline.org Support group: OUD can come back if not treated properly. You may need to try more than one type of I Medication options: treatment to find what works best for you. Medications are one option for treating OUD.Counseling and/or social supports can also be beneficial.The information here �t Other: >-can help you make a decision that's right for you. '° What can medications do for me? .- • Find naloxone and overdose info: stopoverdose.org Medications are proven to work the best at treating opioid use disorder. 4 More info on medications: samhsa.gov/medication-assisted-treatment They help:p • Manage craving and withdrawal. • Reduce illicit opioid use. Pij ADAI CENTERRUG EDUCATOR ION, COMMUNITY-ENGAGED Call the Washington RecoveryHelpLine to talk • Decrease the risk of havingan overdose. I'S'l e d I C a t i o n S DRUG EDUCATION,EPIDEMIOLOGY, 9 ADDICTIONS,DRUG& AND RESEARCH ALCOHOL INSTITUTE about your options for medications,counseling and support groups,and connect to care. Medications can provide stability, allowing W UNIVERSITY of WASHINGTON people to address other things in their lives. for r PSYCHIATRY&BEHAVIORAL SCIENCES e f0nt School of Medicine Recovery Help Line Opioid Use This brochure provides basic information for educational24-Hour Help for Substance Abuse,Problem Gambling&Mental HealthYou can be in recovery purposes.Speak with a health care professional to make 1.866.789.1511 and be on medications D i so rd e r an informed decision that best fits your needs including learning the risks and benefits of all treatment options. warecoveryhelpline.org at the same time. Revised November 2023. Treatment options Methadone Buprenorphine Naltrexone How does this medication work? • Methadone is a full opioid medication. • Buprenorphine is a partial opioid • Naltrexone is an opioid blocker. medication. • The more you take the more you will • It is not an opioid,so you won't feel an } ' I feel its effects. • Has a ceiling effect,so above a certain opioid effect. �, f dose you stop feeling more of its '4 (r •• Manages cravings and withdrawal by effects. • Helps manage cravings for some binding to opioid receptors. people. • Manages cravings and withdrawal by binding to opioid receptors. There are three places where you can get medications for opioid use disorder: Does it lower my risk of dying? Based on research that tracked outcomes in the real world. • Lowers risk of death by about 50%. • Lowers risk of death by about 50%. • Has not been shown to lower the risk of death. • Methadone, buprenorphine, or naltrexone available. How long does it last, and how do I take it? • Highly structured—counseling and • Lasts about 24 hours and is taken by • Oral form lasts about 24 hours, • An injection that lasts for 28 days. supervised dosing may be required. mouth. injectable form lasts up to 28 days. You can't use any opioids for 7-10 days before taking naltrexone. 4, • Buprenorphine or naltrexone available. Where can I get it, and how often do I need to go? • Familiar medical office setting. • Once started,ongoing dispensing is • Prescribed by a medical provider and • Prescribed and given by a medical • Less structure(often weekly or monthly provided only at an opioid treatment picked up at a pharmacy(oral)or provider,or provided at an opioid visits,some don't require counseling). program. given at an appointment(injection). treatment program. Both are available at some opioid • Appointment often needed. • Dosing can start up to 6 days a week, treatment programs. • Visits vary from weekly to monthly. but usually becomes less often over Community program time. • Visits vary from near daily to monthly. • Buprenorphine or naltrexone available. Will I need to go to counseling? • Other services may be offered (syringe exchange, housing supports,etc.). • Requires regular urine drug testing and • Most providers require urine drug • Some providers require urine drug • May have drop-in visits. counseling, testing and some require counseling. testing and counseling.