Community Partnership On Drug Abuse

1
Community PartnershipOn Drug Abuse

• March 2006

2
Purpose
To work collaboratively to address the harmful
impact of the abuse of drugs in the community,
with an initial focus on prescription opiates,
using interventions based on evidence and
research.
3
Member Partners

• Cape Breton District Health Authority
• Cape Breton Regional Police Services
• Cape Breton University
• Royal Canadian Mounted Police
• Cape Breton Victoria Regional School Board
• Nova Scotia Department of Justice
• Nova Scotia Department of Community Services
• Nova Scotia College of Pharmacy
• Nova Scotia Community College, Marconi

4
Community Partnership on Drug Abuse
Steering Committee

Working Group on Community Safety
Working Group on Education/ Prevention
Working Group on Treatment



5
Brief History

• March 2004 Initial Meeting
• April 2004 Steering Committee Formed
• May 2004 Formation of Working Groups
• June 2004 Interim Report Issued
• June 2005 Visioning Day
• August 2005 First Annual Report

6
Recommendation 1

• Prescription Monitoring Program duly constituted
  under provincial legislation with clear
  definitions and accountabilities

• Status completed
• Legislation passed Fall 2004
• Regulations finalized July 2005
• New Board appointed July 2005

7
Recommendation 2

• Existing prescription monitoring program be
  automated and include benzodiazepines

• Status
• Commitment to automate has been made by the
  Department of Health with a one year
  implementation to allow pharmacies to respond to
  requirements for automation
• No response yet on benzodiazepine inclusion

8
Recommendation 3

• Determine threshold levels for daily, monthly and
  annual use to recognize different nature of
  treatments offered to patients

• Status
• Recommendation dependent upon the implementation
  of the automated system
• Will be addressed once automated system is
  implemented

9
Recommendation 4

• Increase use of prescriber profiles to assure
  proper prescribing habits

• Status
• No response to this recommendation has been
  forthcoming at this point

10
Recommendation 5

• Health Canada, as part of the National Drug
  Strategy, will assess effectiveness of
  prescription monitoring programs and options
  available in other provinces to determine where
  higher rates of diversion occur

• Status
• Health Canada released report on prescribing
  patterns for oxycodone products in Atlantic
  Canada in August 2005
• Continued national monitoring will be required
  due to the ease of moving drugs across provincial
  borders

11
Recommendation 6

• Health Canada is requested to re-institute a
  system of random narcotic inspection to ensure
  compliance with legislation and proper control

• Status
• Health Canada has recently posted a position to
  fill this role in Atlantic Canada
• Position is expected to be filled by early 2006

12
Recommendation 7

• Continued support by health care professionals
  and governments for the creation of electronic
  health records

• Status
• Nova Scotia has made steady progress in
  implementing electronic health records with major
  investments in information systems
• First phase, establishing a hospital system, will
  be completed by March 2006
• Second phase for archiving radiology images has
  begun

13
Recommendation 8

• Legislative changes established so that
  pharmacies be required to report suspected cases
  of fraud with appropriate follow-up by policing
  agencies to decrease diversion of prescription
  medications from appropriate use

• Status
• On review, Partners identified that this
  recommendation should be expanded to include
  physicians and dentists
• No progress has been made to date

14
Recommendation 9

• All non-cancer/palliative care patients be
  required to sign a contract with their physician
  and pharmacy when Oxycontin is prescribed and
  that these contracts be registered and audited by
  the Prescription Monitoring Board

• Status
• Limited progress has been made
• Heightened awareness may have reduced the
  potential for diversion

15
Recommendation 10

• Legislative changes to clarify and support
  appropriate access to and sharing of information
  among regulatory bodies and law enforcement
  agencies

• Status
• With the enactment of the Prescription Monitoring
  Board legislation, this recommendation has been
  addressed

16
Recommendation 11

• Establishment of a local Methdone Mainenance
  Therapy Program to provide a cost effective,
  evidence based, comprehensive service to opiate
  dependent people who have been unsuccessful in
  withdrawal efforts in the past

• Status
• The Nova Scotia Department of Health funded the
  Cape Breton District Health Authority for a
  Methadone Maintenance Program in the 2004/05
  budget
• More than 85 people have been enrolled
• There remains a waiting list of close to 100
• Preliminary evaluations are positive

17
Evidence of Effectiveness

• Prescription Monitoring Board reported a 7
  decrease in Oxycodone in Cape Breton between 2003
  and 2004, while total milligrams prescribed
  elsewhere in Nova Scotia increased by 11 during
  this same time period
• Members report significant increase in knowledge,
  understanding and sharing

18
Strategic Directions 2005-06

• Identify emerging issues and products that could
  impact on drug use in Cape Breton
• Identify effective law enforcement approaches to
  enhance community safety, specifically targeting
  drug abuse
• Improve education opportunities for target groups
  on identification, impact and options on drug
  abuse
• Develop options on effective treatment approaches
  for adolescents and youth

19
Strategic Directions (contd)

• Involvement of youth is essential to success
• Develop effective prevention strategies targeting
  youth at risk
• Improve provider knowledge on effective measures
  to address chronic pain and review access to
  services in Cape Breton
• Identify best practice for suport and
  rehabilitation for Methadone Maintenance clients

20
Strategic Directions (contd)

• Develop a community profile and increase access
  to information on the Partnership
• Develop a public website and increase access to
  accurate information on drug abuse issues
• Continue to develop research capacity on
  addictions in Cape Breton and promote the use of
  evidence based practice solutions

21
Next Steps

• Public Awareness and Accountability
• Research Initiatives
• Engagement of Community
• Improved Treatment Options
• Improved Education and Prevention Initiatives
• Ideas/Suggestions?

22
Susan Plath, Coordinator

• [phone]
• Susan_plath_at_capebretonu.ca
• [phone] (fax)
• Cape Breton University, P.O. Box 5300, Sydney, NS
  B1P 6L2