Opioid Overdose Summit

University of Michigan Injury Center Opioid Overdose Summit

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December 1, 2015
Location: 
Palmer Commons, University of Michigan
100 Washtenaw Ave.
Ann Arbor , MI 48109
United States
Contact: 
Tina Creguer
734-647-7635

Thanks to those who joined us for a day of science-based exploration and learning on an emerging public health issue: overdose injury and death related to opioids (prescription pain medications).  Hundreds of researchers, clinicians, public health practitioners, policymakers, students, and members of the media enjoyed the day.  

WEBCAST ARCHIVE NOW AVAILABLE ON OUR YOUTUBE CHANNEL.  And links to individual presentation videos appear within the agenda below.  Scroll through the agenda to navigate to specific presentaitons.  PRESENTATION SLIDES NOW AVAILABLE ON OUR SLIDESHARE PAGE.  Links to event resources will be available soon.  

For an integrated experience of social media, video, relevant articles, and more, explore the STORIFY SUMMARY of this event.

Email us at UMInjuryCenter@umich.edu if you have questions. 

 

Agenda at a Glance

At-A-Glance Agenda PDF: 
Tuesday, December 1st, 2015 - 8:15am - 8:45am
Registration & Continental Breakfast
Tuesday, December 1st, 2015 - 8:45am - 9:00am
Welcome & Opening Remarks
Rebecca Cunningham, MD, University of Michigan
Jeffrey S. Desmond, MD, University of Michigan Health System
Session Video: 
https://youtu.be/5CQe_xs0YEY; https://www.youtube.com/watch?v=Vl1V-PsXcQc
Tuesday, December 1st, 2015 - 9:00am - 9:45am
Epidemiology and the Scope of the Problem
Grant Baldwin, PhD, MPH, Centers for Disease Control and Prevention
Session Video: 
https://youtu.be/Du0gwguESTU
Tuesday, December 1st, 2015 - 9:45am - 10:15am
Non-Medical Use and "Medical Misuse" of Opioids during Adolescence
Carol J. Boyd, PhD, MSN, University of Michigan School of Nursing
Session Video: 
https://youtu.be/LFHZJc77NzM
Tuesday, December 1st, 2015 - 10:15am - 10:30am
Break
Tuesday, December 1st, 2015 - 10:30am - 12:00pm
Clinical Practice Improvements
Michael Von Korff, ScD, Group Health Research Institute
Erin Krebs, MD, MPH, VA CCDOR and University of Minnesota
Mark Ilgen, PhD, University of Michigan
Session Video: 
https://youtu.be/ksZSYSTCITI; https://youtu.be/vjRzrNPBFho; https://youtu.be/sK6KSaC6QmQ
Tuesday, December 1st, 2015 - 12:00pm - 12:35pm
Lunch & Networking
Tuesday, December 1st, 2015 - 12:35pm - 1:20pm
Poster Session
Tuesday, December 1st, 2015 - 1:20pm - 2:20pm
Surveillance and Policy Responses
Tara Gomes, MHSc, University of Toronto
Christina Porucznik, PhD, University of Utah
Session Video: 
https://youtu.be/PFzwFTw_388; https://youtu.be/rMzsadCYMyc
Tuesday, December 1st, 2015 - 2:20pm - 3:20pm
Prevention of Overdose Mortality
Amy Bohnert, PhD, MHS, University of Michigan
Phillip Coffin, MD, MIA, San Francisco Department of Public Health
Session Video: 
https://youtu.be/9xxOtFdS8oc; https://youtu.be/HT25BMWBx7A
Tuesday, December 1st, 2015 - 3:20pm - 3:35pm
Break
Tuesday, December 1st, 2015 - 3:35pm - 4:30pm
Panel Discussion - Unresolved Issues and Future Directions
Grant Baldwin, PhD, MPH, Centers for Disease Control and Prevention
Aaron White, PhD, NIAAA
Jack B. Stein, PhD, MSW, NIDA
Session Video: 
https://www.youtube.com/watch?v=Wxj-mtla4m4; https://youtu.be/A3dXchRB_pA; https://youtu.be/30l_RyxztfM; https://youtu.be/ajEoFpPuw7U
Tuesday, December 1st, 2015 - 4:30pm - 4:45pm
Closing Remarks
Rebecca Cunningham, MD, University of Michigan
Session Video: 
https://youtu.be/UaR7OFOB0Og

Poster Abstracts

Please note: abstracts are listed in the order shown in the table in the print program on pages 22 & 23.
The Michigan Preoperative Analgesic Assessment Tool

Authors: Paul Hilliard, MD and Aaron J. Przybysz, MD, PhD

Identifying patients prior to surgery who are at risk for uncontrollable post-operative pain and related complications from high daily opioid dosing is crucial for their perioperative management. Respiratory depression, opioid-induced hyperalgesia, uncontrolled pain, prolonged PACU stays, and unintended ICU admissions are all known complications of patients undergoing surgery on high-dose opioid therapy. Patients on greater than 100 mg PO morphine equivalents daily may be considered “high-risk” for these complications and may benefit from a pre-operative opioid taper. Identification of these patients in the clinic by the surgical team, potentially months prior to their surgery, is critical for successful perioperative management. The High-Dose Opioid Taper (HOT) Initiative at the University of Michigan aims to identify surgical candidates at risk for opioid-related complications and in cooperation with the patient’s opioid prescriber and the University of Michigan anesthesia and surgical teams intervene by educating the patient on the adverse effects of high-dose opioids, taper their opioid dosing, and initiate multimodal analgesia which may allow for successful optimization of their perioperative pain management and minimize complications associated with high daily opioid dosing.

Presenter: Aaron J. Przybysz, MD, PhD, Department of Anesthesiology, University of Michigan
Implementation of a First Responder Training Program for Opioid Overdose

Authors: Alan Janssen, DO and Ryan Kirby, MD

Purpose: The opioid crisis is widespread.  We set out to implement a program for non-medical responders to rapidly identify, and administer a reversal agent in an overdose victim.

Methods/Approach: We affiliated with a sheriff’s office that provides coverage to over a 907 square mile area in Michigan.  In January 2015 we implemented a 45 minute training program that reviewed signs, symptoms, and the physiology associated with an of opioid overdose.  The pharmacology and administration of an opioid reversal agent was also included in the program. At the conclusion of the program officers were evaluated on material presented.  This included a hands on portion that reviewed medication administration on simulated victims.

Results: From January 2015 through October 2015, a total of 89 Sheriff Deputies were trained.  This was a rolling training session based on reversal agent availability.  Due to the sensitive aspect of time to intervention in these cases; we noted the average time for emergent 911 calls to arrival to be 5:06 minutes.  Over this period overdoses were identified with successful intervention in 16 victims with positive outcomes.  No adverse events or deaths were identified. 

Conclusions: The initiation of an opioid overdose training program may be a successful adjunct to currently established pre-hospital resources in saving lives.  Additional rigorous scientific evaluation is needed.

Innovation and Significance: Further establishment of basic educational programs for first responders and the lay public may make a significant impact on overdose survival.   

Presenter: Alan Janssen, DO FAAEM, FACOEP-D, FACEP, Genesys Regional Medical Center
Outpatient Provider Contact Prior to Unintentional Opioid Overdose

Authors: Allison Lin, Amy Bohnert, Mark Ilgen, Paul Pfeiffer, Dara Ganoczy, Fred Blow

Statement of Purpose: Prescribed opioid medications are the most commonly implicated substances in unintentional overdoses.  Outpatient health care encounters represent a potential opportunity to intervene to reduce opioid overdose risk.  This study assessed the timing and type of outpatient provider contacts prior to overdose.

Methods: This study examined all adult patients nationally in the Veterans Health Administration (VHA) who died from unintentional prescription opioid overdose in fiscal years 2004-2007 and used VHA services anytime within two years of their deaths (n=1,813). For those whose last treatment contact was in an outpatient setting (n=1,457), demographic, clinical and treatment characteristics were compared among patients categorized by the location of their last contact.

Results: 33% (N=479) of those last seen in outpatient settings were seen within one week and 62% (N=910) within one month of their overdose. A substantial proportion of patients were last seen within one month of death in mental health or substance disorder outpatient settings (30% N=438). The majority of patients did not fill an opioid prescription on their last outpatient visit prior to unintentional opioid overdose.

Conclusions: The majority of patients who died by unintentional overdose on prescription opioids were seen within a month of their overdose in outpatient settings.

Innovation and significance: These settings may provide an opportunity to prevent patients from dying from prescription opioid overdoses, and interventions to reduce risk should not be limited to visits that resulted in an opioid prescription.

Presenter: Allison Lin, MD, University of Michigan
Operation Rx: A Systemic Approach To Opiate Misuse and Abuse

AuthorsAndrew Fortunato and Gregory Jakub

Since 2012, drug overdose deaths have increased in Macomb County resulting in 271 deaths in 2014 according to the Macomb County Medical Examiner’s Annual Report. Of those 271 deaths, 107 were attributed to heroin and 164 were, at least in part, attributed to prescription opioids or other narcotics. This is a public health crisis of epidemic proportions.

As a result of this alarming trend, Operation Rx is building a broad community partnership of anti-drug abuse stakeholders, i.e. law enforcement, social services, hospitals, schools, legal, government, and others. Our mission is saving lives by empowering individuals and communities to prevent prescription drug abuse, narcotic misuse and abuse.  

Operation Rx played a key role in equipping Macomb County Sheriff patrol cars with Narcan, a life-saving antidote for heroin and narcotic overdoses; since June 2015, more than 10 lives have been saved. 

Operation Rx also advocates protocols limiting quantities of narcotics prescribed by physicians and dentists. An Operation Rx video public service announcement was also created encouraging safe storage of unused medications. Fifteen sites have been established county-wide for the safe disposal of unused narcotics in a collaborative effort with Macomb County anti-drug coalitions.

Operation Rx aims to provide systemic change in practices surrounding prescription opioids and subsequent treatment of individuals suffering from substance use disorder. Operation Rx partners have developed a strategic plan addressing the following priorities: compiling reliable county-wide data and metrics for successful outcomes; increasing effective substance abuse prevention, treatment, and recovery programs; and advocating for legislation that supports abuse prevention and addiction recovery.

Presenter: Andrew Fortunato, Families Against Narcotics
Saving Lives through Overdose Rescue: Targeted Naloxone Distribution to Injection Drug Users

AuthorsCara Anne Poland, MD, M.Ed, Steve Aslum, BS

Statement of Purpose:  More people in the state of Michigan die of drug overdose than motor vehicle accidents.  Nationally, community based distribution of naloxone rescue kits has shown success in reducing fatality from opioid overdose, yet implementation in Michigan has been slow.  In Grand Rapids, The Red Project provides access to naloxone rescue kits - equipping community members with tools to prevent overdose deaths.

Methods/Approach:  In 2008, Red Project began distributing naloxone kits to injection drug users (IDU) through their programs that center on injection drug use.  Since the inception of naloxone programming at Red Project, over 2,000 kits have been distributed resulting in over 250 overdoses being reported reversed.

Results: One in every six (17%) naloxone rescue kits provided to the community through Red Project is reported as being used to successfully reverse an opioid overdose.

Conclusions: Naloxone distribution works to reduce deaths related to opiate use, thereby saving lives.

Innovation & Significance to the field: Naloxone distribution needs to be made universal.  The state of Michigan has supportive laws to protect providers and end-users.  Education of both the medical industry as well as laypeople is proven to save lives in both a medical model, like Project Lazarus, and a statewide distribution model, as in Massachusetts.  Community based naloxone distribution is supported by organizations including but not limited to ASAM, AMA, APHA, ONDCP, and SAMSHA.  It is imperative that providers reaching individuals at risk for overdose include access to naloxone in their service delivery.

Presenter: Cara Anne Poland, MD, M.Ed, Spectrum Health and Grand Rapids Red Project
Opioid Overdose Prevention Training Using Intranasal Naloxone for Law Enforcement and Laypersons

Authors: Chin Hwa (Gina) Dahlem, Lisa King, Jonathon Eric Waddell, Alice Penrose, Glynis Anderson

Purpose:  To describe opioid overdose training for Washtenaw County’s Sheriff’s deputies and laypersons in the use of intranasal naloxone. 

Methods: Instructional curriculum was developed and modified using materials from Massachusetts Department of Public Health.  Five separate trainings were conducted lasting between one and two hours for deputies (n=94) and community laypersons (n=22).  Training sessions included a didactic presentation using PowerPoint, videos, testimonies, and hands on practice time in assembling and administering intranasal naloxone.  Pre and post surveys were administered for evaluation. 

Results:  Two law enforcement officers used naloxone to reverse opioid overdoses within two weeks of training. 

Significance:  Training law enforcement officers who are often first responders to opioid overdoses in the use of intranasal naloxone is effective. Additional trainings are scheduled for other law enforcement departments and community organizations throughout Washtenaw county.  Training first responders and community laypersons in the use of intranasal naloxone has the potential to save many lives and give hope for recovery to those affected by drug addiction. 

Presenter: Gina Dahlem, PhD, FNP-C, University of Michigan School of Nursing
Perceived Severity of and Susceptibility to Overdose among Injection Drug Users: Relationships with Overdose History

AuthorsErin E. Bonar & Amy S.B. Bohnert

Background: Overdose is relatively common among injection drug users (IDUs) yet little is known about how overdose-related health beliefs influence overdose experiences or risk reduction.

Objectives: This study examines the association of perceived susceptibility to and perceived severity of non-fatal overdose with overdose history among IDUs attending needle exchange programs (NEPs) to inform prevention efforts.

Methods: In 2009-2010, IDUs (N = 91) attending NEPs completed self-report surveys. Negative binomial regression modeled the association between demographics, age of injection initiation, length of time attending the NEP, perceived severity of overdose, and perceived susceptibility to overdose with lifetime history of non-fatal overdose.

Results: Over half (55%) of participants reported lifetime overdose, with a mean of 2.9 overdoses. A multivariable negative binomial regression model revealed that younger current age, older age of first injection, non-Caucasian race, higher perceived severity of overdose, and lower perceived susceptibility to overdose were significantly correlated with fewer lifetime overdoses.

Conclusions: Although our methodology precludes causal inferences, these findings are consistent with the hypothesis that perceived severity and perceived susceptibility are among several factors associated with IDUs’ use of protective behaviors, which could influence the likelihood of overdose. Future prospective research to explore the impact of this and other health beliefs on risk behaviors and overdose could help improve the effectiveness of behavioral interventions.

Presenter: Erin Bonar, PhD, University of Michigan
Descriptive Characteristics of Patients Prescribed Opioids for the Treatment of Chronic Pain

Authors: Jenna Goesling, PhD, Stephanie Moser, PhD, Natalie Galau, BS, Afton Hassett, PsyD, Chad Brummett

Statement of Purpose: There is little empirical evidence supporting the use of long-term opioid therapy for chronic pain. One of the challenges faced by physicians is determining what to do with patients started on opioids for therapeutic use (i.e. pain relief) but who continue to use opioids when benefit is not apparent. The goal of this study was to describe the unique characteristics of chronic pain patients taking opioids.

Methods: This study included 150 new patients seeking treatment for chronic pain at an outpatient pain clinic. A research assistant approached eligible patients and completed a structured interview.  Patients reporting current opioid use rated the helpfulness of opioids across multiple domains, motivation to continue opioids, and interest in learning alternative ways to manage pain. The Prescribed Opioids Difficulties Scale was also administered. Patients completed self-report measures of pain severity, functioning and psychiatric symptoms. Chi-square and t-tests were conducted.

Results: Of the 150 patients, 55.26% (N=84) reported current opioid use. Current opioid use was associated with a worse clinical phenotype, including higher pain severity, worse functioning, and more symptoms of depression. 41% of patients reported less than an hour of pain relief after taking opioids.  Additionally patients reported low confidence in their ability to manage pain without opioids.

Conclusion: These data question the benefits of long term opioid use and highlight important target areas for developing interventions for helping patients not benefiting from opioids taper off opioids. Importantly, the majority of patients reported interest in learning alternative strategies for managing their pain.

Presenter: Jenna Goesling, PhD, University of Michigan, Department of Anesthesiology
Extra-medical Prescription Drug Use Among Adolescents in the Emergency Department: Alcohol Misuse and Other Drugs

Authors: Jessica S. Roche MPH, Lauren K. Whiteside MD, Amy S. Bohnert PhD, Stephen T. Chermack  PhD, Frederic C. Blow PhD, Brenda M. Booth PhD, Rebecca M. Cunningham MD, Maureen A. Walton PhD MPH

Extra-medical prescription drug use is a growing problem among adolescent and young adult populations. This study examined factors, including alcohol misuse, associated with past year extra-medical prescription drug use defined as using prescription sedatives, stimulants or opioids to get high, taking them when they were prescribed to someone else or taking more than was prescribed among patients seeking care in an academic Emergency Department (ED).

Youth (14-20 years) presenting for care were approached to complete a computerized screening questionnaire regarding demographics, alcohol misuse (AUDIT-C > 3 ages 14-17; >4 ages 18-20), extra-medical prescription drug use, illicit drug use, and violence  over a 12 month period as part of a RCT.  Additionally, data regarding the ED visit, ED utilization and current medications were abstracted through chart review.  Logistic regression was used to predict past year extra-medical prescription drug use. 

Over the study time period, there were 2134 participants (86% response rate) of which 296 (13.9%) endorsed past year extra-medical prescription drug use.  Specifically, rates of past year extra-medical use was: 8.7% opioids, 5.4% sedatives, and 8.0% stimulants.  Significant overlap existed among classes, with over 40% using more than one class of medications.  In the multivariate analysis significant predictors of past year extra-medical prescription drug use included being Caucasian (OR 1.49, 95% CI 1.06-2.10), past year history of injury from fighting (OR 2.35, 95% CI 1.59-3.49), dating violence (OR 1.61, 95% CI 1.15-2.25), alcohol misuse (OR 2.72, 95% CI 1.98-3.72), marijuana use (OR 3.26, 95% CI 2.38-4.46), presenting to the ED for a medical (non-injury) complaint (OR 1.46, 95%CI 1.06-2.01), history of previous ED visit in the past year (OR1.41, 95%CI 1.04-1.90), and receipt of IV opiates during the ED visit (OR 1.59, 95%CI 1.08-2.34).

Approximately 1 in 7 adolescents or young adults seeking ED care endorsed extra-medical use of prescription drugs in the past year.  While opioids were the most common drug used, significant overlap was found in classes of extra-medical prescription drug use.  Given the association of alcohol misuse with extra-medical prescription drug use, future alcohol intervention studies should consider addressing extra-medical use of prescription drugs. 

Presenter: Jessica Roche, MPH, University of Michigan Injury Center
Self-Reported Overdose History of Adults in a Residential Drug Treatment Facility

Authors: L Thomas, L Zbizek, M Sanborn, N LaPlena, E Yeagley, A Kogowski, M Jannausch, A Bohnert

Statement of Purpose: Death due to unintentional poisoning is a growing public health concern in the U.S.. The number of drug-related poisoning deaths increased 173% among U.S. adults between 1999 and 2010, with overdose from prescription opioids accounting for much of this increase. The period after an addictions treatment episode is particularly high risk for overdose due to reduced tolerance and frequency of relapse.

Methods: A total of 527 individuals within a residential treatment facility were screened between October 2014 and July 2015. Participants were approached during downtime at the treatment facility and offered $5 in compensation for completing a screening survey; eligibility was based on being age 18 or older. Eligible and interested participants completed a questionnaire that collected information regarding substance use and overdose; we define overdose as “poisoning”, “nodding out”, or an “overdose” or “OD”.

Results: We will utilize this sample to explore the self-reported rates of overdose over participants’ lifetimes, as well as by substances used prior to treatment. Additionally, we will explore the relationship of opioids (both heroin and pain medication) and other substances leading to overdose. Within this, the timeline of onset of opioid use (e.g., heroin used prior to prescription or vice versa) will be examined in relation to overdose risk.

Conclusions and Significance to the field: Limitations include a relatively small, self-selected sample as well as the use of self-reported data. Nonetheless, this report will aid in designing crucial interventions tailored to reducing opioid misuse and death due to overdose.

Presenter: Laura Thomas, MPH, University of Michigan, Department of Psychiatry
Collaborative Care from the ED for Trauma Patients with Prescription Drug Misuse: A Feasibility Study

Authors: Lauren Whiteside MD, Doyanne Darnell PhD, Karlee Jackson, Dennis Donovan PhD, Doug Zatzick MD

Innovation & Significance:  Injured trauma patients in the ED may be a particularly important group to target for screening and intervention for prescription drug misuse (PDM).  Collaborative Care is a longitudinal model of care for patients with complex medical comorbidities and holds promise as an intervention strategy for patients in the ED with the complex comorbidity of PDM. 

Purpose: Determine the feasibility of a collaborative care intervention (RxCC) for injured trauma patients with self-report PDM.

Methods: Adult patients presenting to Harborview Medical Center in Seattle WA with an injury from 02/2015 to 09/2015 were screened for eligibility based on historical ICD-9 codes.  Eligible patients completed a screening assessment for PDM based on NIDA m-ASSIST for prescription opioids sedatives and stimulants and select questions from the COMM.  Participants with a positive screen for PDM completed a baseline assessment and were enrolled in the ‘Prescription Collaborative Care (RxCC)’ intervention.  Presented today are baseline characteristics and feasibility measures.

Results:  A total of 36 participants (56.2% of patients approached) had self-report PDM (33% female, 44.3 years old, 31% homeless/temporarily housed); 30 had reliable phone numbers and were enrolled.  All eligible participants that screened positive for PDM agreed to participate.  A total of 28 participants (93.3%) were engaged with the study team and completed the one month assessment.

Conclusions: Initiating a longitudinal collaborative care intervention for PDM from the ED is feasible and holds promise as an intervention strategy for this complex population.  Future directions include completing 3 and 6-month assessments and further intervention refinement.

Presenter: Lauren Whiteside, MD, MS, FACEP, University of Washington
Overdose Experiences Among Patients at an Urban Emergency Department

AuthorsLynn S. Massey, LMSW, Amy S.B. Bohnert, PhD, Maureen A. Walton, PhD, Mark A. Ilgen, PhD, Rebecca M. Cunningham, MD, Kristen L. Barry, PhD, Stephen Chermack, PhD, Frederic C. Blow, PhD

Aims: While it is known that emergency department (ED) patients have elevated levels of substance use, little research has examined their overdose history. The purpose of this study was to describe overdose experiences among ED patients and to examine substance use correlates of overdose history.

Methods: Patients waiting for care at an urban ED in Flint, Michigan were selected randomly to be approached between February 2011 and March 2013; 74% of those approached agreed to participate in a cross-sectional survey (n=4,575). Multivariable logistic regression was used to examine the association of patient characteristics with lifetime overdose history.

Results: 553 (12.1%) respondents reported one or more overdoses in their lifetime. In an adjusted model, past year non-medical prescription opioid use (odds ratio [OR] = 2.9, 95% Confidence Interval [CI]: 1.9-4.3), non-medical prescription sedative use (OR = 2.4, 95% CI: 1.5-3.8), cocaine use (OR = 2.4, 95% CI: 1.6-3.4), marijuana use (OR = 1.6, 95% CI: 1.3-2.0), and binge drinking on a monthly basis or more (OR = 2.3; 95% CI: 1.8-2.8) were independently associated with overdose history. In a separate adjusted model, use of any one drug compared to none was associated with an OR of 2.0 (95% CI: 1.6-2.5), two drugs compared to none was associated with an OR of 5.3 (95% CI: 3.6-7.6), three drugs compared to none was associated with an OR of 5.7 (95% CI: 3.1-10.6), and four or more drugs compared to none was associated with an OR of 16.9 (95% CI: 9.9-28.9).

Conclusions: A history of overdose is relatively common among ED patients. Individuals who use multiple drugs are more likely to have had an overdose. Given that prior overdose is the strongest predictor of future overdose, these findings can inform screening methods to identify ED patients at risk for future overdoses.

Presenter: Lynn Massey, LMSW, University of Michigan
Adolescents’ Future Orientation and Non-medical Use of Prescription Drugs

Authors: Rena M. Steiger, BA, Sarah A. Stoddard, PhD, and Jennifer M. Pierce, MA

Statement of Purpose: How adolescents think about their future (i.e., future orientation) impacts their risk-taking behavior. The purpose of the present analysis was to 1) explore the relationship between future orientation and the non-medical use of prescription drugs (NMUPD) and 2) determine what aspects of future orientation are most strongly associated with NMUPD.

Methods: Data were collected from a sample of 9th-12th grade students in a single Midwestern school. Logistic regression was used to examine the relationship between three aspects of future orientation (future time perspective [FTP], future expectations [FE], and perceived risk of prescription drug use to future goals [RG]) and NMUPD.  Two items assessed lifetime use of prescription medications (i.e., stimulants and painkillers) and were dichotomized (1= any lifetime use; 0= no use) for analysis. 

Results: Higher FE and RG were associated with lower likelihood of adolescent-reported stimulant use (N= 246; OR= 0.204, 95% CI: 0.075, 0.553; OR= 0.468, 95% CI: 0.262, 0.836, respectively). In contrast, only higher RG was associated with lower likelihood of adolescent-reported painkiller use (N= 236; OR= 0.435, 95% CI: 0.249, 0.760).

Conclusions: Results of this analysis suggest that possessing a higher future orientation is associated with lower likelihood of NMUPD use; furthermore, the differential impact of aspects of future orientation may depend on the type of NMUPD use.

Innovation and Significance to the Field: Adolescence is a critical time to curtail NMUPD. This analysis provides direction for future work which may identify novel places for prevention and intervention.

Presenter: Rena M. Steiger, BA, University of Michigan School of Nursing
Addressing Opioid Addiction and Overdose Deaths through the Washtenaw Health Initiative Opioid Project

Authors: Theresa R. F. Dreyer, MPH, Alice Penrose, MD, MPH, Marci Scalera, ACSW, LMSW, CAADC, Stephen Strobbe, PhD, RN, and Adreanne Waller, MPH

Statement of Purpose: To describe the work of the Washtenaw Health Initiative Opioid Project to reduce opioid  overdoses and deaths in Washtenaw County, Michigan.

Methods/Approach:  The Opioid Project was formed in 2013 with representatives from local health systems, safety net clinics, treatment providers, law enforcement, public health, and other community organizations.

Results: The Opioid Project implemented four initiatives from 2014 to 2015, with support from an existing opioid    surveillance system. In November 2014, members educated providers on safe prescribing with the Washtenaw   County Medical Society. In March 2015, members disseminated evidence-based guidelines to treatment providers, with ongoing compliance monitoring. Members formed an independent organization to reduce stigma for people in recovery and held a walk to increase awareness in Ann Arbor with 250 participants in May 2015. In summer 2015, members also worked with the Washtenaw County Sherriff’s Department to equip and train its deputies with naloxone, an overdose reversal drug, and deputies saved six lives within three months. To supplement these initiatives, the Opioid Project adopted the Project Lazarus model in August 2015, an evidence-based approach for counties to reduce overdose deaths, and held an event to educate 100 key stakeholders and develop new interventions. 

Conclusions: The Opioid Project harnesses existing community resources to reduce opioid overdoses and deaths by increasing access to naloxone and educating providers and the community.

Innovation & Significance to the field: The Opioid Project demonstrates how communities can come together to adopt evidence-based practices to address this epidemic.

Presenter: Theresa Dreyer, MPH, Center for Healthcare Research & Transformation
Oakland County Prescription Drug Abuse Partnership: Addressing Prescription Drug Abuse Through Increased Knowledge, System Change, and Environmental Assessment

AuthorsTrisha Zizumbo, Jennifer Kirby

Statement of Purpose: The Oakland County Prescription Drug Abuse Partnership (OCPDAP) was created in March 2015 by Oakland County Health Division to create a strategic approach for preventing and reducing prescription drug abuse. The partnership’s multi-disciplinary members include physicians, pharmacists, substance abuse treatment and prevention agencies, court judges, law enforcement, Drug Enforcement Agency, public health, academia, and grassroots organizations.

Methods/Approach: OCPDAP develops and implements strategies that educate medical providers, assess drug deaths, integrate systems, and increase awareness. In eight months, OCPDAP implemented a countywide awareness campaign, increased the medical community’s knowledge by providing Boston University’s evidence-based SCOPE of Pain Training, and initiated a Drug Death Review Committee with Oakland County’s Medical Examiner.

Results: The countywide awareness campaign on transit buses reached 308,000 residents. 130 healthcare professionals attended the Scope of Pain training with 83% stating intent to change practices regarding opioid prescribing. Prior to the training, the pre-test knowledge score was 63.25% but the post-test knowledge score raised to 90.94%. The Drug Death Review Committee is establishing processes for reviewing cases and recommending changes that reduce preventable drug abuse deaths.

Conclusions: SAMSHA recognizes coalitions as an evidence-based approach to effectively reduce substance use. OCPDAP is a prime example of a multi-faceted partnership that positively addresses prescription drug abuse through increased knowledge, system change, and environmental assessment. 

Innovation & Significance to the field: Efforts simultaneously targets both prevention and treatment approaches through the implementation of a large-scale awareness campaign, training of medical professionals, and creation of a drug death review committee.

Presenter: Trisha Zizumbo, BS, MSA, Oakland County Health Division

Attractions and Travel Information

Driving Directions to Palmer Commons

Directions from the NorthU.S. 23 South to Exit 45, M-14 West. Take Exit 3, 'Ann Arbor' (you will now be on Main Street). Take Main Street to Huron Street. Turn left (East) onto Huron Street. Proceed East on Huron Street. Huron street becomes Washtenaw Avenue. Turn right onto Palmer Drive (100 yards past Huron/Washtenaw curve). Parking structure has 2 entrances on left side of Palmer Drive: First is for UM faculty and staff, second is for visitors, UM faculty and staff (100 yards further on Palmer Drive).

Directions from the SouthU.S. 23 North to Exit 37B, Washtenaw Avenue West. Take Washtenaw Avenue West to Palmer Drive.Turn left onto Palmer Drive. 

Directions from the East from M-14: M-14 West to Exit 8, U.S. 23 South. Take U.S. 23 South to Exit 37B, Washtenaw Avenue West. Take Washtenaw Avenue West to Palmer Drive. Turn left onto Palmer Drive. 

Directions from the East from l-94I-94 West to Exit 180-B, U.S. 23 North. Take U.S. 23 North to Exit 37B, Washtenaw Avenue West. Take Washtenaw Avenue West to Palmer Drive. Turn left onto Palmer Drive.

Directions from the West from l-94I-94 East to Exit 180-B, U.S. 23 North. Take U.S. 23 North to Exit 37B, Washtenaw Avenue West. Take Washtenaw Avenue West to Palmer Drive. Turn left onto Palmer Drive.

Parking at Palmer Commons

The Palmer Drive Parking Structure is a U-M faculty-staff parking facility with 180 visitor parking spaces. It is adjacent to Palmer Commons at the intersection of Washtenaw Avenue and Palmer Drive. The Palmer Structure is managed by the U-M Parking and Transportation Services

Visitor Parking Palmer Drive Structure

From Washtenaw Avenue, turn on Palmer Drive, proceed approximately 100 yards to the 2nd parking entrance on your left that is marked "Visitor Parking".

  • Pull a ticket, (which is .70 per half-hour) and park on levels LL (lower level) and P1 (level 1).
  • Upon exiting your vehicle, look for large metal Maize and Blue signs that read "East Elevators."
  • Proceed towards the East Elevators (there are 3 sets of elevators in the structure: East, North and South) and follow the signs that list Palmer Commons .
  • In the elevator, push the PL Level (Plaza Level) and exit onto the outdoor plaza near the Life Science Institute entrance. Continue across the outdoor plaza to Palmer Commons.
Faculty/Staff/Permit Parking Palmer Drive Structure

From Washtenaw Avenue, turn on Palmer Drive, use 1st parking structure entrance on your left.

  • This entrance is designated for Blue/Gold/Permit Parking, primarily Faculty and Staff. It accommodates Blue, Gold and other permit parking pass holders. Access to this entrance is controlled by gates. An electronic AVI device or swipe card is required to use these areas.
  • Upon exiting your vehicle, look for large metal Maize and Blue signs that read "East Elevators."
  • Proceed towards the East Elevators (there are 3 sets of elevators in the structure: East, North and South) and follow the signs that list Palmer Commons .
  • In the elevator, push the PL Level (Plaza Level) and exit onto the outdoor plaza near the Life Science Institute entrance. Continue across the outdoor plaza to Palmer Commons.

Navigating Palmer Commons

Once in Palmer Commons, keep an eye out for our balloons and event signage. Locate the South or North elevators and take them up to the 4th floor. The registration table will be at the north end of the 4th floor atrium. 

Travel Information - Ann Arbor, MI

Click here to find information on accommodationsdiningtransportationthings to do, and events in Ann Arbor. 

Hotel Accommodations

Bell Tower Hotel www.belltowerhotel.com

A block of rooms has been reserved for attendees at a discounted rate of $173 per night at the Bell Tower Hotel. Please reference the UM Injury Center Opioid Overdose Summit when reserving your room and book by October 30th to secure this rate. 

The Dahlmann Campus Inn - www.campusinn.com

  • 615 E. Huron Street, Ann Arbor, MI 48104
  • 734-769-2200 or 800-666-8693
  • Click here to view map - (~ 9 minute walk to Palmer Commons)

To find additional hotel accommodations in Ann Arbor, click here

Transportation Information

Airport Transportation

Click here for a list of recommended limo or car services and a list of recommended taxis

Getting Around Ann Arbor

Click here to find a list of rental car agencies, taxi cab providers, Zipcar locations, limousine providers, and information on the public transit system.