Clallam County Opioid Surveillance Dashboard Version 4, Edition 1, January 2019

The purpose of this Dashboard is to share current, relevant data to inform practice decisions and interventions. The
Dashbaord will be updated quarterly with new indicators and new data as available. The contents are organized in four
sections: Adverse Outcomes, Treatment, Prescribing Practices, and Prevalence and Perceptions.
ADVERSE OUTCOMES

# Opioid Overdose Reports to Clallam County Public Health Available: 2016-

20 OMC ED, Forks ED and Clallam County
17 14 11 9 10 6 6 7 8 6 9 Coroner began reporting all opioid-
Heroin
related overdose events to CCHHS in
Total
2016 Q12016 Q22016 Q32016 Q42017 Q12017 Q22017 Q32017 Q42018 Q12018 Q22018 Q32018 Q4 December 2015. In 2018, the majority of
reports were via syringe exchange.
2016 2017 2018
By location of residence: 2016 : 2017. In 2018, location of residence was NOT collected. # overdose reports: 62 31 30
% of total overdoses, rate per 10,000 Heroin-involved: 69% 0% 0%
Unknown, 0%
Report source: Fatal overdose: 10% 23% 7%
100% WestEnd Where did overdoses occur?
14% : 32%
Syr Ex Port Angeles 63% 63% 73%
10 : 10 Central/PA
50%
Coroner per 10,000 66% : 55%
East/Sequim
Sequim 13% 13% 13%
ED 11 : 5 per 10,000
0% 16% : 13% West End 19% 19% 13%
2016 2017 2018 4 : 1 per 10,000
Unknown 0% 0% 0%
# Opioid Related Deaths (Clallam residents) Available: 2010-
Source: WA State Department of Health, Center for Health Statistics, Death Certificate data, Restricted access in CHAT. *DOH drug overdose dashboard.

16
Death data are as reported on the death
13 14
11 heroin certificate and from post-mortem toxicology
9 9 10 involved
7 results. WA State Dept. of Health releases
2 all
preliminary quarterly data; interpret with
opioids
caution.
2010 2011 2012 2013 2014 2015 2016 2017 2018*

By location of residence: 2015 2016 2017

2015 : 2016 : 2017 Unknown, 0% : 0%
Accidental overdose: 89% 69% 100%

West End Where did Clallam resident overdose

11% : 6% : 30% deaths occur (county):
Central/PA
44% : 50% : 50% Clallam County: 66% 75% 90%
East/Sequim
44% : 44% : 20% 2015: King 22%; Kitsap 11% 2017: King 10%

2016: King 6%; Pierce 6%; Snohomish 6%

# Opioid Overdose Hospitalizations (Clallam residents) Available: 2010-

Source: WA State Dept of Health, counts: Drug Overdose Quarterly Reporting dashboard; by residence: Inpatient hospitalization data are based
Comprehensive Hospital Abstract Reporting System, Restricted access in CHAT on discharge diagnoses (primary and
36 contributing causes) and include
24 27
19 22 Heroin overdoses. Residence data are not
18 15
11
available prior to 2016 due to transition
Any
opioid
from ICD-9 to ICD-10 reporting which
2010 2011 2012 2013 2014 2015 2016 2017 2018 changed code definitions enought that
they are not comparable historically.
2016-17 By location (zip code) of residence: 2018 data are not yet available.
% of total and rate per 10,000
residents
West End,
16%, 4.5 per
10,000
PA, 46%, 3.6
per 10,000 Sequim, 39%,
3.9 per 10,000

For more information, contact Dr. Allison Unthank, Health Officer, Clallam County Health and Human Services. aunthank@co.clallam.wa.us
 Clallam County Opioid Surveillance Dashboard Version 4, Edition 1, January 2019
TREATMENT
Medicaid beneficiaries: 2015 2016 2017 FY: 2018
Receiving buprenorphine 0 101 suppressed 235 Available: 2015-
Receiving methadone 0 13 suppressed suppressed Available: 2015-
% of indiviuals with opiate use disorder
who receive treatment (opiate use n/a n/a 36% Available: 2017-
disorder treatment penetration rate)
PRESCRIBING PRACTICES

Prescription Drug Monitoring Program: Online includes updates through Q2 2018 Available: 2012-
Source: WA State Department of Health, Clallam County residents. Available at:
https://www.doh.wa.gov/DataandStatisticalReports/HealthDataVisualization/OpioidPrescriptionsandDrugOverdosesCountyData

Patients with any opioid prescription 150.0 #individuals rateper1000 11,000

# of individuals
Adjusted rate per
1,000 population
100.0 10,000
50.0 9,000
0.0 8,000

2012Q1
2012Q2
2012Q3
2012Q4
2013Q1
2013Q2
2013Q3
2013Q4
2014Q1
2014Q2
2014Q3
2014Q4
2015Q1
2015Q2
2015Q3
2015Q4
2016Q1
2016Q2
2016Q3
2016Q4
Patients with chronic opioid prescriptions 4.0
#individuals rateper1000

# of individuals
Adjusted rate per
1,000 population

400
2.0
200

0.0 0
2012Q2
2012Q3
2012Q4
2013Q1
2013Q2
2013Q3
2013Q4
2014Q1
2014Q2
2014Q3
2014Q4
2015Q1
2015Q2
2015Q3
2015Q4
2016Q1
2016Q2
2016Q3
2016Q4
Patients with high-dose chronic opioid 40.0 2,000
#individuals rateper1000

# of individuals
Adjusted rate per
1,000 population

prescriptions
20.0 1,000
≥ 50 Morphine Miligram
Equivalents (MME) 0.0 0
2012Q1
2012Q2
2012Q3
2012Q4
2013Q1
2013Q2
2013Q3
2013Q4
2014Q1
2014Q2
2014Q3
2014Q4
2015Q1
2015Q2
2015Q3
2015Q4
2016Q1
2016Q2
2016Q3
2016Q4
20.0 2,000
#individuals rateper1000

# of individuals
1,000 population
Adjusted rate per

≥ 90 Morphine Miligram
10.0 1,000
Equivalents (MME)
0.0 0
2012Q1
2012Q2
2012Q3
2012Q4
2013Q1
2013Q2
2013Q3
2013Q4
2014Q1
2014Q2
2014Q3
2014Q4
2015Q1
2015Q2
2015Q3
2015Q4
2016Q1
2016Q2
2016Q3
2016Q4

Patients with concurrent opioid and 40.0

#individuals rateper1000
4,000
# of individuals
Adjusted rate per
1,000 population

sedative prescriptions
20.0 2,000

0.0 0
2012Q1
2012Q2
2012Q3
2012Q4
2013Q1
2013Q2
2013Q3
2013Q4
2014Q1
2014Q2
2014Q3
2014Q4
2015Q1
2015Q2
2015Q3
2015Q4
2016Q1
2016Q2
2016Q3
2016Q4

Patients with new opioid prescriptions 800.0 4,000

#individuals rateper1000
# of individuals
new rx patients
Rate per 1,000

with days supply above guideline 600.0

400.0 2,000
(4+ days)
200.0
0.0 0
2012Q1
2012Q2
2012Q3
2012Q4
2013Q1
2013Q2
2013Q3
2013Q4
2014Q1
2014Q2
2014Q3
2014Q4
2015Q1
2015Q2
2015Q3
2015Q4
2016Q1
2016Q2
2016Q3
2016Q4

For more information, contact Dr. Allison Unthank, Health Officer, Clallam County Health and Human Services. aunthank@co.clallam.wa.us
 Clallam County Opioid Surveillance Dashboard Version 4, Edition 1, January 2019
Patients with new chronic opioid 4.0
#individuals rateper1000

# of individuals
Adjusted Rate per
1,000 population
400
prescriptions
2.0
200

0.0 0

2012Q2
2012Q3
2012Q4
2013Q1
2013Q2
2013Q3
2013Q4
2014Q1
2014Q2
2014Q3
2014Q4
2015Q1
2015Q2
2015Q3
2015Q4
2016Q1
2016Q2
2016Q3
2016Q4
RISK REDUCTION

# syringes exchanged at Clallam County Health & Human Services 2012-

Source: Clallam County Health and Human Services
In fall 2018, CCHHS
400,000
expanded syringe
200,000 exchange into Forks.
0
*2018 is a projection.
2012 2013 2014 2015 2016 2017 2018*
PREVALENCE & PERCEPTIONS

% of Syringe Exchange Participant Health Survey respondents: 2015, 2017

Source: University of Washington Alcohol & Drug Abuse Institute, WA State responses
80% 80%
60% 60%
40%
40%
2015 2017 20%
Heroin reported as main drug 0%
2015 2017
Very or somewhat interested in getting help to reduce or quit Have had an opioid overdose in previous 12 months
opioid use Have witnessed an opioid overdose in previous 12 months
Heroin users who report having been 'hooked on' prescription-
type opiates before heroin Opioid users owning naloxone kit (excluding King County)

% of 10th grade Healthy Youth Survey respondents: Even years only

Source: WA State Healthy Youth Survey, Clallam County responses

100% 10%
75%
5%
50%
2012 2014 2016 0%
parents feel it's wrong or very wrong to use prescription drugs 2012 2014 2016
not prescribed to you used a pain killer to get high in the past 30 days
friends feel it's wrong or very wrong to use prescription drugs
not prescribed to you used prescription drugs not prescribed to you in past 30 days
great risk of harm from using prescription drugs not prescribed
ever used heroin
to you

For more information, contact Dr. Allison Unthank, Health Officer, Clallam County Health and Human Services. aunthank@co.clallam.wa.us