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Opioid painkiller prescribing rates have decreased since 2012, while benzodiazepine-prescribing rates have remained steady in Nevada. Nevada counties with the highest prescription rates for both opioid painkillers and benzodiazepines are Mineral, Nye, and Storey counties.

Death rates are highest among whites and individuals between the ages of 45-64 and lowest among Asian/Pacific Islander and Hispanic/Latino individuals. Death trends differed by type of opioid. Heroin deaths increased from 2010-2015, then remained stable from 2015-2016.

On the other hand, deaths caused by synthetic opioids (including those caused by drugs such as fentanyl) increased from 2015-2016. However, methadone overdose deaths decreased from 2010-2016.

The Prescription Drug Crisis In Nevada

The opioid crisis is impacting the entire country. Since 1999, the amount of prescription opioids dispensed in the United States and the number of overdose deaths involving opioids have both quadrupled (per the CDC).

In 2016, Nevada ranked 13th in opioid painkiller prescribing rates, at 80.7 per 100 residents, compared to a national average of 66.5. this is according to data released by the CDC - the Centers for Disease Control and Prevention.

Heroin seizures in Nevada more than doubled from 2014 to 2015 (Nevada HIDTA, 2016). Neonatal exposure to substances has increased each year since 2012 (per the Nevada Division of Child &Family Services, 2017).

Based on data from the Nevada PMP, the opioid painkiller prescribing rate has decreased since its highest point in 2012. CDC estimates show opioid prescribing rates in Nevada continuing to decline. The two sources use different definitions of opioids and population. The CDC rates are estimates based on a sample of pharmacies.

Opioid prescribing rates are highest in Mineral County (158.1), followed by Nye County (155.6), Storey County (146.9), and Lyon County (129.9). Nine counties have prescribing rates higher than the state prescribing rate (87.4) and 14counties are higher than the U.S. prescribing rate (66.5).

Esmeralda County and Pershing County saw a decrease in opioid prescribing rates of 18% and 17%, respectively, from 2015 to 2016. The counties with the largest increase in percent change in prescribing rates from 2015 to 2016 are: Lincoln (40%), White Pine (22%), Mineral (17%) and Eureka (14%) counties. All prescriptions are reported by county where the patients live. This may be different than the county where the prescription was written.

The Benzodiazepine prescribing rate is highest in Nye County (65.6), Storey County (60.7), and Mineral County (55.9) — each significantly higher than the state prescribing rate of 38.8.

The prescription rate of Benzodiazepine in Pershing County decreased by 20% from 2015 to 2016. Conversely, the prescribing rates percent change increased by 46% in Lincoln County, 21% in Mineral County,and 14% in White Pine County from 2015 to 2016.

In 2017, Nevada providers wrote 73.0 opioid prescriptions for every 100 persons, compared to the average U.S. rate of 58.7 prescriptions. This is the lowest rate in the state since 2006 when data became available (per the CDC).

The age-adjusted rate of deaths involving opioid prescriptions has been decreasing since 2010, dropping from an age-adjusted rate per 100,000 persons of 13.3 that year to 8.7 in 2017.

The opioid-related overdose rate in Nevada has been lower than the U.S.rate for the past four years. There has seen a 22% decrease in overdose-related deaths since 2011 and a 6% decrease in overdose-related deaths since 2015.

In 2017, there were 412 overdose deaths involving opioids in Nevada — an age-adjusted rate of 13.3 deaths per 100,000 persons, dropping below the national rate —currently 14.6 — for the first time since at least 1999. Since 2012, heroin-involved deaths more than doubled, from 45 to 94.

Prescription opioid deaths on the other hand peaked in 2010, at 369, and have been declining steadily since. Still, the highest number of deaths in 2017, 276, involved prescription opioids. Synthetic opioid other than methadone (predominantly Fentanyl) were involved in 66 overdose deaths in 2017.

NAS or neonatal opioid withdrawal syndrome (NOWS) may occur when a pregnant woman uses drugs such as opioids during pregnancy. A recent national study revealed a fivefold increase in the incidence of NAS/NOWS between 2004 and 2014, from 1.5 cases per 1,000 hospital births to 8.0 cases per 1,000 hospital births. This is the equivalent of one baby born with symptoms of NAS/NOWS every 15 minutes in the United States.

Cases of NAS/NOWS in Nevada have increased from 145 in 2011 to 293 in 2017- a rate per 1,000 hospital births of 4.1 to 8.3, respectively (per the Nevada Substance Abuse Prevention and Treatment Agency).

Of the new HIV cases in 2015, 525 occurred in Nevada. Among males, 10.9 percent of new HIV cases were attributed to opioid abuse or male-to-male contact and opioid abuse. Among females, 15.3 percent of new cases were attributed to opioid abuse and prescription opioid abuse.

In 2015, an estimated 8,906 persons were living with a diagnosed HIV infection in Nevada — a rate of 371 cases per 100,000 persons. Of those, 15.5 percent of male cases were attributed to opioid abuse or male-to-male contact and opioid abuse. Among females, 21.8 percent were living with HIV attributed to opioid abuse and prescription opioid abuse.

In 2016, there were 16 reported cases of acute HCV in Nevada (0.5 cases per 100,000) (per the CDC). In Nevada, there are an estimated 22,200 persons living with Hepatitis C (2013-2016 annual average), a rate of 1,020 cases per 100,000 persons.

Addiction Treatment In Nevada

The great news is that there are numerous centers of treatment and rehab. There are many types of treatment centers such as long term addiction treatment facilities, short term drug abuse treatment, outpatient detoxification programs, outpatient substance abuse treatment services, inpatient drug abuse treatment and others.

There is a wide range of drug and alcohol rehab facilities available. They include individual psychotherapy, dialectical behavior therapy, couple/family therapy, trauma therapy, trauma-related counseling, cognitive/behavior therapy and others, to name a few. If you need rehab in Nevada, all you need to do is place a call to any of the available rehab centers.

CITATIONS

https://www.carnevaleassociates.com/our-work/emerging-drug-trends-prevention-issue-brief.html

https://www.dea.gov/resource-center/2016%20NDTA%20Summary.pdf#page=40&zoom=auto,-80,792

https://www.dea.gov/sites/default/files/2018-11/DIR-032-18%202018%20NDTA%20final%20low%20resolution.pdf

https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs

https://www.getsmartaboutdrugs.gov/news-statistics/emerging-drug-trends

https://www.ncbi.nlm.nih.gov/books/NBK234579/

https://www.shadac.org/publications/50-state-analysis-drug-overdose-trends-evolving-opioid-crisis-across-states

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