What's in the Newsletter

• Project Updates
• ONE Rx in the News
• North Dakota Opioid Stats
• Available Recordings

Project Updates

ONE Rx Growth
Upon completion of 1831 patient screenings, we summarized the service utilization according to our screening tool (below). The top graphic shows that ONE Rx pharmacists are taking action to provide services to those in greatest need of opioid use disorder or accidental overdose). The bottom graphic shows pharmacists being more restrained with those identified as in less need. This is great to see. It shows that the pharmacist's time is well spent, and those being provided services are those who need them most.

ONE Rx in the News

Press Release from 06/27/2019

This recent press release reports on the growth and success of ONE Rx, including our 2000th patient screening.
“ONE Rx adds another opportunity for systematic prevention,” said Michael Dulitz, Opioid Response Project Coordinator for Grand Forks Public Health. “Universal screening reduces stigma; ONE Rx empowers pharmacists to identify individuals at risk and select the necessary tools to help address that risk." To view the complete press release follow the link provided below. 
https://www.ndsu.edu/pharmacy/news/detail/38224/

North Dakota Opioid Stats

How many new cases of opioid use disorder are there each year? 
Assuming a prevalence for opioid use disorder (addiction) of 10.9% in the adult chronic pain population,^[1] and a duration of disease of 10 years, which is a low estimate based on the long-term experience of heroin users,^[2] the incidence of new cases of substance use disorder is 10.9 new cases per 1000 chronic pain patients per year. In other words, to reverse the current trends would require reducing the new cases of substance use disorder to fewer than 10.9 new cases per 1000 chronic pain patients per year.

How big is this challenge in North Dakota? 
The adult population in North Dakota is 633,360. Using an estimated chronic pain prevalence of 20.4%,^[3] and an OUD incidence among chronic pain patients of 10.9 per 1000, one can estimate approximately 1408 new cases of OUD per year in North Dakota (633,360*.204*.0109).

How many of these individuals began with prescription opioids? 
If 39% of those individuals began with prescription opioid use,^[4] then the goal to reverse the trend would be to prevent 549 (.39*1408) chronic pain patients per year in North Dakota from beginning an opioid use disorder with a prescription opioid.

What role might North Dakota pharmacists play in this? 
The goal of ONE Rx is to reduce the prevalence of opioid use disorder and opioid overdose in North Dakota over the long-term by preventing the start of new cases. This is primary prevention. Every pharmacist in the state is in a position to help some of these estimated 549 people to avoid beginning down a pathway of opioid use disorder. ONE Rx is designed to identify individuals who may be among this high risk group, and provide needed interventions for them. Let’s join together and bring this number down.

1. Vowles KE, McEntee ML, Julnes PS et al. Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain. 2015;156(4):569-76.

2. Hser Y-I, Hoffman V, Grella CE et al. A 33-Year Follow-up of Narcotics Addicts. JAMA Psychiatry. 2001;58(5):503-08.

3. Dahlhamer J, Lucas J, Zelaya C et al. Prevalence of chronic pain and high-impact chronic pain among adults -- United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;671001-06.

4. Peavy KM, Banta-Green CJ, Kingston S et al. “Hooked on” Prescription-Type Opiates Prior to Using Heroin: Results from a Survey of Syringe Exchange Clients. Journal of Psychoactive Drugs. 2012;44(3):259-65.

Available Recordings