The latest statistics show that the number of deaths in Nebraska attributed to opioid misuse has dropped, but officials say that ongoing ­work must be done to prevent more opioid misuse. Opioids include prescription pain relievers, heroin, and synthetic opioids such as fentanyl.

Officials from the U.S. Attorney’s Office, the Nebraska Attorney General’s Office, the Nebraska Department of Health and Human Services, and UNMC released a report today that outlines the progress the state has made on the issue of opioid misuse. The report stems from work that the coalition began at a summit in 2016. 

The report includes information about opioid prescribing rates, treatment, the prescription drug monitoring program, pain management guidelines, prescription drug take-back, public awareness about opioid misuse, overdose data, and emergency treatment with naloxone.

“The coalition’s collaboration has served to strengthen Nebraska as we address the opioid epidemic felt across the nation,” said Attorney General Doug Peterson, “This report shows important progress has been made in curbing opioid abuse in Nebraska. We will continue working together on methods best to prevent abuse.”

In 2017, 183 people in Nebraska died of a drug overdose, at least 59 were confirmed to have involved opioids. Nebraska’s drug overdose death rate in 2017 was 9.8 overdose deaths for every 100,000 people. In 2018, 154 people in Nebraska died of a drug overdose, at least 60 involved opioids. Nebraska’s drug overdose death rate was 8.2 overdose deaths for every 100,000 people in 2018.

Of the 154 overdose deaths in 2018, only 42.8% have “unspecified drug” listed on the death certificate. Since 2006 there has not been a year in which the unspecified drug rate has been lower than 54%.

UNMC Chancellor, Jeffrey P. Gold, M.D., said progress is being made at UNMC to proactively address the most appropriate use of prescription opioids and develop new programs to curb incidence of opioid misuse in Nebraska. “This is an issue that has a significant and long-lasting impact on the health of Nebraskans and their families,” Dr. Gold said.

“Since more than three years ago when 300 leaders gathered at UNMC for a summit, UNMC is continuing to educate more and more health care professionals so our citizens have access to the help they need. We also are sharing information, tracking and studying data so that we can make evidence-based decisions on how we can better serve our fellow Nebraskans. We thank our state legislators and Governor Ricketts, for passing and signing laws based upon evidence and best practices. This allows us to collect and share this data, and to allocate appropriate resources to stand with our fellow Nebraskans in this fight.”

Sheri Dawson, director of the Division of Behavioral Health for the Nebraska Department of Health and Human Services, said while Nebraska has a low rate of opioid use disorder and overdose fatalities, the department plans to keep it that way through a number of proactive initiatives with its Nebraska Coalition to Prevent Opioid Abuse partners.

“Grants from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) have provided the opportunity for innovation,” said Dawson. “Our State Opioid Response Grant provides more than $4 million per year to continue and expand upon the efforts of the State Targeted Response grants to increase access to medication-assisted treatment, reduce unmet treatment needs, and reduce opioid overdose-related deaths.”

Dawson said other recent DHHS milestones include:

• Pilot project with the Nebraska Pharmacy Association and Region V Systems involving supplying two Lincoln pharmacies, Kohll’s/Wagey Drug and HyVee, and Hyrum’s Family Value Pharmacy in Auburn with free naloxone nasal spray kits. To date, more than 144 kits have been purchased with the goal to ultimately take the program statewide.
• Distribution more than 3,400 naloxone kits to law enforcement.
• Nebraska Medical Association partnership around medication assisted treatment to grow the primary care capacity.
• Nebraska Medication Education for Disposal Strategies has collected over 110,000 pounds of medications. Grants from SAMHSA have netted more than 1,500 pounds of medication through community take-back events and distributed over 4,000 prescription lockboxes.

The Centers for Disease Control and Prevention estimates that the total "economic burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.

Ken Zoucha, M.D., director of the UNMC Addiction Medicine Division, said UNMC accepted its first fellow in the UNMC addiction medicine fellowship program, which began last August with a second fellow slated to start in July. In addition, 27 providers have completed UNMC’s month-long executive fellowship in addiction medicine that began in November 2018. Two more are completing the executive fellowship in January and February of this year. The program continues to get inquiries about the executive fellowship.

“Not only does this crisis we’re seeing affect public health, it also has an impact on social and economic welfare,” Dr. Zoucha said. “Those who live in rural areas are more greatly affected by distance and economic barriers.”