Ohio Opiate TrendsThe poison center perspective

Alfred Aleguas, BS Pharm, PharmD, D.ABATDirector, Northern Ohio Poison Center

Cleveland, OH

Ohio Poison Center Collaborative• 3 Ohio poison centers serving 11.5 million

– Northern Ohio Poison Center (NOPC), Cleveland– Central Ohio Poison Center (COPC), Columbus– Cincinnati Drug and Poison Information Center

(DPIC)

All 3 are certified by the American Association of Poison Control Centers (AAPCC); there are 57 such centers

All data is transmitted into the National Poison Data System, in near real-time.

Stats

Analyzed all opiate exposures from 2005-2012 (extrap) for all of Ohio

• Looked at the numbers with an outcome of moderate, severe or death

• Compared the age ranges involved

Drugs

• Hydrocodone/APAP• Oxycodone(+/- APAP)• Methadone• Morphine

• Tramadol• Buprenorphine• Oxymorphone• Fentanyl

1369 1343

1,500

1599

1821

1693 16811619

0

200

400

600

800

1000

1200

1400

1600

1800

2000

2005 2006 2007 2008 2009 2010 2011 2012

Year

Ohio Exposures

303

350

393

546

445 438

533 524

0

100

200

300

400

500

600

2005 2006 2007 2008 2009 2010 2011 2012Year

HCF Severity

Exposures

361 371

343

490

548

449

160

135

0

100

200

300

400

500

600

2005 2006 2007 2008 2009 2010 2011 2012Year

Hydrocodone/APAP

Exposures

263274

302308

341328

258

300

0

50

100

150

200

250

300

350

2005 2006 2007 2008 2009 2010 2011 2012

Year

Oxycodone

Oxycodone

168 168174

145149

141

108

83

0

20

40

60

80

100

120

140

160

180

2005 2006 2007 2008 2009 2010 2011 2012Year

Methadone

126

84

128

111114

108

91

83

0

20

40

60

80

100

120

140

2005 2006 2007 2008 2009 2010 2011 2012Year

Morphine

290

332349

446

506

472

521497

0

100

200

300

400

500

600

2005 2006 2007 2008 2009 2010 2011 2012

Year

Tramadol

Tramadol

42

23

184

90

194

86

0

50

100

150

200

250

300

2010 2011 2012Year

Buprenorphine

Buprenorphine<5 yo

Buprenorphine total

2010

2011

2012

Oxymorphone

Fentanyl

12

74

45

8

46

41

0

10

20

30

40

50

60

70

80

Year

Oxymorphone and Fentanyl

Oxymorphone

Fentanyl

0

10

20

30

40

50

60

70

80

Percent

1 2Year

Ped vs Adult 2005,2010

Peds

Adults

0

5

10

15

20

25

30

35

40

Percent

<19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 >90

Age group % 2005, 2010

2005

2010

12048

14378

21104

28606

25130

17140

15638

11851

0

5000

10000

15000

20000

25000

30000

2005 2006 2007 2008 2009 2010 2011 2012Year

Hydrocodone/APAP

4833

9829

15086

17634

11335

10683

8968

6525

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

2005 2006 2007 2008 2009 2010 2011 2012Year

Oxycodone

Oxycodone

8831

10903

17525

20866

19970

15556

14594

10028

0

5000

10000

15000

20000

25000

2005 2006 2007 2008 2009 2010 2011 2012Year

Oxycodone/APAP

Oxycodone/APAP

1561

3178

3419

3760

2344

1824

1440 1415

0

500

1000

1500

2000

2500

3000

3500

4000

2005 2006 2007 2008 2009 2010 2011 2012Year

Methadone

Methadone

2533

3003

4014

5177

4385

2758

2209

1733

0

1000

2000

3000

4000

5000

6000

2005 2006 2007 2008 2009 2010 2011 2012Year

Morphine

Morphine

2952

4110

5328

6730

4601

3207

2935

2391

0

1000

2000

3000

4000

5000

6000

7000

2005 2006 2007 2008 2009 2010 2011 2012Year

Tramadol

Tramadol