Healthcare Providers:• Use the Utah Clinical Guidelines for Prescribing Opioids for the Treatment of Pain (guidelines to improve prescriber behavior such as co-prescribing naloxone, practicing conservative opioid prescribing, avoiding potentially fatal drug combinations, and other guidelines).• Develop/employ universal risk assessment such as Screening, Brief Intervention, and Referral to Treatment (SBIRT) to identify; reduce, and prevent problematic use, abuse, and dependence on opioids and provide naloxone and follow-up services when high-risk patients are identified.• Develop and implement universal post-surgical safety planning and safe pain management (could include follow-up services, home healthcare, home visiting, peer outreach, communication with chronic pain treatment provider, monitoring regular pain medication regimen and post-surgical pain).• Develop guidance on best prescribing practices of opioids for patients with traumatic brain injuries (TBIs).• Distribute naloxone at the time of discharge for any patient hospitalized or treated for an opioid overdose.• Establish guidelines to facilitate a “warm hand-off ” to treatment programs following treatment or hospitalization for overdose.• Improve patient and prescriber education on the increased risk of fatal respiratory depression/sleep apnea for obese patients who are or may be prescribed opioids.

Overdose is the leading cause of injury death. The rate of overdose death exceeds that of motor vehicle collisions and firearms. More than 10 Utahns die every week from an overdose. Utah had the 4th highest rate of drug overdose death in the U.S. in 2012-2014, the 7th highest rate in 2013-2015, and 21st highest rate 2014-2016. Utah has the 1st highest rate of drug overdose death for veterans (2014). These rates increased nearly 400% between 2000-2010, and are continuting to rise. Children and adolescents are impacted both directly and indirectly by opioid overdose.   The substances most responsible for poisoning deaths come from opioid medications including morphine, methadone, hydrocodone, fentanyl, oxycodone, and from heroin. Opioid overdose is reversible through the timely administration of the drug naloxone (Narcan®) and the provision of emergency care. Naloxone (Narcan®) is an antidote for opioid overdose. It can reverse the overdose and save a life.    This is a very safe antidote and it is LEGAL to have in the state of Utah.  If this can benefit you or someone you love, let's get naloxone in your life.  These lives matter!

Naloxone Saves Lives On December 8, 2016 the executive director of the Utah Department of Health signed a statewide standing order allowing to dispense naloxone, without a prior prescription, to anyone at increased risk of experiencing or witnessing an overdose. Through this standing order, anyone can walk into a pharmacy and purchase naloxone without a prescription. Click here to full list of locations offering naloxone in stock. If you call 911, you are protected from legal charges concerning that person, the overdose, and any side effects of naloxone, because you are trying to save a life. However, you must remain at the scene and comply with medical providers and law enforcement.  If you leave the person without calling 911 and that person dies, you can be charged with his or her death. See Utah’s Good Samaritan Law and Overdose Reporting Amendment for more information. Who should have Naloxone: Anyone prescribed opioid medication(s) (morphine, methadone, burenorphone, hydrocodone, oxycodone) for chronic or acute pain Anyone with family or friends who are prescribed an opioid medication(s) Anyone who uses heroin or other opioids Anyone with family or friends who use heroin or other opioids Anyone taking medications treating depression or depressive substances like alcohol in conjunction with opioids Anyone recently released from prison, detox, or substance use treatment (even after a few days, a persons tolerance for opioids decreases significantly) Anyone injecting opioids

Utah has ranked top 10 in the nation for overdose deaths over the last 10 years. Between 2013-2015, Utah ranked 7th in the U.S. for drug poisoning deaths, which have outpaced deaths due to firearms, falls, and motor vehicle crashes (2). Currently, opioid overdose deaths are highest in Carbon, Emery, Duchesne, Juab, Weber, Salt Lake, and Tooele counties, where rates are above the state average of 20.3 deaths per 100,000 population.

Revised March 2019 Opioid-Involved Overdose Deaths In 2017, there were 456 drug overdose deaths involving opioids in Utah—a rate1 of 15.5 deaths per 100,000 persons, compared to the national rate of 14.6 deaths per 100,000 persons. Prescription opioids are the main driver of overdose deaths with nearly 70 percent of deaths in 2017 involving these drugs. The greatest increase, however, occurred among heroin-involved overdose deaths, from 55 deaths in 2010 to 147 deaths in 2017. In the same 7-year period, deaths involving synthetic opioids other than methadone (predominantly fentanyl) doubled from 50 to 92 cases (Figure 1) Figure 1. Number of overdose deaths involving opioids in Utah, by opioid category. Drug categories presented are not mutually exclusive, and deaths might have involved more than one substance. Source: CDC WONDER. Opioid Pain Reliever Prescriptions In 2017, Utah providers wrote 63.8 opioid prescriptions for every 100 persons (Figure 2) compared to the average U.S. rate of 58.7 prescriptions (CDC). This represents a 30 percent decline from a peak in 2008 of 91.3 opioid prescriptions for every 100 persons. The age adjusted rate of overdose deaths involving opioid prescriptions is also trending down with 10.8 deaths per 100,000 persons in 2017 compared to 14.6 deaths per 100,000 in 2014 (Figure 2).