Policy Basics

Ohio Health Value Review– October 2017

January 23, 2018

October 2017

The Ohio Health Value Review is a quarterly electronic update from the Health Policy Institute of Ohio designed to strengthen connections between public health and healthcare partners in Ohio and highlight opportunities for different sectors to work together to improve health value in our state. If you have questions about the newsletter or have suggested tools or resources you would like to see included in future editions, please contact Nick Wiselogel, HPIO’s Vice President of Strategic Communications. 

Ohio opioid addiction crisis calls for comprehensive policy response

Opiate addiction and the rising number of overdose deaths in Ohio have dominated news headlines in recent years.

In 2015, Ohio had the third highest drug overdose death rate in the country1.

Between 2010 and 2016, unintentional injuries surpassed cancer as the leading cause of premature death in Ohio, and more than 70 percent of accidental deaths are because of drug overdoses. Unintentional drug overdose deaths alone (a subcategory of unintentional injuries) became the second leading cause of premature death in Ohio in 2016, surpassing heart disease 2.

Prescription drug overdose deaths (excluding fentanyl) peaked in Ohio in 2011 and opioid prescribing peaked in 2012.3 As prescription opioid deaths were declining, deaths from heroin and fentanyl rose substantially (see graphic below)4, and studies have found that many heroin users first became addicted to prescription pain killers before transitioning to heroin.567 In recent years, Ohio has also seen a growing number of overdose deaths involving cocaine and benzodiazepines.

These trends indicate that although policy changes may reduce the supply of one type of drug (such as prescription opioids), other drugs may emerge and be widely used unless the underlying demand for addictive substances is also reduced through effective prevention and treatment.

There is evidence for what works to prevent, treat and recover from addiction. Progress is being made across the country and throughout Ohio, but more can be done to identify and implement effective strategies in a widespread and coordinated way. That is why HPIO is launching the Addiction Evidence Project, which will provide state policymakers and other stakeholders with tools to:

  • Quickly find existing information about what works
  • Review addiction policy changes enacted in Ohio in recent years
  • Assess the extent to which those policies aligned with existing standards and evidence
  • Identify areas where Ohio policy could be better aligned with standards and evidence, including potential gaps in Ohio’s response to the opiate crisis

HPIO plans to soon post three types of tools on its forthcome HPIO Addiction Evidence Project website:

  • Resource page: Hub for clinical standards/guidelines, expert consensus statements/recommendations, model policies and evidence registries
  • Policy inventory: List of legislation, regulations, funding allocation amounts, practice guidelines, state agency initiatives and legislative initiatives
  • Policy scorecard: Analysis of strengths and gaps in Ohio’s policy response to addiction

HPIO will develop these tools in phases, starting with prevention, treatment and recovery. Future phases will address harm reduction, overdose reversal, children services, law enforcement, criminal justice reform and surveillance and evaluation, depending on resource availability and capacity.

While there is no quick or easy answer to the problem of opiate addiction in Ohio, it is encouraging that proven strategies are available and state policymakers are working to make progress on this health challenge.

Health value graphic

The Ohio Department of Health graphic below shows the dramatic increase in fentanyl overdose deaths, as well as a significant increase in cocaine overdose deaths since 2013.

Health value tools

The  2017 Health Value Dashboard found that Ohio ranks 46 out of 50 states and the District of Columbia on health value, landing in the bottom quartile. This means that Ohioans are living less healthy lives and we spend more on health care than people in most other states. The tools below can be used to help improve health value in Ohio.

Population health and healthcare spending

Social and economic environment

Access to care

Healthcare system

Public health and prevention

Physical environment

Health equity 

State Health Improvement Plan (SHIP) priority topics

Mental health and addiction

Chronic disease

Maternal and infant health

Upcoming events

Nov. 17 – HPIO Online seminar: The path forward: What’s on the horizon for health policy?

The third in a series of three seminars on federal health policy, the webinar will feature Leanne Gassaway, Senior Vice President of State Affairs, America’s Health Insurance Plans and Matt Salo, Executive Director, National Association of Medicaid Directors

Nov. 29-Dec. 1- Midwest Forum on Hospitals, Health Systems and Population Health Partnerships to Build a Culture of Health (Chicago)

HPIO is partnering with organizations from other Midwestern states to host a three-day forum in Chicago. The goal of the meeting is to engage attendees in a broad dialogue across sectors to solve complex issues to improve the health of communities and integrate clinical and community health and prevention strategies.

  1. Number of deaths due to drug overdose per 100,000 population (age adjusted). CDC WONDER. Get cite from Dashboard sources.
  2. Premature death refers to years of potential life lost (YPLL) before age 75, age-adjusted rate per 1,000 population. Ohio Department of Health Bureau of Vital Statistics
  3. 2016 Ohio Drug Overdose Data: General Findings. Ohio Department of Health, 2017.
  4. 2016 Ohio Drug Overdose Data: General Findings. Ohio Department of Health, 2017.
  5. Associations of nonmedical pain reliever use and initiation of heroin use in the United States. Muhuri, et. Al. 2013. Accessed 9/27/17: https://www.samhsa.gov/data/sites/default/files/DR006/DR006/nonmedical-pain-reliever-use-2013.htm#tab2note1
  6. Lankenau, et. Al. Misuse of prescription and illicit drugs among high-risk young adults in Los Angeles and New York. Journal of Public Health Research, 2012. https://www.ncbi.nlm.nih.gov/pubmed/22798990
  7. Compton, et. Al. Relationship between nonmedical prescription-opioid use and heroin use. New England Journal of Medicine. 2016. http://www.nejm.org/doi/pdf/10.1056/NEJMra1508490