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3,302,879
Total Opioid Prescriptions, 2017
312
Total Overdose Deaths, 2017-2018
2,336
Total Number of Naloxone Administrations, 2017-2018

Findings

  • During 2017, over 3.3 million opioid prescriptions were dispensed in Mississippi. On average, over half of million dosage units (e.g., pills) were dispensed every day during this year.
  • Compared to the first three months of 2017, there were 168,156 fewer opioid prescriptions dispensed during the first three months of 2018. This was a 19.4% decrease. During the same period, the number of dosage units dispensed decreased even more by 22.6% or 10,971,850 pills.

Opioid Prescriptions, 2017

  • Total number: 3,302,879
  • Average number per month: 275,240
  • Average number per day: 9,049
  • The rate was 110.5 opioid prescriptions per 100 persons – enough for each person in Mississippi to have 1 opioid prescription during 2017

Data Source: Mississippi Board of Pharmacy

Opioid Dosage Units, 2017

  • Total number: 182,882,444
  • Average number per month: 15,240,204
  • Average number per day: 501,048
  • The rate was 6,119 opioid dosage units per 100 persons — enough for each person in Mississippi to have a supply of 61 opioid dosage units during 2017

Data Source: Mississippi Board of Pharmacy

Considerations

This report identified a considerable decline in the number of opioid prescriptions within a year. Such downward movement could be driven, in part, by statewide educational initiatives. For example, the Mississippi Bureau of Narcotics along with the Board of Pharmacy and the Mississippi Department of Mental Health have organized numerous town hall meetings to educate communities about the dangers of opioid overconsumption during the last year. In addition, the Mississippi State Department of Health has campaigned actively among the Mississippi’s medical community since early 2017. This campaign involves presentations for health care providers on the scope of the state’s opioid epidemic, the latest opioid treatment guidelines, and prevention strategies. One of these strategies includes the utilization of the state PMP data for identifying non-medical use of opioids. Recent encouraging trends in opioid prescriptions highlight the importance of such data-driven educational events. Nonetheless, Mississippi’s prescription rates remain high and warrant continuous educational outreach and preventive efforts.

Findings

  • The preliminary number of suspected overdose deaths reported to Mississippi Bureau of Narcotics reached 256 during 2017. Opioid-related deaths accounted for over two-thirds (173 or 67.6%) of those deaths.
  • During the first quarter of 2018, there were 57 reported overdose deaths in Mississippi; of which 29 (50.9%) involved opioids. Compared to the first quarter of 2017, deaths for every category except “fentanyl and prescription related overdose deaths” were up in the first quarter of 2018. This may be due to an increase in drug overdose deaths; however, it is also possible that the process of drug overdose death reporting has improved.

Data Source: Mississippi Bureau of Narcotics

Number and Percent of Suspected Overdose Deaths reported to Mississippi Bureau of Narcotics by Type of Involved Substance, MS, 2017-2018
Q1, 2017 Q2, 2017 Q3, 2017 Q4, 2017 Q1, 2018
Overall total overdose deaths 27 40 76 112 57
Total opioid related overdose deaths 18 31 52 71 29
Prescription opioid related overdose deaths 7 12 24 39 15
Fentanyl related overdose deaths 2 7 8 3 1
Fentanyl and prescription related overdose deaths 4 4 11 12 2
Heroin related overdose deaths 4 5 9 11 7
Heroin and prescription related overdose deaths 1 1 0 0 1
Heroin and fentanyl related overdose deaths 0 2 0 6 3
Other related overdose deaths 9 7 10 23 24
Prescription related overdose deaths 0 2 14 18 4

Considerations

The accurate assessment of drug-related fatalities depends on complete and good quality data. The reliability of mortality data, however, has been impacted by several constraints such as insufficient resources, training, or time for performing thorough death investigations. In addition, our state lacks a centralized system for connecting different entities involved in the compilation and reporting of mortality data. Efficient collaboration among state agencies, educational outreach for coroners, and standardized protocols for drug overdose investigation and reporting are measures that can improve drug-related mortality surveillance.

Findings

  • Emergency Medical Services (EMS) data revealed that naloxone was administered 2,085 times during 2017.
  • The number of naloxone administrations reported so far for the first three months of 2018 is 251.

Note: Naloxone administration is performed when an opioid toxicity is suspected. Data are preliminary.

Considerations

Opioid-associated toxicity can lead to respiratory depression and cardiac arrest, both of which require an emergency response. The life-saving drug naloxone, an opioid antagonist, is used to reverse opioid overdose. The emergence and growing popularity of highly toxic synthetic opioid substances necessitates ready access to naloxone for patients with opioid use disorders.

Important Message

In a continued effort to curb the opioid epidemic in Mississippi, State Health Officer Dr. Mary Currier signed a standing order that covers, without a prescription, the dispensing and administration of a drug that reverses the effects of an opioid overdose. With this standing order, pharmacies will be able to provide naloxone to a family member, friend, or other person in a position to assist someone at risk of opioid overdose. It is recommended that patients currently taking high doses of opioids prescribed for pain, those misusing prescription opioids, those using illicit opioids such as heroin or fentanyl, as well as those who live with or are often in the presence of people with an opioid use disorder, know how to use naloxone and have it within reach.

Findings

  • The top 5 counties, DeSoto (8), Pearl River (6), Harrison (5), Lowndes (4), and Forrest (3) accounted for 45.6% (26) of all suspected overdose deaths.
  • The top 5 counties, Rankin (39), DeSoto (20), Tate (14), Lee (10) and Madison (10) accounted for 40.1% (93) of all Naloxone administrations.
Number of Suspected Overdose Deaths by County, MS Q1, 2018
Number of Naloxone Administrations by County, MS Q1, 2018

Data Sources: Mississippi Bureau of Narcotics (left), Mississippi State Department of Health (right)
Note: Records for missing or erroneous values for county of residence and such cases were excluded. This analysis included 232 cases.

Findings

  • The following figure displays data on opioid-related admissions to facilities certified by the Department of Mental Health (DMH).
  • The table below categorizes the use of opioids as the primary, secondary, or tertiary substance. On average, there were over three admissions per patient during each of the studied years. There were close to 2,000 admissions during the first quarter of 2018.
  • The below chart displays the total admissions. The number of total opioid-related admissions increased by 7.4% between 2015 and 2016 and by 33.5% between 2016 and 2017. The number of unique patients admitted for treatment of opioid-related disorder substance jumped by 12.6% between 2015 and 2016 and by 41.0% from 2016 to 2017.

Number of Admissions and Unique Patients, Department of Mental Health, MS, 2015, 2016, 2017, and Q1 of 2018

2015 2016 2017 Q1, 2018
Admissions Patients Admissions Patients Admissions Patients Admissions Patients
Primary 2,938 838 3,080 941 4,545 1,379 1,215 404
Secondary 1,589 444 1,783 500 2,147 680 458 174
Tertiary 742 213 797 243 864 316 231 88
Total 5,269 1,495 5,660 1,684 7,556 2,375 1,904 666

Findings

The chart below categorizes the type of opioid involved. The largest category listed as “other opioids” includes prescription opioids and represented 77.7% of all opioids during 2015. This percentage decreased, however, to 69.4% during 2017 due to a spike in heroin-related admissions. While the number of admissions for use of prescription opioids increased by 28% between 2015 and 2017, the number of heroin-related admissions more than doubled, from 1,025 admissions in 2015 to 2,199 admissions in 2017. Admissions for methadone dependence were rare and such admissions declined during the study period.

Considerations

  • The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that 121,000 Mississippians are in need of substance use disorder treatment services. Currently, our state does not have the capacity to provide treatment for all the patients in need
  • The Department of Mental Health data system for capturing admissions and treatments is continually being updated and modified; therefore, the statistics presented in this report are current as of 3/31/2018 and subject to changes.

Findings

Drug-Related Arrests:

  • The total number of drug-related crimes reported in 2017 was 19,650, a rate of 6.6 arrests per 1,000 residents.
  • On average, 1,638 drug-related crimes were reported each month during 2017.
  • During 2017, the greatest numbers of drug-related arrests were reported in DeSoto (3,449), Hinds (2,118), Harrison (1,746), Rankin (1,628), and Madison (986).
  • The five counties with highest rates of drug-related crimes per 1,000 persons were DeSoto (19.6), Pearl River (17.6), Tate (13.3), Lowndes (13.2), and Forrest (13.0).

Drug-Related Arrests, First Quarter of 2018: The number of drug-related arrest during the first quarter of 2018 was 4,454.

Pharmacy Burglaries: Six (15.8%) of the 38 pharmacy burglaries in the state occurred in the town of Meridian during 2017. During the first quarter of 2018, there were 9 pharmacy burglaries and 2 attempts. Five of the nine burglaries were in DeSoto County.

Rates of Reported Drug-Related Arrests per 1,000 Persons: MS, Q1, 2018

Data Sources: Mississippi Department of Public Safety, Mississippi Bureau of Narcotics
Note: Twenty eight counties do not have any cases reported. These counties are presented in gray.

Drug-Related Crime Data, MS, 2017-2018
Type of Crime Q1, 2017 Q2, 2017 Q3, 2017 Q4, 2017 Q1, 2018
Drug-related arrests 5,284 5,184 4,818 4,364 4,454
Pharmacy burglaries 11 11 12 4 9

Data Sources: Mississippi Department of Public Safety, Mississippi Bureau of Narcotics

Suspected Overdose Deaths, EMS Naloxone Administrations, and Drug-Related Arrests Reported by County, MS, Q1, 2018
County Number of Suspected Overdose Deaths Number of EMS Naloxone Administrations Number of Reported Drug-Related Arrests Drug-Related Arrest Rates per 1,000 Persons County Number of Suspected Overdose Deaths Number of EMS Naloxone Administrations Number of Reported Drug-Related Arrests Drug-Related Arrest Rates per 1,000 Persons
Adams 0 0 67 2.1 Leflore 0 1 11 0.4
Alcorn 8 1 0 0.0 Lincoln 2 0 6 0.2
Amite 1 0 16 1.3 Lowndes 6 4 186 3.1
Attala 1 0 7 0.4 Madison 10 0 226 2.2
Benton 2 0 2 0.2 Marion 1 1 0 0.0
Bolivar 7 0 14 0.4 Marshall 3 1 76 2.1
Calhoun 1 0 0 0.0 Monroe 1 0 12 0.3
Carroll 0 0 0 0.0 Montgomery 0 0 0 0.0
Chickasaw 0 0 21 1.2 Neshoba 1 0 0 0.0
Choctaw 1 0 0 0.0 Newton 6 1 0 0.0
Claiborne 0 0 0 0.0 Noxubee 1 0 0 0.0
Clarke 0 0 0 0.0 Oktibbeha 2 0 11 0.2
Clay 0 0 27 1.4 Panola 0 0 13 0.4
Coahoma 3 1 0 0.0 Pearl River 6 6 223 4.0
Copiah 0 0 19 0.7 Perry 1 0 0 0.0
Covington 4 0 15 0.8 Pike 5 1 79 2.0
DeSoto 20 8 782 4.5 Pontotoc 1 1 7 0.2
Forrest 6 3 302 4.0 Prentiss 1 1 1 0.0
Franklin 1 0 0 0.0 Quitman 0 0 0 0.0
George 0 1 0 0.0 Rankin 39 1 361 2.4
Greene 1 0 7 0.5 Scott 3 1 42 1.5
Grenada 1 0 0 0.0 Sharkey 0 0 0 0.0
Hancock 1 0 52 1.1 Simpson 0 0 22 0.8
Harrison 0 5 328 1.6 Smith 1 0 34 2.1
Hinds 4 1 482 2.0 Stone 0 0 19 2.1
Holmes 0 0 0 0.0 Sunflower 0 1 0 0.0
Humphreys 0 0 0 0.0 Tallahatchie 2 0 0 0.0
Issaquena 0 0 0 0.0 Tate 14 1 62 2.2
Itawamba 3 0 0 0.0 Tippah 3 1 0 0.0
Jackson 1 3 164 1.2 Tishomingo 4 0 24 1.2
Jasper 2 1 68 4.1 Tunica 1 1 2 0.2
Jefferson 0 0 8 1.1 Union 2 0 32 1.1
Jefferson Davis 0 0 0 0.0 Walthall 1 1 18 1.2
Jones 4 1 65 1.0 Warren 7 0 36 0.8
Kemper 3 1 0 0.0 Washington 3 0 19 0.4
Lafayette 0 2 95 1.8 Wayne 0 0 55 2.7
Lamar 1 1 96 1.6 Webster 0 0 0 0.0
Lauderdale 7 2 78 1.0 Wilkinson 0 0 0 0.0
Lawrence 1 0 0 0.0 Winston 4 0 0 0.0
Leake 2 0 60 2.7 Yalobusha 3 0 0 0.0
Lee 10 2 102 1.2 Yazoo 2 0 0 0.0

Note: The zero values in this table may signify either that cases of overdose deaths, naloxone administrations, and drug-related crimes have not occurred or that such cases did occur but were not reported by the relevant authorities.