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BACKGROUND: Prescription drug misuse and abuse has been identified as a public health priority in Marin County, an affluent, suburban and rural county in the San Francisco Bay Area. In early 2014, RxSafe Marin, a community-wide group was convened with representatives from public health, environmental health, health care, law enforcement, elected officials, education, and community-based organizations to develop a strategic plan to reduce prescription drug misuse and abuse. One goal of RxSafe Marin was to develop a Report Card to describe the problem in Marin County. While metrics have been developed to describe the problem at the state and national levels, the methodology needed to be adapted to explore the issue locally.
METHODS: RxSafe Marin formed a data collection and monitoring team to develop standardized metrics to describe prescription drug misuse and abuse locally, communicate findings, and track changes over time. We sought assistance and tools from local, state and national agencies. County-level data were reviewed from both traditional and non-traditional public health sources. Potential indicators were identified and voted on by stakeholders for inclusion in the report card. Subject-matter experts advised the team on data analysis and interpretation. We generated the RxSafe Marin Report Card with indicators from 2009 to 2013 to share findings and inform interventions.
RESULTS: Of the fourteen indicators identified, ten were selected from nine distinct sources. Some examples of the indicators include: the number of drug related deaths and emergency department visits; the number of controlled substance prescriptions; pounds of safely disposed medication; summarized data on outpatient naloxone administration; and the number of drug possessions. The report card was shared locally and with colleagues from other counties and organizations. RxSafe Marin has used the report card to inform initiatives for increasing drug collection sites, reducing the amount of pills per opioid prescription, and enhancing communication between law enforcement and prescribers regarding prescription drug-related crimes.
CONCLUSIONS: Understanding prescription drug abuse and misuse is a complex public health challenge requiring coordinated efforts in multiple sectors. The RxSafe Marin Report Card provides one model for achieving this goal at the local level and synchronizing disparate partners to focus on shared priorities. Continued collaborations and partnerships within Marin, with California state agencies and other local health departments will strengthen public health efforts to reduce prescription drug misuse and abuse.