Effectiveness of the Kentucky Operation UNITE (Unlawful Narcotics Investigations, Treatment and Education) as Evaluated by RADARS® System Poison Centers

Objective: Operation UNITE was implemented in 4/2003 with the purpose of reducing illegal drug use in 29 Kentucky counties, and the first UNITE activities were held in early 2004. This study evaluates UNITE's effect on poison center (PC) prescription opioid abuse calls as reported by RADARS® System PC. Methods: PC use a standardized, electronic data collection system to manage and record spontaneous calls from the public and health professionals. Abuse and withdrawal (A+W) call rates (per 100,000 persons and 1,000 unique recipient of dispensed drug-URDD) for buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine and oxycodone were compared before and after 3rd quarter 2004 for 3-digit zip codes (3DZ) in UNITE counties versus the rest of Kentucky (1/2003-6/2006). Results: Trends over time indicate that UNITE 3DZ have a higher average year-quarter A+W call rate than the rest of Kentucky (population rates: UNITE=3.55, Other=1.03; p<0.001; URDD rates: UNITE=0.25, Other=0.08; p<0.001). Neither region had significantly increasing or decreasing rates before or after implementation. However, the UNITE's slope after implementation is significantly lower than the slope before (population: before=0.501, after=-0.061; p=0.004; URDD: before=0.038, after=-0.012, p=0.005), but not for the rest of Kentucky (population: before=0.066, after=-0.060; p=0.106; URDD: before=0.003, after=-0.004; p=0.253). Identical results were obtained when the analysis was performed on the larger category of intentional exposure calls (suicide, intentional misuse, abuse, intentional unknown, withdrawal). Conclusions: UNITE has had a significant positive impact as reported by PC cases involving substance abuse. Since implementation, change in PC abuse rates have significantly decreased within the UNITE region.