ER visits for opioid overdoses up 30 percent in one year
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ER visits for opioid overdoses up 30 percent in one year
Midwest sees biggest spike in reported cases
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Health and Human Services Secretary Alex Azar recently said medication-assisted treatment is a proven method for treating addicted people, yet only a third of substance abuse programs offer it. (Associated Press/File) more >
By Tom Howell Jr. - The Washington Times -
Tuesday, March 6, 2018
Emergency room visits from opioid overdoses spiked by 30 percent across the U.S. from mid-2016 to late 2017, the government said in a sobering report Tuesday that underscored the need for resources to reel in a worsening crisis.
Every region reported an uptick in the prescription painkiller and heroin scourge, led by a 70 percent rise in the Midwest and followed by the West’s 40 percent increase, according to the Centers for Disease Control and Prevention.
All told, more than 142,000 people were taken to emergency rooms to treat opioid overdoses from July 2016 to September 2017, the CDC said.
ER visits related to opioids more than doubled in Wisconsin and Delaware. Minor decreases in a few states offered a smidgen of promising news in an otherwise gloomy report.
The data suggest that the calamitous drug crisis is only getting worse, particularly in major cities, and that addiction affects Americans of all ages and demographics.
President Trump labeled the opioid crisis a public health emergency last year, prodding federal agencies and Congress to free up resources and devise strategies to fight addiction.
“We have been challenged to keep up with this fast-moving epidemic,” said Dr. Anne Schuchat, the acting CDC director.
The CDC said it has reviewed ER visits in 45 states because it wants to understand the crisis upstream — rather than focusing on fatalities alone — and devise a “timely, strategic, and coordinated” response.
Officials could supply more naloxone, an overdose-reversing drug, to specific communities or connect more patients with treatment in those areas. Research shows that a person who has an overdose is likely to have another.
“We don’t have to wait until it’s too late,” Dr. Schuchat said. “For every fatal case, there are many more nonfatal cases, each one with its own personal and economic toll.”
The CDC said increases in ER visits as a result of overdoses were substantial among both men and women and all age groups older than 25. Cities and towns of all types reported increases, though the most dramatic spike, at 54 percent, was in metropolitan areas of 1 million or more people.
Dr. Schuchat said the reason for the increasing city numbers is unclear, though it may reflect changes in the drug supply in urban centers, particularly because of the influx of fentanyl in the heroin supply from clandestine labs overseas.
Keith Humphreys, a Stanford University professor who tracks the issue, said multiple factors could explain the overall spike: the increasing prevalence of potent fentanyl; expanded use of naloxone, which means more people make it to emergency rooms instead of dying; and a better job by ER doctors at tracking instances of overdose as awareness of the opioid problem grows.
The CDC also pored over ER data from 16 states that were hit particularly hard by the crisis. These states reported a slightly higher spike in ER visits — at 35 percent — than the 45-state average.
States with dramatic upticks in ER visits to treat overdose included Wisconsin at 109 percent, Delaware at 105 percent and Pennsylvania at 81 percent.
The Wisconsin Department of Health Services said its whopping figure includes confirmed and suspected cases. Relying solely on confirmed cases drops the increase to just 26 percent. The rate of fatal overdoses in the state decreased 19 percent from the third quarter of 2016 to the fourth quarter of 2017.
“We attribute that decline to increased awareness about the opioid crisis, as well as an increase in the use of naloxone to reverse opioid overdoses,” said Jennifer C. Miller, the state’s Department of Health Services spokeswoman. “While not all of the data for 2017 has been compiled yet, we look forward to what we hope will be an even greater decline in the number of overdose deaths.”
The CDC said it is important to realize those changes show the trend line in terms of progress or setbacks rather than the scope of the problem in individual states. For instance, states in New England that reported slight decreases still have big problems.
“Sometimes, places that have such high rates don’t really have much more room to increase, and the decrease may reflect some instability,” Dr. Schuchat said. “We wish that it was going down everywhere, and we wish it was going down even further.”
Opioid overdoses killed at least 42,000 people in 2016, and early estimates suggest an even higher number died last year.
Administration officials say they are open to debating and stress-testing ideas, such as whether it makes sense to begin medication-assisted treatment for addicted people before they leave emergency rooms.
“We do think trying innovative approaches makes sense,” Dr. Schuchat said.
Health and Human Services Secretary Alex Azar recently said medication-assisted treatment is a proven method for helping addicted people, yet only one-third of substance abuse programs offer it.
He said the administration is promoting ways to administer a key treatment drug — buprenorphine — more easily. It also is encouraging researchers to look closely at ER visits and overdose data.
“For many people struggling with addiction, failing to offer [medication-assisted treatment]is like trying to treat an infection without antibiotics,” he told the National Governors Association. “Given what we know, and given the scale of this epidemic, having just one-third of treatment programs offer the most effective intervention for opioid addiction is simply unacceptable.”
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