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An ambulance enters the emergency room entrance area at the Adena Regional Medical Center in Chillicothe, Ohio, U.S. Novem...

Emergency department visits for opioid overdoses rise by 30 percent in a year

Emergency room visits for suspected opioid overdoses have risen 30 percent, according to new data from the Centers for Disease Control and Prevention.

And within emergency departments across 16 high-risk states — Delaware, Illinois, Indiana, Kentucky, Maine, Massachusetts, Missouri, Nevada, New Hampshire, New Mexico, North Carolina, Ohio, Pennsylvania Rhode Island, West Virginia and Wisconsin — those overdoses went up by 35 percent, according to a new report released Tuesday. Wisconsin, Pennsylvania, Delaware and Illinois reported an uptick of 50 percent or more, the report said.

All five monitored regions revealed a spike in people with possible opioid overdoses between July 2016 and September 2017, according to data from the CDC’s Enhanced State Opioid Overdose Surveillance Program. Among those regions, Midwestern emergency departments experienced the highest increase in overdoses — up to 70 percent — compared to those in the Southeast, which saw a rise of 14 percent.

“The sharp increases and variation across states and counties indicate the need for better coordination,” CDC Acting Director Anne Schuchat said Tuesday in a call with Surgeon General Jerome Adams and reporters.

Schuchat called the report “very, very concerning” and said it served as a “wake-up call about the need to improve what happens when a patient leaves the emergency department.”

These latest numbers follow a recent CDC analysis that showed the opioid crisis already has led to a decrease in the average American’s life expectancy. And researchers there estimate 63,000 people died after they overdosed on drugs in 2016. Of those, 42,000 deaths were linked to opioid use.

But when a person dies and a drug overdose is suspected, medical examiners and coroners launch investigations that sometimes take weeks, if not months, to complete. Medical staffs often lack resources to fully test and record all the substances in a person’s system at the time of death, especially as more people use increasingly potent synthetic opioids, such as fentanyl, carfentanil and analogues. In states where the opioid crisis has been especially prevalent, backlogs have emerged. Roughly two years pass before national data collection is completed, analyzed and released to the public.

Emergency department visits, as outlined in Tuesday’s report, capture a snapshot of the opioid crisis faster, and the picture shows virtually no sign of improvement across much of the U.S.

The data did not reveal what types of drugs or drug combinations led to these suspected opioid overdoses, Schuchat said. Once a person is revived, emergency departments don’t have clinical reasons to test for those drugs, and insurance does not reimburse those costs, she said.

So how can emergency departments respond to rising overdoses? Schuchat called these services “essential hubs” in stemming the opioid crisis. Medical staff can administer naloxone — a life-saving antidote that can act in seconds to reverse a potentially fatal opioid overdose — and teach loved ones how to use the medication to prevent death from an opioid overdose.

Health departments also can notify communities about emerging spikes in emergency department overdoses so that public health and public safety resources can be better coordinated to respond when help is needed most.

The report also encouraged the broadened availability and use of medication-assisted treatment, such as methadone, naltrexone or buprenorphine, to help people with opioid use disorder, as well as peer navigators who can help a person if they are ready to seek treatment but don’t know how or where to look.

When someone is seen by medical professionals in the emergency department, “we are presented with an opportunity of preventing another overdose,” Schuchat said Tuesday.

Benjamin Miller with the Well Being Trust, a national foundation that explores holistic health issues, said the latest CDC data on opioid overdoses is tragic, unsurprising and offers the latest “reflection of our country’s inability to have a timely and comprehensive response to these issues.”

In his organization’s recent report, Pain in the Nation, Miller, along with the Trust for America’s Health, called for a national resilience strategy to address “deaths of despair,” that in 2015 amounted to 127,500 deaths driven by drug overdoses, alcohol and suicide.

“Incrementalism is insufficient,” he said. “We need to think much more comprehensively about this issue. This is not just health care,” he said.

The Trump administration launched an opioid commission last year, which produced 56 recommendations for how the nation can move forward in addressing this epidemic. In October, President Donald Trump declared opioids a public health crisis, but critics said the president’s actions were insufficient and that federal funding for more resources to combat this problem come up short.

In the opioid crisis, physical and mental health issues become tightly intertwined and complicate efforts for policymakers to find resolution, Miller said. He added that communities and the country should broaden their perspective to include looking at health care, education, economy and more, and in that process, may develop better ideas on how to stem early death.