ED opioid overdose visits jump 30 percent in a year
Thursday, March 29, 2018
The opioid epidemic is still getting worse. The evidence? Emergency department visits for opioid overdoses have skyrocketed in just one year.
A new report by the Centers for Disease Control and Prevention (CDC) shows the number of ED visits for opioid overdoses increased 30 percent from July 2016 to September 2017. Only a few areas of the U.S. have seen declines in ED visits for opioid overdoses.
CDC researchers examined ED and hospital billing data on opioid-involved overdoses and analyzed information about ED visits gathered from the CDC's National Syndromic Surveillance Program (NSSP) and Enhanced State Opioid Overdose Surveillance (ESOOS) program. They looked at opioid overdose trends in 52 jurisdictions in 45 states, and analyzed the data by demographic characteristics and at regional levels. The researchers also studied data from 16 states by state and urbanization levels to assess trends associated with urban development.
Among the approximately 91 million ED visits reported in NSSP, 142,557 were suspected overdoses. Of the approximately 45 million ED visits reported by the 16 ESOOS states, 119,198 were likely opioid overdoses.
EDs in the Midwest saw the largest increase in opioid overdoses, jumping 69.7 percent between 2016 and 2017. The number of opioid overdoses rose by 40.3 percent in the West, 21.3 percent in the Northeast, 20.2 percent in the Southwest and 14 percent in the Southeast.
Wisconsin and Delaware saw the largest increases among the states, with 109 percent and 104 percent leaps in opioid overdoses, respectively. Kentucky actually experienced a 14 percent decrease in opioid overdoses presenting to EDs.
Opioid overdoses increased 30 percent among males and 24 percent among females. The number of opioid overdoses could likely be even higher, as many people who overdose on the painkillers never go to the hospital.
Urban areas have been especially hard hit by the opioid epidemic. Visits to the ED for opioid overdoses increased 54.1 percent in large metropolitan areas, 42.6 percent in medium-sized metro areas and 36.9 percent in small metropolitan areas.
The opioid overdose epidemic began in the 1990s, and it has worsened in the decades that followed. The number of opioid-related deaths was five times higher in 2016 than it was in 1999, according to Health and Human Services (HHS).
In 2016, the number of drug overdose deaths increased 21.4 percent from the previous year. Opioids were involved in 66.4 percent of drug overdose deaths in 2016, which is a 27.7 percent increase over 2015. Heroin and synthetic opioids, especially fentanyl, are the driving force behind many of these opioid-involved deaths.
Tracking these overdoses is essential for enacting targeted interventions; knowing which EDs are experiencing increases in opioid overdose patients helps affected officials, administrators and medical professionals prepare.
Unfortunately, timely national data on opioid overdoses seen in EDs has been unavailable. Billing data is an important source of ED-evaluated opioid overdose information, but the lag time between the availability of the data and patients showing up in the ED poses challenges to monitoring and response.
ED syndromic data can potentially identify changes in opioid overdoses quickly by collecting data in near real-time that is viewable within 24 to 48 hours of an ED visit. The rapid availability of ED syndromic data can potentially help predict future fatal overdose trends and trigger localized responses.
EDs also provide an important opportunity to connect patients with treatment to help avoid repeat overdoses, as research shows that people who experience one overdose are at a high risk for subsequent overdoses.
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