The Middletown Press (Middletown, CT)
ER visits spike from overdoses
Hospitals see 30% increase in opioid emergencies nationwide
With the opioid crisis showing no signs of slowing, emergency room visits for opioid overdoses shot up 30 percent nationwide between July 2016 and 2017.
And, although a Centers for Disease Control and Prevention report doesn’t specifically contain data about Connecticut, local experts said drug-related hospital visits are spiking here as well.
In an email, state Department of Public Health spokeswoman Maura Downes said that “preliminary review of the 2016 data shows that there was a substantial increase of about 50 percent in all drug overdose-related (emergency department) visits and in heroin overdose ... visits between 2015-2016.”
Carl Schiessl, director of regulatory advocacy for the Connecticut Hospital Association, agreed
that such visits have been on the rise for years.
Although he didn’t have specific numbers, “anecdotally, I can tell you that the incidence of opioid overdoses treated in the emergency department remain a priority.”
Accidental drug intoxication death in the state jumped to 1,038 in 2017, from 357 in 2012 — the first time the total had hit more than a thousand. Many of those deaths involved some sort of opioid
‘Mainstream’ drugs
Opioids are a class of drugs that includes both illegal drugs, such as heroin, and several legal prescription pain relievers, such as oxycodone.
From July 2016 through September 2017, a total of 142,557 emergency department visits from 52 jurisdictions in 45 states were suspected opioid-involved overdoses, according to the CDC report.
Over the period studied, emergency department visits among those 11 and older jumped 29.7 percent overall. Rates increased across demographic groups and in all five U.S. regions, with the largest increases in the Southwest, Midwest and West.
The CDC also tracked data in the 16 states that are part of its Enhanced State Opioid Overdose Surveillance Program. These include several in New England, but not Connecticut. In most of these states, the number of overdoses increased, though some —including Massachusetts, New Hampshire and Rhode Island — saw decreases.
Though not singled out in the report, state and local experts said opioid abuse and drug overdoses in general have been an escalating problem in Connecticut.
Accidental drug intoxication death in the state jumped to 1,038 in 2017, from 357 in 2012 — the first time the total had hit more than a thousand, according to the state’s office of the chief medical examiner.
Many of those deaths involved some sort of opioid. For instance, 474 of 2017’s deaths involved heroin and 677 involved the powerful opiate fentanyl.
Locally, several area hospitals said they had seen a spike in emergency room visits for overdoses in recent years.
Three of the Yale New Haven Health System hospitals — Bridgeport Hospital, Yale New Haven Hospital and the Saint Raphael campus of Yale New Haven — went to 946 emergency department visits for narcotic overdoses in 2017, up from a total of 446 in 2014.
Bridgeport Hospital went to 385 in 2017, from 119 overdose visits in 2014. Yale hospital went to 496, from 264 in that period.
“There’s more availability,” said Dr. Darcy Harris, associate chair of Bridgeport Hospital’s emergency department on the increase. “Opiates have become more mainstream.”
However, one area hospital, St. Vincent’s Medical Center in Bridgeport, saw some mixed numbers on opioid overdoses.
In 2016, the hospital’s emergency room received 145 cases of overdoses (heroin, opioid or methadone) resulting in 10 fatalities. In 2017, there were 120 overdoses resulting in 13 fatalities.
Thus, the overdoses went down, but fatalities went up slightly.
So far this year the hospital reports there have been 22 overdoses, with no fatalities.
Possible solutions?
In Connecticut, authorities have been looking at ways to curb rising opioid overdose numbers for a while. Downes said Connecticut recently received a grant from the CDC that allowed the state to join the CDC’s Enhanced State Surveillance of Opioid-Involved Morbidity and Mortality Project. The funds will be used to strengthen prevention efforts and better track of opioid-related overdoses.
“We have been working since the fall with our partners in (emergency departments) throughout the state to add suspected overdoses into the ED hospital coding that is reported daily, in real time to the state’s Syndromic Surveillance System,” Downes said in her email. “This coding should be operational, and DPH should start receiving real time data in the next several weeks.”
The hospital association, meanwhile, has been looking at the issue for several years — at least, Schiessl said — since the topic of a bump in overdoses first came up at an emergency department directors meeting in 2013.
In 2015, the Connecticut Hospital Association issued voluntary prescribing guidelines, aimed at helping emergency department staff treat patients with chronic pain conditions who come to the hospital.
The goal was to reduce the inappropriate use of opioids, while still helping patients with pain. Schiessl said the state intends to update the guidelines in the near future.
When the hospital association began talking about overdoses in earnest, “it was mostly about prescription drug abuse (than the use of illegal street drugs), but we were anticipating what we saw as the beginning of a very dangerous wave of activity,” Schiessl said.