Opioid abuse stats relatively low here
Even so, epidemic seen throughout U.S. still a problem in county
Abuse of opioid drugs has been declared an epidemic by Gov. Doug Ducey and the leaders of five more states, and President Trump is on the verge of following suit. But the recent spotlight has not yet hit Yuma County.
Surveys have found the county falls in the low to mid-range in terms of severity of the opioid abuse problem, behind the sheer number of users in Maricopa and Pima counties and the higher death rates in other rural areas such as Mohave County.
But the epidemic is present here as well, and Dr. Kristina Diaz of Yuma Regional Medical Center is seeing it while seeing patients in the several units she helps staff at the hospital.
“I’d say the increase has been over the last five years,” she said, with most cases of opioid dependence or overdose tied to overuse or extended use of prescription pain medication.
On Thursday, Ducey announced the extension of his executive order mandating increased reporting of suspected opioid overdoses, first issued June 15. It requires health care professionals, first responders and other caregivers to report overdoses believed to be opioid-related to the state within 24 hours. Going through normal channels it can take up to a year for the state to receive the data.
The Arizona Department of Health Services said in its most recent “Opioid Report” under the mandatory rapid reporting of possible overdoses, 1,147 cases were documented between July 15 and Aug. 3, and 15 percent of the suspected cases were fatal.
According to a map of the data, the majority of suspected overdoses were reported in Maricopa (893) and Pima (294) counties. Yuma was one of eight counties grouped together as reporting 10-78 possible
overdoses, with no indication of where they sat on that scale. Locations of fatal cases were not included.
Another ADHS presentation indicates no opioid overdose deaths were documented in Yuma County during 2016. Yet another, released a year ago, found the county had a rate of 0.3 opioid (including prescription drugs and heroin) per 100,000 residents, the lowest in the state. The highest death rate was 14.3 per 100,000 in Mohave County.
Other research shows opioid abuse is still a problem for Yuma County. The Opioid and Health Indicator Database, maintained by AmFAR, the Foundation for AIDS Research, said 4.67 percent of Yuma County residents age 12 and older, reported using non-medical use of pain relievers. This was lower than the state average of 5.18 percent and national average of 4.31 percent, and again comparable to seven other Arizona counties
“The majority of the problems are coming from long-term use opiate use in painkillers, and I’m seeing it in the clinic, in the hospital, in the ER,” Diaz said.
Many patients are turning to the ER, either following an overdose or to try to obtain more painkillers, as their physicians try to follow new guidelines for their use being issued in response to concerns about overuse and addiction. Some standalone pain clinics have shut down entirely.
“Some of them are in real pain, have chronic pain, and others are just not amenable to trying other kinds of treatment,” Diaz said. “There are people who have been using Percoset or something else for 10 years now, and all of a sudden their doctor isn’t prescribing it anymore. They have to try to get buy-in from the patient,” she said.
Since Ducey’s declaration of a statewide opioid emergency June 3, the state health department has taken other steps, including making naxalone, the medication most widely used to treat an opioid overdose, more easily available to health and law enforcement agencies, providing training if needed.
YRMC Pharmacy Director Mark Jordan said the hospital has a stable supply of naxalone, and its medical, nursing and pharmacy staffs are trained in the use of this and other medication assisted treatment for overdoses. He said medical professionals are continually being trained and retrained in various treatments and practices as part of their job, and opioid use is no exception.
The hospital’s staff “are responding to emphasis being placed on safe opioid use, early identification of those at risk of opioid related adverse events, mitigating risk of overdose through education of individuals and caregivers to respond in community settings, and compliance with reporting to surveillance systems. These efforts will and do require training of all parties involved.”