By Rob Stein
There’s more bad news about the nation’s devastating opioid epidemic.
The overall increase in opioid overdoses seen in hospital emergency rooms between the third quarter of 2016 and the third quarter of 2017 occurred across the nation. Some parts of the country experienced far greater increases, while a few have reported declines, the analysis shows.
“We have an emergency on our hands,” says acting CDC Director Anne Schuchat. “The fast-moving opioid overdose epidemic continues and is accelerating.”
The largest regional increase occurred in the Midwest, which saw a 69.7 percent jump in opioid overdoses, according to the report. The jump was driven in part by a 109 percent increase in Wisconsin. Overdoses increased 40.3 percent in the West, 21.3 percent in the Northeast, 20.2 percent in the Southwest and 14 percent in the Southeast.
“We saw, sadly, that in every region, in every age group of adults, in both men and women, overdoses from opioids are increasing,” Schuchat says.
The latest data could underestimate the overdoses, because many people who overdose never end up in the emergency room. “It might be even worse,” Schuchat says.
The report didn’t specify why overdoses vary across the country. But one factor is probably the differences in availability of newer, highly potent illegal opioids, such as fentanyl, which have been flooding the country in recent years, Schuchat says.
“We think that the number of people addicted to opioids is relatively stable. But the substances are more dangerous than five years ago,” Schuchat says. “The margin of error for taking one of these substances is small now and people may not know what they have.”
The supply of those more dangerous drugs is increasing faster in some parts of the country than in others, which may help explain the geographic variations, Schuchat says.
“Overall as a nation, we are still failing to adequately respond to the opioid addiction epidemic,” says Dr. Andrew Kolodny, co-director of opioid policy research at Brandeis University. “It is concerning that 20 years into this epidemic, it is still getting worse. The number of Americans experiencing opioid overdoses is still increasing.”
Although the Trump administration recently declared the epidemic to be an emergency, a significant increase in funding is urgently needed to treat Americans addicted to opioids. Kolodny says.
“It’s kind of like pointing to a burning building and saying, ‘Oh, there’s a fire there. There’s an emergency.’ And then not calling the fire department and watching it burn down,” Kolodny says. “There’s been a lot of talk from Congress and from the administration and a recognition that we need to do something about this problem. But nothing yet has happened.”
Others say the key is integrating addiction treatment better into the health care system. For example, emergency room staff need better training to make sure people with substance-use disorder get follow-up addiction treatment, says Jessica Hulsey Nickel, president and chief executive officer of the Addiction Policy Forum. Too often, addicts are simply revived and sent home without follow-up care, only to overdose again, she says.
“We can use this near-death experience — use it as moment to change that person’s life,” Nickel says.
The latest analysis is an attempt by the CDC to track the opioid epidemic more closely, Schuchat says. Previously, the agency looked at death from opioids, which lag behind reports from emergency rooms.
“We wanted more timely information,” Schuchat says.
The analysis was based on about 91 million emergency room visits that occurred between July 2016 and September 2017, including 142,557 visits that were suspected opioid overdoses.
That survey showed an increase of 29.7 percent in 52 jurisdictions in 45 states between July through September 2016 and the same period in 2017, according to the report.
The researchers also analyzed 45 million emergency department visits that occurred in 16 states during the same period, which included 119,198 suspected opioid overdoses.
That analysis showed a 34.5 percent increase between the same periods in 2016 and 2017. But those increases varied dramatically from state to state, even within a region.
For example, overdoses increased 105 percent in Delaware, compared with 80.6 percent in Pennsylvania and 34 percent in Maine. Overdoses may have actually slightly decreased in Massachusetts, New Hampshire and Rhode Island. In Kentucky, the CDC’s analysis showed a 15 percent drop in overdoses.
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