Delaware ED Data Shows Significant Increase in Opioid Overdoses;DPH Announces Forum for First Responders and EDs to Address Overdose Management

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Date Posted: Wednesday, March 7th, 2018
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Dover – The Centers for Disease Control and Prevention (CDC) on Tuesday, released data from emergency departments (EDs) showing substantial increases in opioid overdose numbers nationwide, including in Delaware. According to the CDC’s Vital Signs report, which examined ED visit data in 45 states, visits for suspected opioid overdoses increased 30 percent nationwide from July 2016 to September 2017. Of 16 states participating in enhanced data surveillance, Delaware reported the second-highest percent change for suspected opioid overdose ED visits during that time period (105 percent).

Of 2,075 suspected overdose-related ED visits during this time, 1,529 (74 percent) were in New Castle County, 355 (17 percent) in Sussex County and 191 (nine percent) in Kent County. Most significantly, the number of ED overdose visits increased most sharply and more than doubled in New Castle County from 189 in the third quarter of 2016 to 464 in the third quarter of 2017. It is important to note, however, that the report does not include the state rates per 100,000 overdose-related deaths, which is a more stable measure of increases and decreases over time.

Emergency department data can point to alarming increases in opioid overdoses, and clearly we are concerned about the increases here in Delaware,” said Division of Public Health (DPH) Director, Dr. Karyl Rattay. “The report’s findings highlight the need for enhanced prevention and treatment efforts in EDs, including offering overdose prevention education, naloxone and related training for patients, family members, and friends, initiating buprenorphine in the ED and linking patients to treatment and services in the community as needed.”

The Division of Public Health, already recognizing the important role that not only emergency departments, but also first responders have to play in battling the state’s opioid epidemic, is holding the Acute Overdose Management System of Care Forum on Tuesday, March 13, 2018, at Delaware Technical Community College in Dover for these audiences.

DPH hopes to use the System of Care approach that it has successfully used with its Trauma, Pediatric and Stroke programs to address opioid overdoses in the state. The System of Care approach focuses on an organized approach to patient management throughout the continuum of ca

CDC Opioid Overdose Graphic

re statewide. It involves coordination of care from pre-hospital transport through acute-care discharge, multidisciplinary involvement from dispatch, prehospital, hospitals, medical specialists, prevention, the use of documenting system data resulting in improved communication and collaboration among stakeholders to ensure patients receive the same quality of care no matter where in the state they enter the system. A goal of developing the Acute Overdose System of Care includes better connecting individuals in need of treatment to the Centers of Excellence Substance Use Model of Care which is also currently in development.

“Partnerships, organized into a System of Care, will strengthen and expand efforts, providing better patient experience and outcome system-wide,” Dr. Rattay said. “We will also use the opportunity to encourage emergency responders at all levels to provide all-important and extremely critical connections to treatment resources for patients in crisis.”

Data from 16 states in the CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) Program were analyzed for the report, showing quarterly trends by state and rural/urban differences from July 2016 through September 2017. Overall, ED visits for suspected opioid overdoses increased 35 percent in these 16 states hit hard by the epidemic. The data show:

  • Eight states from three U.S. regions report substantial increases—25 percent or greater—in the rate of opioid overdose ED visits.
  • Significant increases in all states reporting in the Midwest, including Wisconsin (109 percent), Illinois (66 percent), Indiana (35 percent), Ohio (28 percent), and Missouri (21 percent).
  • Considerable variation among states in the Northeast and Southeast; some states reported substantial increases and others modest decreases:

    • In the Northeast, large increases were seen in Delaware (105 percent), Pennsylvania (81 percent), and Maine (34 percent), but other states, like Massachusetts, New Hampshire, and Rhode Island, showed nonsignificant decreases (less than 10 percent).
    • In the Southeast, North Carolina reported an increase (31 percent), while Kentucky reported a statistically significant decrease (15 percent).
  • Continued rises in cities and towns of all types. Highest rate increases (54 percent) were in large central metropolitan areas (a population of 1 million or more and covering a principal city).

While Delaware’s ED overdose visits more than doubled during this time period (from 296 in the third quarter of 2016 to 596 at the end of the third quarter of 2017), due to Delaware’s small population, it is possible that our rates of ED overdose visits are still lower than other states’ rates who did not show a percent change (or a negligible one) during this time.

The sharp increases and variation across states and counties indicate the need for better coordination to address overdose outbreaks spreading across county and state borders. Closer coordination between public health and public safety agencies can support identification of changes in supply and use of illicit opioids, further allowing communities to take appropriate action to reduce opioid overdoses.

To learn more about the signs of addiction, prevention and treatment resources, and the availability of naloxone training in the community, visit HelpIsHereDe.com.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

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