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ED Visits Up for Opioid Overdoses; What Staff Can Do to Help

Emergency department (ED) visits for overdoses continue to rise, and public health officials are asking ED staff to do more to resolve the issue.

The U.S. Centers for Disease Control and Prevention (CDC) reports that, from July 2016 to September 2017, opioid overdose-related ED visits for those 11 and older in the United States increased 29.7% overall and 34.5% in 16 states with high prevalence of overdose mortality.

The article in the Morbidity & Mortality Weekly Report found that 142,557 ED visits — 15.7 per 10,000 visits — from 52 jurisdictions in 45 states were suspected opioid-involved overdoses, increasing on average by 5.6% per quarter. While rates increased across all five U.S. regions, the greatest spikes were in the Southwest, Midwest, and West, averaging 7% to 11% per quarter.

The CDC suggests that “increases in prevalence of ED visits for suspected opioid overdoses in the Southwest and West and decreases in the Southeast (Kentucky and West Virginia) were unanticipated and might foreshadow changes in opioid overdose death trends in 2017.”

Suspected opioid-involved overdoses made up a greater proportion of ED visits in 16 states, where 119,198 ED visits — 26.7 per 10,000 visits — fell into that category. Opioid overdose-related ED visits shot up 109% in Wisconsin and 105% in Delaware. Rates also increased 31% in North Carolina.

On the other hand, nonsignificant decreases of less than 10% were calculated in three Northeastern states. In the Southeast, those categories of visits decreased by 15% in Kentucky and 5.3% in West Virginia.

The increases cut across every demographic group, the CDC said, including males (30%) and females (24%) as well as all age groups — a 31% increase for those age 25 to 34 years, a 36% increase for those 35 to 54 years, and a 32% increase for those 55 years and older.

Large central metropolitan areas with a million or more residents had the highest opioid overdose rate increases, according to the report.

The CDC notes that ED visits “can serve as an early warning system to alert communities of changes in opioid overdoses,” pointing out that the data usually is available 24 to 48 hours after presentation.

As opioid overdoses continue to rise, providing timely data can promote informed action by ED physicians and public health practitioners. “Increases in opioid overdoses varied by region and urbanization level, indicating a need for localized responses,” the study concludes. “Educating ED physicians and staff members about appropriate services for immediate care and treatment and implementing a post-overdose protocol that includes naloxone provision and linking persons into treatment could assist EDs with preventing overdose.”

Public health officials also said that the opioid overdose epidemic continued to worsen in the U.S. in 2016, with 63,632 drug overdose deaths occurring, which is a 21.4% increase from 2015. Although prescription drugs play a large role, the CDC said that “heroin and synthetic opioids (e.g., fentanyl) are driving increases in opioid-involved deaths.”

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