Vital Signs: Trends in Emergency Department Visits for Suspected Opioid Overdoses — United States, July 2016–September 2017

Abstract

IntroductionFrom 2015 to 2016, opioid overdose deaths increased 27.7%, indicating a worsening of the opioid overdose epidemic and highlighting the importance of rapid data collection, analysis, and dissemination.MethodsEmergency department (ED) syndromic and hospital billing data on opioid-involved overdoses during July 2016–September 2017 were examined. Temporal trends in opioid overdoses from 52 jurisdictions in 45 states were analyzed at the regional level and by demographic characteristics. To assess trends based on urban development, data from 16 states were analyzed by state and urbanization level.ResultsFrom July 2016 through September 2017, a total of 142,557 ED visits (15.7 per 10,000 visits) from 52 jurisdictions in 45 states were suspected opioid-involved overdoses. This rate increased on average by 5.6% per quarter. Rates increased across demographic groups and all five U.S. regions, with largest increases in the Southwest, Midwest, and West (approximately 7%–11% per quarter). In 16 states, 119,198 ED visits (26.7 per 10,000 visits) were suspected opioid-involved overdoses. Ten states (Delaware, Illinois, Indiana, Maine, Missouri, Nevada, North Carolina, Ohio, Pennsylvania, and Wisconsin) experienced significant quarterly rate increases from third quarter 2016 to third quarter 2017, and in one state (Kentucky), rates decreased significantly. The highest rate increases occurred in large central metropolitan areas.Conclusions and Implications for Public Health PracticeWith continued increases in opioid overdoses, availability of timely data are important to inform actions taken by EDs and public health practitioners. Increases in opioid overdoses varied by region and urbanization level, indicating a need for localized responses. 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.

Epidemiology of the U.S. opioid crisis: the importance of the vector

“…In addition to the significant rise in mortality, opioid use has been associated with increasing morbidity. For instance, opioid‐related emergency department (ED) visits increased 30% between July 2016 and September 2017 . Further, the use of opioids by pregnant women, which can lead to serious complications for the baby, including fetal death and infants born physically dependent on opioids (i.e., neonatal abstinence syndrome or NAS), has been increasing in recent years, as have infectious diseases from sharing infected injection drug paraphernalia.…”

Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data

“…Burden of Disease Collaborators, 2018). The continued increases in substance-involved overdoses demonstrate an urgent need to study comorbid alcohol/drug use disorders and chronic diseases to inform healthcare services for improving alcohol/drug use disorder care and outcomes in medical settings (Hedegaard et al, 2017; Hoge et al, 2014; Vivolo-Kantor et al, 2018). …”

Rural‐Urban Trends in Opioid Overdose Discharges in Missouri Emergency Departments, 2012‐2016

“…ED data have the additional benefit of a reduced time lag in comparison to receiving finalized death certificates, which can better assist states in not only identifying opioid‐involved overdose, but also in responding more effectively by quickly providing resources to communities in need. Most recent estimates from 16 states across the United States indicate a 30% increase in opioid overdose visits to EDs from July 2016 through September 2017 . Vivolo‐Kantor et al also found increases for most states in the United States, with some states showing larger increases than other states.…”

“…Most recent estimates from 16 states across the United States indicate a 30% increase in opioid overdose visits to EDs from July 2016 through September 2017 . Vivolo‐Kantor et al also found increases for most states in the United States, with some states showing larger increases than other states. In addition, disparities between levels of urbanization were examined.…”

“…In addition, disparities between levels of urbanization were examined. Though all urbanization levels saw large increases, large fringe metropolitan areas witnessed the largest increases (54%), indicating a potential worsening of the epidemic in certain types of geographic areas . Tracking opioid overdose deaths by geographic areas and urbanization is critical to inform and target interventions.…”