Is the opioid epidemic getting worse?
New data from the Centers for Disease Control and Prevention (CDCP) indicates that it could be, according to CDC Acting Director Anne Schuchat, M.D.
The data shows a sharp increase in emergency room visits for opioid overdoses from 2016 to 2017 – a 30 percent increase in ER visits for overdoses in 45 states,from July 2016 to September 2017.
The report analyzes the most recent data available to CDC on ED visits for opioid overdoses across multiple states. Overall, ED visits (reported by 52 jurisdictions in 45 states) for suspected opioid overdoses increased 30 percent in the U.S., from July 2016 through September 2017. Opioid overdoses increased for men and women, all age groups, and all regions, but varied by state, with differences beteween rural and urban areas.
Schchat said the findings point to a need for enhanced prevention and treatment efforts in EDs and for greater access to evidence-based opioid use disorder treatments, including medication-assisted treatment and harm reduction services.
“Long before we receive data from death certificates, emergency department data can point to alarming increases in opioid overdoses,” Schuchat said. said CDC Acting Director Anne Schuchat, M.D. “This fast-moving epidemic affects both men and women, and people of every age. It does not respect state or county lines and is still increasing in every region in the United States.”
The CDC analyzed data from 16 states in its Enhanced State Opioid Overdose Surveillance (ESOOS) Program, 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 most impacted by the epidemic. The data show:
- Eight states from three U.S. regions reporting 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).
- Sizeable 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 (<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).
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, officials said. Better coordination between public health and public safety agencies is needed to more effectively track changes in supply and use of illicit opioids, so communities can take timely action.
CDC also examined data from the National Syndromic Surveillance Program (NSSP) BioSense platform, using ESSENCE (Electronic Surveillance System for the Early Notification of Community-based Epidemics) software. Analysis of data from 52 jurisdictions in 45 states, which covers over 60 percent of ED visits in the U.S., found that from July 2016 through September 2017:
- All five U.S. regions experienced rate increases; the largest was in the Midwest (70 percent), followed by the West (40 percent), Northeast (21 percent), Southwest (20 percent), and Southeast (14 percent).
- Every demographic group experienced substantial rate increases, including men (30 percent) and women (24 percent) and people ages 25-34 (31 percent), 35-54 (36 percent), and 55 or older (32 percent).
“Research shows that people who have had an overdose are more likely to have another. Emergency department education and post-overdose protocols, including providing naloxone and linking people to treatment, are critical needs,” said Alana Vivolo-Kantor, behavioral scientist in CDC’s National Center for Injury Prevention and Control. “Data on opioid overdoses treated in emergency departments can inform timely, strategic, and coordinated response efforts in the community as well.”