The Opioid Crisis Causes a Massive Spike in ER Admissions

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According to new data released by the CDC, the number of emergency room visits for opioid overdoses has increased 30% over the span of 14 months. During this time, a total of 1.27 million Americans reportedly needed urgent medical care for opioid-related issues. However, this is not the first time the United States has experienced such a drastic increase in opioid-related ER admissions.

A 2017 Statistical Brief by the Agency for Healthcare Research and Quality (AHRQ) showed a similar spike in hospitalizations. According to the AHRQ’s report, the number of opioid-related hospitalizations nationwide increased by 64% over the course of nine years. During this same time, the number of ER admissions for opioid overdose nearly doubled.

What’s troubling about the AHRQ’s findings is that they show twice the number of opioid-related hospitalizations from the CDC’s report, which was only just released earlier this March. In other words, half a decade’s worth of opioid cases flooded hospitals in just this past year. More information about both reports is shown below.

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The Statistical Brief from the Agency for Healthcare Research and Quality

The information provided in the AHRQ report covered U.S. hospitalizations between 2005 and 2014. Researchers examined inpatient and ER admission trends on both a national and state level. During this nine-year span, opioid-related hospital cases increased for both men and women, and across all age groups.

Inpatient Stays vs. ER Admissions

Overall, the rate at which opioid-related ER admissions increased between 2005 and 2014 was faster than the inpatient stay rate. This was true for both male and female patients across all age groups. In fact, the report states that the number of opioid-related ER admissions for men increased by 103% while inpatient cases increased by 55% as compared to the hospitalization rates before 2005. For women, the increases in ER admissions versus inpatient stays were 95% and 75% respectively.

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Opioid-Related Inpatient Hospitalizations by Gender

The AHRQ reported that the rate of opioid-related inpatient hospitalizations rose more quickly for women than for men from 2005 to 2014. However, this doesn’t mean that the number of female patients was always higher for opioid cases. In fact, 2005 saw the inpatient check-in rate of 145.6 per 100,000 for men. Meanwhile, the inpatient check-in rate for women was 127.8 per 100,000.

After that, non-emergency hospital patients with opioid use disorders were predominantly female. By 2014, women had a statistically higher rate of opioid-related inpatient stays than men did. This was true for the majority of the states.

The average number of inpatient opioid-related hospitalizations across 33 states was 221.2 per 100,000 women. Meanwhile, men had higher rates than women in 11 states, with an average admissions rate of 339.9 per 100,000.

Opioid-Related ER Admissions by Gender

In 2005, male patients had 99.9 per 100,000 ER visits for opioid-related issues while female patients had 78.6 per 100,000. These rising ER admission rates remained consistent throughout the next nine years. In 2014, men still had a higher rate of opioid-related ER visits (202.8 per 100,000) than women did (153.2 per 100,000).

Overall, women seemed to have a higher number of overall inpatient admissions while men had a higher number of ER visits between 2005 and 2014.

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Opioid-Related Inpatient Hospitalizations by Age Group

Regarding opioid-related inpatient hospitalization, patients in two different age groups had strikingly similar admissions rates between 2005 and 2014. Interestingly enough, these nearly identical rates between the two groups were also the highest of all three age groups.

By 2014, the rate of opioid-related inpatient admissions was highest among:

  • Patients aged 25 to 44 in 22 states (414.4 per 100,000)
  • Patients aged 45 to 64 years in 9 states and D.C. (491.5 per 100,000)
  • Patients aged 65 years or more in 13 states (290.0 per 100,000)

Opioid-Related ER Admissions by Age Group

The rate of opioid-related ER admissions for all age groups increased faster than that of opioid-related inpatient cases. For example, ER admissions for opioid overdose patients aged 25 to 44 years increased by 109% while the rate of inpatient stays for the same age group increased by almost half that at 55%.

By 2014, the rate of opioid-related ER admissions was highest among patients aged 25 to 44 in 30 states. Patients aged 45 to 64 years had the second highest ER admissions rates.

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The Vital Signs Report from the CDC

The recent spike in opioid-related hospital admissions was seen across all demographics, but varied by state. The most recent issue of the CDC’s Vital Signs Health Topic monthly report collected and shared hospital emergency department data using two distinct methods. The first is the CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) Program, which provides data on both fatal and nonfatal opioid overdoses, as well as the risk factors associated with fatal overdoses. This program focused mainly on the states that have been the most severely affected by the opioid crisis.

The second is the National Syndromic Surveillance Program (NSSP) BioSense Platform, which is a collaborative data collection and sharing platform between public health agencies and CDC partners. This platform improves public awareness of (and responsiveness to) epidemic events, such as the opioid crisis.

Using these two methods of data collection, CDC’s researchers identified 142,557 ER-treated cases of opioid overdose during the 14-month study period.

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Findings from the ESOOS Program

The ESOOS program focused primarily on detecting changes in opioid-related ER admission trends in each of the 50 states. Through this program, the CDC found that 16 states experienced notable variations in ER visits from July 2016 through September 2017. Some states showed a decrease in opioid-related ER admissions while others showed mild to drastic increases. Overall, ER admissions for opioid overdoses increased by a cumulative 35% in these 16 states.

Details from the ESOOS data report reveal that:

  • Kentucky, Massachusetts, New Hampshire, Rhode Island, and West Virginia were the only states to experience a decrease in opioid-related ER admissions.
  • Missouri, Nevada, New Mexico experienced an increase in opioid-related ER admissions ranging from 1% to 24%.
  • Indiana, Maine, North Carolina, and Ohio experienced an increase in opioid-related ER admissions ranging from 25% to 49%.
  • Delaware, Illinois, Pennsylvania, and Wisconsin experienced an increase in opioid-related ER admissions by 50% or more.

The most significant increases in ER admissions seem to have been in both the Midwest and the Northeast. Wisconsin saw the most devastating rise in opioid overdoses at 109%. Others include Delaware at 105%, Pennsylvania at 81%, and Illinois at 66%.

Also, the rise in ER admissions seemed to affect cities and towns of all types. The highest increase at 54% affected large, central metropolitan areas with populations of 1 million or more.

Findings from the NSSP BioSense Platform

The NSSP BioSense platform allowed CDC researchers to examine the changes in opioid-related ER admission trends on a much larger scale. The information gathered through this method was included, along with the ESOOS program’s findings, in the final report. The main reason for this could be because the ESOOS method only gathered information from 16 states.

The NSSP BioSense platform gathered data from a total of 52 jurisdictions in 45 states. This area represents more than 60% of ER admissions in the United States. This collection of data revealed that the rates of opioid-related overdoses between July 2016 and September 2017 have increased by an average of:

  • 30% in 52 jurisdictions across 45 states
  • 14% in the Southeast region of the U.S.
  • 20% in the Southwest region of the U.S.
  • 21% in the Northeast region of the U.S.
  • 40% in the West region of the U.S.
  • 70% in the Midwest region of the U.S.
  • 31% for people 25 to 34 years of age
  • 36% for people 35 to 54 years of age
  • 32% for people 55 years of age and older
  • 24% for women overall
  • 30% for men overall

This wave of ER admissions across a wide variety of data points covered in the analysis demonstrates the severity of the ongoing opioid crisis.

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Ways to Battle the Opioid Crisis Going Forward

The AHRQ report and the Vital Signs report— and many others like it— are meant to help identify and track changes in health trends nationwide. Both the AHRQ’s and the CDC’s findings highlight the need for changes in the way the nation addresses the opioid crisis.

The sharp increase in opioid-related ER admissions illustrates that local health departments, healthcare providers, medical emergency departments and the federal government all play a central role in battling the effects of the opioid crisis. Both the AHRQ and CDC reports suggest that public health would benefit from:

  • Better coordinated efforts between the medical community, law enforcement, federal government and general public
  • More advanced opioid use disorder treatment methods
  • Improved opioid use disorder prevention efforts

Health Departments

Health departments on both the state and local level can improve their efforts to combat the opioid crisis by:

  • Using ED data (instead of national-level statistics) to keep communities and lawmakers informed about the status of the crisis
  • Increasing the availability of naloxone to first responders, law enforcement officers, and community members in affected areas
  • Provide more access to addiction treatment services, like mental health services and medically-assisted detox
  • Alerting communities to any increases in overdoses seen in ERs
  • Coordinating faster responses as ER trends fluctuate

Healthcare Providers

Healthcare providers, such as doctors and physician assistants (PAs), can do their part to combat the opioid crisis by:

  • Sharing information with patients regarding mental health services and treatment options in the event of opioid addiction development
  • Examining a patient’s prescription drug history to determine the risks of opioid addiction development
  • Prescribing opioids to patients only when the benefits outweigh the risks
  • Prescribing opioids to patients only if no other alternatives are available
  • Following the CDC’s Guideline for Prescribing Opioids for Chronic Pain

Emergency Departments

Emergency departments nationwide already help opioid overdose patients through ER treatment. Still, there are also other ways they can help, such as:

  • Providing information about overdose prevention, naloxone, and other related educational training for patients, their friends and family, and the community
  • Making naloxone and other opioid addiction prevention resources more widely accessible
  • Developing appropriate post-opioid overdose protocols to ensure better patient recovery
  • Sending patients to addiction treatment and mental health services as needed

The Federal Government

The federal government has already taken several progressive steps toward combatting the ongoing opioid crisis nationwide. However, there are still more ways it can lend assistance to the general public. For example, the federal government can improve its efforts by:

  • Providing guidance to healthcare providers about safe and effective chronic pain management for patients
  • Regularly tracking opioid overdose trends for better understanding and responsiveness to the crisis
  • Working with healthcare agencies and EDs to improve access to opioid use disorder treatment options
  • Educating both healthcare providers and the public about the effects and consequences of opioid use
  • Supplying state healthcare systems with the resources necessary for safe prescribing practices
  • Supporting research that improves pain management and opioid addiction treatment
  • Assisting in making naloxone more accessible to the general public

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Treatment for Opioid Addiction at TTC Outpatient Services

Unfortunately, the studies conducted and reported by both the AHRQ and the CDC indicate that the opioid crisis is still on the rise. There has been some progress in slowing it down, but the agencies mentioned above must make collaborative efforts to end the opioid crisis entirely.

If you or someone you know is struggling with an opioid use disorder, please call TTC Outpatient Services. Our customized programs and services will allow you to receive the treatment you need without impeding on your daily routine. For more information, speak to one of our admissions counselors at 844-665-6834.