[Subtitle]: Identifying Opportunities for Action
Hashtag Vital Signs March 2018.
Emergency department (E D) visits for opioid overdoses rose thirty percent in all parts of the U.S. from July 2016 through September 2017. People who have had an overdose are more likely to have another, so being seen in the E D is an opportunity for action. Repeat overdoses may be prevented with medication assisted treatment (M A T) for opioid use disorder (O U D), which is defined as a problematic pattern of opioid use. Emergency departments can provide naloxone, link patients to treatment and referral services, and provide health departments with critical data on overdoses. E D data provide an early warning system for health departments to identify increases in opioid overdoses more quickly and coordinate response efforts. This fast-moving epidemic does not stay within state and county lines. Coordinated action between emergency departments, health departments, mental health and treatment providers, community based organizations, and law enforcement can prevent opioid overdose and death.
Opioids include prescription pain medications, heroin, and illicitly manufactured fentanyl.
Want to learn more? Visit www.cdc.gov/vitalsigns
[Logo: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.]
Statistics
- Opioid overdoses went up thirty percent from July 2016 through September 2017 in fifty two areas in forty five states.
- The Midwestern region saw opioid overdoses increase seventy percent from July 2016 through September 2017.
- Opioid overdoses in large cities increased by fifty four percent in sixteen states.
Health Departments Can:
- Alert communities to rapid increases in overdoses seen in EDs for an informed and timely response.
- Increase naloxone distribution (an overdose-reversing drug) to first responders, family and friends, and other community members in affected areas, as policies permit.
- Increase availability of and access to treatment services, including mental health services and M A T for O U D.
- Support programs which reduce harms from injecting opioids, including those offering screening for H I V and hepatitis B and C, in combination with referral to treatment.
- Support the use of the C D C Guideline for Prescribing Opioids for Chronic Pain, which encourages using prescription drug monitoring programs (P D M Ps) to inform clinical practice.
https://go.usa.gov/xn6uQ
Opioid overdose emergency department visits continued to rise from 2016 to 2017
From July 2016 through September 2017, opioid overdoses increased for:
- Men by thirty percent and women by twenty four percent.
- People ages twenty five to thirty four by thirty one percent; ages thirty five to fifty four by thirty six percent, and ages fifty five and over by thirty two percent.
- Most states by thirty percent average, especially in the Midwest which saw seventy percent average.
Source: C D C’s National Syndromic Surveillance Program, fifty two jurisdictions in forty five states reporting.
Opioid overdoses continued to increase in cities and towns of all types
[Bar graph shows the following increases:]
- Twenty one percent in non core, non metro areas.
- Twenty four percent in micropolitans, or non metros.
- Thirty seven percent in small metros.
- Forty three percent in medium metros.
- Twenty one percent in large fringe metros.
- Fifty four percent in large central metros. There have been large and steady increases in large cities.
Source: C D C’s Enhanced State Opioid Overdose Surveillance (E S O O S) Program, sixteen states reporting percent changes from July 2016 through September 2017.
Detecting recent trends in opioid overdose emergency department visits provides opportunities for action in this fast-moving epidemic
[Map of United States showing percent change in overdose emergency department visits.]
- Decrease in Kentucky, West Virginia, New Hampshire, Massachusetts, and Rhode Island.
- Increase of one to twenty four percent in Nevada, New Mexico, and Missouri.
- Increase of twenty five to forty nine percent in Indiana, Ohio, North Carolina, and Maine.
- Increase of fifty percent or more in Wisconsin, Illinois, Pennsylvania, and Delaware.
- Data unavailable for remainder of states.
Source: C D C’s Enhanced State Opioid Overdose Surveillance (E S O O S) Program, sixteen states reporting percent changes from July 2016 through September 2017.
A rise in opioid overdoses is detected. What now?
Naloxone is a drug that can reverse the effects of opioid overdose and can be life-saving if administered in time.
Medication-assisted treatment (M A T) for opioid use disorder (O U D) can aid in preventing repeat overdoses. M A T combines the use of medication (methadone, buprenorphine, or naltrexone) with counseling and behavioral therapies.
Coordinated, informed efforts can better prevent opioid overdoses and deaths.
Local Emergency Department
- Offer naloxone and training to patient’s family and friends, in case the patient has another overdose.
- Connect patients with hospital case managers or peer navigators to link them to follow-up treatment and services.
- Plan for the increasing number of patients with opioid-related conditions, including overdose, injection related concerns, and withdrawal.
First Responders, Public Safety, Law Enforcement Officers
- Get adequate supply and training for naloxone administration.
- Identify changes in illicit drug supply and work with state and local health departments to respond effectively.
- Collaborate with public health departments and health systems to enhance linkage to treatment and services.
Mental Health and Substance Abuse Treatment Providers
- Increase treatment services, including M A T for O U D.
- Increase and coordinate mental health services for conditions that often occur with O U D.
Community Based Organizations
- Assist in mobilizing a community response to those most at risk.
- Provide resources to reduce harms that can occur when injecting drugs, including ones that offer screening for H I V and hepatitis B and C, in combination with referral to treatment and naloxone provision.
Local Health Departments
- Alert the community to the rapid increase in opioid overdoses seen in emergency departments and inform strategic plans and timely responses.
- Ensure an adequate naloxone supply.
- Increase availability and access to necessary services.
- Coordinate with key community groups to detect and respond to any changes in illicit drug use.
Community Members
- Connect with organizations in the community that provide public health services, treatment, counseling, and naloxone distribution.
Source: C D C Vital Signs, March 2018.
What Can Be Done
The federal government is:
- Tracking overdose trends to better understand and more quickly respond to the opioid overdose epidemic.
- Improving access to O U D treatment, such as M A T , and overdose reversing drugs, such as naloxone.
- Educating healthcare providers and the public about O U D and opioid overdose, and providing guidance on safe and effective pain management.
- Equipping states with resources to implement and evaluate safe prescribing practices.
- Coordinating actions to reduce production and impacts of the illicit opioid supply in the US through the High Intensity Drug Trafficking Areas (H I D T A) Program.
- Supporting cutting edge research to improve pain management and O U D treatment.
Health departments can:
- Alert communities to rapid increases in overdoses seen in E Ds for an informed and timely response.
- Increase naloxone distribution (an overdose reversing drug) to first responders, family and friends, and other community members in affected areas, as policies permit.
- Increase availability of and access to treatment services, including mental health services and M A T for O U D.
- Support programs that reduce harms which can occur when injecting opioids, including those offering screening for H I V and hepatitis B and C, in combination with referral to treatment.
- Support the use of the C D C Guideline for Prescribing Opioids for Chronic Pain, which encourages using prescription drug monitoring programs (P D M Ps) to inform clinical practice.
https://go.usa.gov/xn6uQ
Emergency departments can:
- Develop post-opioid overdose protocols, which may include:
- Offering overdose prevention education, naloxone, and related training for patients, family members, and friends.
- Linking patients to treatment and services in the community as needed.
- Starting M A T in the E D.
Healthcare providers can:
Prescribe opioids only when benefits are likely to
outweigh risks.
- Determine a patient’s prescription drug history and level of risk by accessing data from their state P D M P.
- Identify mental health, social services, and treatment options to provide appropriate care for patients who have O U D.
- Follow the C D C Guideline for Prescribing Opioids for Chronic Pain. https://go.usa.gov/xn6uQ
Everyone can:
- Learn about the risks of opioids. https://go.usa.gov/xn6um
- Learn about naloxone, its availability, and how to use it. https://go.usa.gov/xn6uV
- Store prescription opioids in a secure place, out of reach of others (including children, family, friends, and visitors).
- Contact S A M H S A’s National Helpline: 1 8 0 0 6 6 2 4 3 5 7 for anyone who has trouble with opioid use. https://go.usa.gov/xn6uw
[The Fine Print]
For more information, please contact
Telephone: 1 8 0 0 C D C INFO (2 3 2 4 6 3 6)
T T Y: 1 8 8 8 2 3 2 6 3 4 8 Web: www.cdc.gov
Centers for Disease Control and Prevention
1600 Clifton Road N E, Atlanta, GA 30333
www.cdc.gov/vitalsigns
www.cdc.gov/vitalsigns/opioid-overdoses/
Publication date: March 6, 2018