app.com: Opioid-related trips to NJ ERs have doubled

6/21/2017

Opioid-related trips to emergency departments in New Jersey doubled between 2005 and 2014, according to new data from a federal report.

Inpatient stays in New Jersey increased at a much lower rate, bringing the combination of both to a 50 percent rise over the 10-year period, according to the data.

That’s small compared with the national picture.

Across the country, the rate of both emergency department visits and inpatient stays because of opioids jumped 91 percent between 2005 and 2014.

Nationally, Americans made 1.28 million overall trips to a hospital because of opioid problems in 2014. In New Jersey, the trips stood at 44,800, up from 29,900 in 2005.

DEATH TOLL: Should NJ sue Big Pharma over the opioid epidemic? Watch the video at the top of this story

The numbers provide a snapshot of the growing strain the opioid epidemic has placed on the nation’s hospitals. A report by the Agency for Healthcare Research and Quality, which is under the U.S. Department of Health and Human Services, breaks the numbers down by gender and age.

The rising death toll from opioid use has captured the devastation of the epidemic. Opioids killed 33,000 people in the United States in 2015.

“It’s really just the tip of the iceberg,” said Anne Elixhauser, co-author of the report.

The report shows another layer of the crisis. The number of hospital visits is more than 40 times the number of deaths from opioids in the U.S. in 2014.

Local burden

Dr. Christopher Freer, who oversees 11 emergency departments in New Jersey for RWJBarnabas Health, said the uptick in cases has dramatically altered the way patients with opioid problems are being handled.

The health care system has put opioid-related problems on par with the potentially deadly infection sepsis as priorities, he said.

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Freer began his career as a resident at The Johns Hopkins Hospital in Baltimore, where heroin addiction has long strained the health care system there.

The problem in emergency rooms in New Jersey really came to a head about three years ago, he said.

“There were no resources for the patients ending up at our doorstep at all hours because of an overdose or just looking for help,” he said.

Now, opioid prescriptions are closely monitored at the hospitals in the system and narcotics are no longer a first line of defense against pain, he said.

Educating staff on addiction is a big part of “turning the tide,” he said. Heroin addicts when they come to an emergency department “are not in a good spot,” he said. They are difficult to deal with, affecting the general impression of those patients.

The addition of recovery specialists in hospitals – former addicts who try to steer addicts into treatment – have ushered in an enormous change in how addiction patients are viewed in emergency departments, removing some of the stigma of addiction, he said. The specialists provide an example of how addicts can transform themselves, he said.

“It’s really changing people’s attitudes,” he said.

Unlike the data for other states, the data for New Jersey go beyond 2014. And the visits keep climbing.

From 2014 to 2015 alone, both emergency department visits and inpatient admissions rose 13 percent in New Jersey.

And they show no signs of flagging.

In the first three quarters of 2016, the most up-to-date figures available, inpatient treatments rose to 22,450. That’s an 11 percent increase from the first three quarters of 2015, which saw 20,300 in-patient treatments in New Jersey.

Economic toll

Figures for emergency department visits were not available for 2016.

Researchers from the National Center for Injury Prevention and Control, part of the Centers for Disease Control and Prevention, estimated the cost of the opioid epidemic at $78.5 billion in 2013 dollars. Health care costs accounted for $28 billion, all but $2 billion covered by insurance.

Lost productivity cost $20 billion, according to the study. Criminal justice costs were about $7.7 billion.

Public sources, including Medicaid, Medicare and veterans’ programs, covered nearly a quarter of the costs.

The report and the raw data show how New Jersey ranks in certain categories:

  • New Jersey had the eighth-highest number nationally of male patients with opioid-related inpatient stays in 2014
  • New Jersey had the sixth-highest number of male patients who visited emergency departments for opioid problems in 2014, among the 30 states that participated
  • While the rate of females has caught up with that of males nationally when it comes to impatient stays, in New Jersey a gap between the two has remained steady over the 10 years, with males being seen more.
  • New Jersey’s rate of visits and stays is about 50 percent higher than the national average, partly explained by the fact that urban settings see higher numbers than rural areas.