The Dorothy Rider Pool Health Care Trust

The national and state impact of the opioid epidemic

There are daily updates in the local and national news media about the opioids epidemic in America and its impact on communities everywhere. But while we’ve been hearing more and more about opioids lately, the crisis has been steadily building since the 1990s with drugs like OxyContin taking center stage.

The Centers for Disease Control and Prevention (CDC) reports some sobering statistics, which continue to change each year. Highlights include:

  • Most drug overdose deaths (more than six out of 10) involve an opioid
  • Since 1999, the number of overdose deaths involving opioids (including prescription opioids and heroin) quadrupled
  • From 2000 to 2015 more than half a million-people died from drug overdoses
  • 91 Americans die every day from an opioid overdose

According to an August 8 article, nearly 15,000 Americans died of an opioid overdose in 2005, and in 2015 that number soared to 33,000. But a recent Washington Post blog post by Keith Humphreys, a Professor of Psychiatry at Stanford University, suggests that the federal government is consistently undercounting the number of heroin users.

According to this August 22 post, the federal government’s annual National Household Survey on Drug Use and Health “has two serious flaws that lead it to dramatically underestimate the prevalence of heroin use disorder. First, it excludes people who are incarcerated and people who are living on the street, both of whom have very high rates of drug use. Second, it relies on self-reports: While most people are comfortable telling government surveyors about their use of tobacco, alcohol and marijuana, many understandably fear acknowledging use of heroin… The degree to which NSDUH underestimates the prevalence of heroin use disorder is enormous… The true level of heroin use disorder today could easily be double or even triple NSUDH’s estimate, but no one can truly know.”

Intended to treat moderate-to-severe pain, prescriptions for opioids have increased in the past 20 years as medical professionals more readily prescribed them and abuse took off. But prescription opioid availability can become a challenge once a treatment course ends for drugs like hydrocodone, oxycodone, morphine, and codeine.

The Substance Abuse and Mental Health Services Administration noted, “As people use opioids repeatedly, their tolerance increases and they may not be able to maintain the source for the drugs. This can cause them to turn to the black market for these drugs and even switch from prescription drugs to cheaper and more risky substitutes like heroin.”

The CDC supported this observation noting, “The number of people who started to use heroin in the past year is also trending up. Among new heroin users, approximately three out of four report abusing prescription opioids prior to using heroin.”

The crisis once again took center stage nationally on August 10, when “President Donald Trump declared the opioid crisis a national emergency… a designation that would offer states and federal agencies more resources and power to combat the epidemic” according to a report.

The epidemic in the Commonwealth

Pennsylvania has not escaped the crisis. According to the web site, “this epidemic affects every walk of life… At least 10 Pennsylvanians die every day from a drug overdose, with over 3,500 overdose deaths in Pennsylvania in 2015 alone.”

An August 7 article in The Morning Call on a new report by the American Journal of Preventative Medicine stated “Pennsylvania has the fourth highest heroin death rate and the seventh highest opioid death rate.” The study “adjusted 2014 death rates to compensate for disparities in how drug deaths are documented. Pennsylvania was previously ranked 20th for heroin deaths and 32nd for opioid deaths. The adjusted rate showed that 17.8 out of 100,000 people died of an opioid overdose in Pennsylvania in 2014. The state had the greatest increase after the study adjusted overdose death rates nationally.”

The Morning Call article went on to state “In 2016, heroin took a life nearly every other day in the Lehigh Valley. Last year, 58 people in Northampton County died of opioid or heroin overdoses, according to a review of coroner records by The Morning Call. In Lehigh County, there were 38 accidental overdoses involving opiates, as well as 73 deaths tied to multiple drugs.”

A new state law in 2014 expanded who can legally administer the drug Naloxone (also known by the brand name Narcan) to assist in saving an opioid overdose victim. The new law allows the rescue drug to be legally administered by medical service providers, law enforcement, and even friends and family, of someone suffering from a drug overdose.

Governor Tom Wolf announced at a December 2016 press conference, that more than 2,000 opioid overdoses in Pennsylvania had been reversed by naloxone since November 2014. An August 4, 2017 map of Naloxone Reversals by Police Officers in Opioid Overdoes Events created by the Pennsylvania Department of Drug and Alcohol Programs showed 3,845 total reversals in the Commonwealth, and a combined total of 166 reversals in Lehigh and Northampton Counties to-date.