The Opioid Epidemic and the Emergency Department

According to the Centers for Disease Control and Prevention (CDC) there are over 42,000 opioid-related deaths in the United States each year, a statistic that’s been on the rise for years. This opioid death rate is now more than five times greater than it was in 1999. Drug overdoses are one of the leading causes of death for Americans under the age of 50, according to data from the National Center for Health Statistics.

1.What is an opioid?

The CDC defines opioids as “a class of drugs used to reduce pain.” Despite this seemingly basic definition, opioids are anything but basic and work in different ways. Common opioids include OxyContin, Vicodin, Percocet, codeine, fentanyl, methadone and heroin. There’s a wide range of legal and illegal drugs that are classified as opioids. For example, Vicodin, a legal painkiller commonly prescribed to patients, is an opioid. By comparison, heroin, an illegally manufactured drug that has no medical use, is also an opioid.

2.The Opioid Epidemic

Unlike other drug epidemics, the reach of opioids is unique. This crisis affects all people in all economic classes, but in different ways. People who can afford prescription drugs are just as susceptible to an overdose as those who cannot afford them because of the unprecedented availability of cheap substitutes.

This widespread availability creates an ironic problem for which the solution is unorthodox. In response to drug problems, the United States typically takes a hardened approach. In the case of the opioid epidemic, it doesn’t, as the solution isn’t about withholding opioids altogether.

Because opioids can be legally prescribed, it’s especially difficult to crack down on and eliminate the opioid problem. Now, the country must figure out how to contend with a saturated market, new synthetic drugs and a skyrocketing overdose rate.

3.The Opioid Epidemic – Impact on Emergency Departments

As one can assume, the opioid crisis has led to increased utilization of and visits to the emergency department (ED). According to the most recent CDC Vital Signs analysis of near real-time data from ERs, ED visits due to suspected opioid overdoses increased nearly 30 percent from the third quarter of 2016 to the third quarter of 2017. This data supports the public’s demands for enhanced prevention and treatment ED methods.

When a suspected overdose occurs, emergency intervention is required. EDs who have been properly trained to respond to overdoses with education and naloxone (an overdose-reversing drug) distribution have a higher success rate at successfully treating overdoses, saving lives and reducing health care costs. Moreover, EDs who receive proper opioid prescribing training can help reduce their contribution to the epidemic.

4.The Patient Population

People who have had an overdose are more likely to have another, so being seen in the ED is an opportunity for action. Repeat overdoses may be prevented with medication-assisted treatment (MAT) for opioid use disorder (OUD), which is defined as a problematic pattern of opioid use. EDs can provide naloxone, link patients to treatment and referral services, and provide health departments with critical data on overdoses.

ED 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. Collaborative efforts between EDs, health departments, mental health and treatment providers, community-based organizations and law enforcement can prevent opioid overdose and death.

5.Summary

The opioid crisis is not going away. In fact, with newer and more lethal illegal opioids being created every single day, the crisis may only get worse. That’s why it’s imperative that EDs, physicians and providers become properly educated and prepared to effectively combat the opioid epidemic.

By: MedEdNow Staff