ERs see a 30 percent spike in drug overdose cases, as opioid crisis worsens

cdc-opoid-overdose-300x136America’s drug overdose crisis keeps  worsening, with federal officials reporting that emergency room treatment of opioid overdoses spiked by 30 percent across the nation in 2017.

Abuse of opioids, including the synthetic painkiller fentanyl and heroin, also is triggering significant outbreaks of diseases, including hepatitis C, which is costly to treat, and deadly major bacterial infections.

And the prescription painkiller crisis — which studies increasingly show was been launched, in part, based on wrong information about drugs’ purported benefits — may be masking the worrisome rise, yet again, of cocaine abuse.

Although no region of the nation was spared, the Midwest (up 70 percent) and big cities (up 54 percent) saw the greatest increases in ER treatment for opioid overdoses, treatment involving a total of 142,000 patients across the country from July 2017 to September 2017, the federal Centers for Disease Control and Prevention reported.

As the Washington Post also said of the CDC data on ER opioid care: “In 16 states that have suffered high rates of overdose deaths, the jump was even higher, at 34.5 percent … two states — Wisconsin and Delaware — saw overdose visits to their emergency rooms more than double.”

The CDC drilled down on ER treatment data because it gives a timelier view of the nation’s opioid crisis. Many reports have focused, instead, on overdose fatalities, the reporting of which often lags at least a year behind. In 2016, federal officials found that almost 64,000 Americans died of drug overdoses, two-thirds of them from opioids. That’s a rising toll that makes overdoses the leading cause of death for Americans younger than 50.

But the harms of the opioid crisis also extend beyond escalating ER care, which is among the costliest treatment in the U.S. health system, or the increasing number of tragic deaths of younger Americans.

Vox, a news and information site, reports that areas hard-hit by the opioid crisis also are seeing big increases in hepatitis C and nasty bacterial infections. These occur because abusers use contaminated drugs or syringes, engage in intoxicated and unprotected sex, or just plain neglect basic hygiene. Experts already have noted how prescription painkiller pills acted as a gateway to abuse of powerful drugs like fentanyl and heroin, which often are injected or snorted.

This is creating what some public health officials are calling an “epidemic of epidemics,” with detected cases of hepatitis C, for example, increasing by 325 and 400 percent among key age groups nationally in which opioids often are abused. Public health officials, doctors, and physicians also told Vox that they are seeing sharp rises in bacterial infections linked to injected drug abuse, cases affecting patients’ limbs and even spreading into their blood, hearts, and lungs.

Hepatitis C — debilitating and potentially deadly, as well as difficult to detect — can be treated. But the drug regimen that all but eliminates the problematic virus can cost $120,000 or so per patient. Taxpayers, through Medicaid, often end up footing that cost when hep C patients decline, can’t work, and turn up in ERs or in need of public care.

Vox reports that treating drug abusers’ other infections also can be costly, averaging $120,000 per patient because their conditions often can be so poor and cases so complex (including care for bacterial damage to the heart and other organs). The news site says, “Out of the $15 billion hospitals billed to treat opioid patients in 2012, more than $700 million went to treating patients with infections.”

While opioid overdoses can be treated with drugs like naloxone, another drug scourge is rising and killing Americans because its abuses resist medical intervention. That all too familiar menace is cocaine. It’s resurgent, in part, because of political changes in the drug’s sourcing areas in Latin America, including restoration of peace in Colombia.

Coke abuse is, among illicit drugs, the No. 2 killer, and it kills more black men than heroin does, as health economist Austin Frackt reported in the New York Times’ evidence-based column, “The Upshot.”

Keith Humphreys, a Stanford University School of Medicine professor who advises governments on drug prevention and treatment policies, told Frackt: “We have multiple drug problems in the U.S. We need to focus on more than one drug at a time.”

Frackt, a health policy expert, points out that those with coke and other substance abuse problems,  often require extensive psychological and other mental health services to kick their addictions — what the Wall Street Journal, in a separate report, describes as “the crushing cost of rehab,” especially if patients need multiple rounds of treatment.

But who helps the troubled and their loved ones through crises, especially if partisans persist in slashing safety net programs like Medicaid that provide desperately needed assistance, including to not just poor but also middle-class families?

In my practice, I certainly see not only the harms that patients suffer while seeking medical services, but also how they labor to access and afford safe and quality medical care, especially when they’ve had major injury inflicted on them by dangerous pharmaceuticals, including prescription opioids and illicit street drugs.

It’s important to understand how we got into the opioid crisis — and ways we might dig our way out. Considerable attention remains focused on the civil justice system, notably a raft of lawsuits consolidated and to be resolved by a federal judge in Cleveland, well-profiled by the New York Times. Can he reach a sweeping deal akin to what occurred with Big Tobacco, and that led to sharp reductions due to the harms of cigarettes and smoking?

Our collective awakening about opioids, however, also may sadly include debunking with rigorous research the big falsehood foisted by Big Pharma, insurers, hospitals, and others on patients and too gullible doctors about prescription painkillers and their purported benefits. These drugs come with huge risk — perhaps too much of it. And they’re not showing over the longer term to be more effective than other meds with lower consequence. We need to act with urgency to corral these killers, now.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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