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Pa. hospitals see increase in opioid overdose admissions

A rising number of Pennsylvanians is being hospitalized for overdosing on pain medication and heroin, according to data released last week by the Pa. Health Care Cost Containment Council.

The data explored hospital discharges of Pennsylvania residents aged 15 and older.

It showed that between 2000 and 2014 there was a 225 percent increase in the number of hospitalizations for pain medication overdoses and a 162 percent increase in hospitalizations for heroin overdoses.

Craig Skurcenski, chairman of the Department of Emergency Medicine at Harrisburg-based PinnacleHealth System, said his hospital doesn’t single out overdose data for opioids and heroin, but that it did see a 20 percent increase in all overdose admissions between 2014 and 2015.

“We have definitely seen a rise in the use of opioids over that time frame for a number of factors,” Skurcenski said.

Reducing opioid prescriptions in the emergency department

Ongoing efforts are being made at the state and federal level to address the increase in opioid use — a big one being to reduce the amount of opioids that are prescribed in emergency rooms.

In 2013, PinnacleHealth changed its policies to limit the use of prescription narcotics for patients with chronic or ongoing pain in the emergency room by directing them to their physicians for refills.

Once the policies were put in place, the number of prescriptions written fell 20 percent.

According to Skurcenski, there’s a concern that the rise in prescription drug abuse is prompting people to move toward heroin use, or that prescribed opioids are the gateway to heroin.

Skurcenski noted the hospital has also seen a general increase in the use of heroin.

Heroin on the rise

Typically when it comes to heroin, overdose victims will show up in large numbers over a short period of time due to the batch of the heroin and its potency or purity levels, Skurcenski explained.

The council’s research found that while all hospital overdose admissions are on the rise, the largest increases between 2000 and 2014 were found among rural county residents for heroin, with a 315 percent increase. Pain medication hospitalizations saw a 285 percent increase.

In urban counties, the increases were 208 percent for pain medication and 143 percent for heroin.

When it comes to age groups, among the 919 admissions for heroin overdoses in 2014, 40 percent of patients were 20 to 29 years old. Of the 929 admissions for pain medication overdoses, 28 percent of patients were 50 to 59 years of age.

Life-saving efforts

In 2014, more than twice as many Pennsylvanians died of drug overdoses as from vehicle accidents, according to Michael J. Consuelos, the senior vice president for clinical integration at the Hospital and Healthsystem Association of Pennsylvania.

Statewide efforts are being made to reduce overdose fatalities with the use of Naloxone, known by the brand name Narcan.

The medication reverses the effects of opioid overdoses, whether caused by prescription pain medication or heroin. It is available via nasal spray or injection.

In April 2015,  Rachel Levine, the Pennsylvania physician general, signed a standing-order prescription for Naloxone for law enforcement officers and firefighters. This fall she issued a standing order statewide, meaning that pharmacists can give Naloxone to any Pennsylvania residents who are unable to obtain prescriptions from their health care providers.

Capital BlueCross recently donated $100,000 worth of Naloxone to law enforcement agencies within its 21-county service area.

This week, Gov. Tom Wolf announced that a limited supply of the life-saving drug was made available to all public schools in the state.

“We’re fortunate to have Naloxone,” Skurcenski said. “It’s truly lifesaving. It’s one of the more dramatic medications that we have in the setting of overdoses.”

He described overdose victims as unconscious or having stopped breathing. When Naloxone is administered in time, it can reverse those symptoms.

“The issue is that sometimes they’re not found in time,” Skurcenski said.

Even if people survive, they can suffer brain damage caused by the temporary lack of oxygen.

State hospitalizations for pain medication and heroin overdoses amount to an estimated $12.2 million in payments based on data from 2012, according to research released by the council.

“These statewide and regional hospitalization findings stress the alarming impact this current drug problem is having on communities across the commonwealth,” said Joe Martin, the council’s executive director. “Whether urban or rural, this issue is an equal opportunity offender.”

Lenay Ruhl

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