Data released this month by the CDC show that in some places, the number of drug overdoses declined in the year that ended in July of 2017, though in most states it continued to go up.
David Royse | LedeTree
While the numbers of overdose deaths have declined in 14 states, most places continued to see increases in overdose deaths last year, including some incredibly large spikes.
Overdose deaths went up almost 40 percent in Florida in the 12 months ending last July, from just under 4,000 to more than 5,500.
Pennsylvania saw an even bigger increase, the second largest in the nation, at 43.4 percent.
And the place where the opioid crisis seems to have really taken off last year: Washington D.C., where overdose deaths ballooned 45.7 percent from 219 to 319. Many of the largest increases were in the Middle Atlantic states: in Delaware (37.3 percent increase), New Jersey (34.7 percent increase) and Maryland, which had a 28.5 percent increase.
There’s also a geographic pattern to the states that saw declines, with the biggest drops in overdose deaths all coming in the West. Wyoming saw a nearly 40 percent drop, and other double digit percentage drops in deaths were reported in Utah, Washington and Montana.
The Pew Charitable Trusts’ Stateline publication on Thursday looked at the numbers, focusing first on the good news – with the headline “Overdose Deaths Fall in 14 States.”
So the question is, what’s working?
The first thing likely going on is the number of prescriptions for opioids, which can lead to addiction, has started to drop because the medical community and state and local policymakers are so aware of the crisis now.
After going up dramatically from 2006 to 2012, the number of opioid prescriptions written decreased by 5 percent each year between 2012 and 2016, according to the CDC’s most recent data. In 2016, doctors were writing about 66 opioid prescriptions per 100 people, down from about 72 per 100 in 2006.
We don’t know what’s happened since, because we don’t yet have 2017 data, but it would seem logical that doctors have continued to decrease their prescribing of opioids.
We do know that Florida – despite the fact that it saw an increase in deaths last year, has seen declines in prescribing in some parts of the state – and then in deaths. The CDC cites Florida as an example of states that had been making progress, noting that opioids prescribed decreased in 80 percent of counties from 2010 to 2015, and the state saw lower deaths during that time frame. Better laws that required tighter pain clinic regulation and mandated reporting of dispensed prescriptions likely led to the decrease, the CDC said.
The CDC graph below shows the correlation going all the way back to the 2010-2012 period – fewer opioids prescribed, fewer deaths. Seems simple. But what happened to make overdose deaths go back up last year in Florida isn’t clear.
Another thing not clear is whether the issue is in looking at overall deaths, as the new data do, versus deaths per capita, as the chart does. Florida has seen an influx of population after Hurricane Maria, and it’s possible that per capita deaths haven’t increased.
From the Stateline story:
“Another likely reason for a tapering in death counts is the widespread use of the overdose antidote naloxone, public health experts say.”
While the death rates have continued to go up in West Virginia, “It’s hard to imagine how high the death toll would be without naloxone,” Michael Kilkenny, the Cabell-Huntington public health director in West Virginia, says in the story.
The CDC says increased use of prescription drug monitoring systems, state-run databases that track prescriptions appear to have worked in some states and should be considered by state lawmakers. The CDC also recommends states audit state medical data from Medicaid and workers comp to try to identify potential abuse, and look to increase access to programs for addiction treatment.
Wyoming Public Media late last year looked at three places that had gotten national grants to try to address the addiction and overdose problem. It looked at a naloxone program in Birmingham, an outreach program near Cincinnati, and prescription drug monitoring in St. Louis.