MADISON, Wis. — UW Health is sharing the trends it has observed regarding patients experiencing an overdose interacting with emergency services and how it relates to what’s being seen at the national level.
At UW Health and nationally, emergency departments have witnessed a seemingly unceasing number of visits related to opioid overdoses.
Nationally, the rate of nonfatal opioid overdose patient encounters with emergency medical services has increased by about 4% each quarter from Jan. 2018 to March 2022, which equates to an increase of around 98 to 179 per 10,000 encounters, according to a Centers for Disease Control and Prevention report in August.
Not all nonfatal overdoses result in emergency medical services transporting a patient to the emergency department, but the increase in encounters correlates with the increase in overdose rates in emergency departments nationally, according to the report.
At UW Health’s emergency departments, an estimated 583 people arrived for care related to an opioid overdose in 2022, a decrease from a recent yearly high of about 631 in 2021, which followed two years of increases in the number of opioid overdose cases.
According to Dr. Elizabeth Salisbury-Afshar, an addiction medicine physician at UW Health and associate professor of family medicine and community health at the UW School of Medicine and Public Health, one of the reasons people could be calling for emergency care less could be because they don’t want to get in trouble during an overdose situation.
“It could be that people just don’t feel safe calling 911,” she said. “We hear that a lot from our patients. They’re really afraid of calling 911 because it could lead to criminal charges or it could lead to incarceration.
Dr. Salisbury-Afshar said the rise in overdoses is being driven by a changing drug supply in the United States.
“Increasingly, we’re hearing about fentanyl that’s being cut into cocaine, methamphetamine, and so people that aren’t even expecting and have no experience with opioids are having accidental exposures,” she added.
While some people aren’t aware the drugs they are taking are mixed with fentanyl, putting them at high risk for overdose, others may be aware they are using fentanyl but have no way to know the potency of the fentanyl they are using.
“People may not know whether the substance they are using is 5% fentanyl or 95% fentanyl, making it difficult to know how much is a non-lethal amount,” said Dr. Salisbury-Afshar.
More and more people in Wisconsin are not making it to the emergency departments because of the potency of these drugs, according to a recent report from the Wisconsin Department of Health Services.
From 2020 to 2021, the number of deaths statewide increased by about 16%, from 1,231 to 1,427, according to the report.
As of June, 579 people have died related to opioids. Highly effective treatments exist, however, and it’s Dr. Salisbury-Afshar’s hope to support more people who struggle with substance use disorders to gain access to treatment.
“As an addiction specialist, we really acknowledge that addiction is a chronic health condition,” she said. “We know that people can and do get better, and there’s so much shame and so much stigma.”
In the Dane County area, Public Health Madison & Dane County provides naloxone, a medication that can reverse opioid overdose, and education to help people prevent overdose.
“If you know someone, check in with them,” said Dr. Salisbury-Afshar. “Let them know there’s hope.”
Additionally, most pharmacies can also dispense naloxone. People across the state who are struggling with substance use disorder can find more information about treatment at 211 Wisconsin.
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