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Dramatic Increase In Number Of People Being Hospitalized Due To Opioids

Jun 20, 2017
Originally published on June 20, 2017 6:15 pm
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AUDIE CORNISH, HOST:

Numbers from the federal government today provide more detail about the extent of the nation's opioid crisis and who's affected. The report from the Agency for Healthcare Research and Quality looks at how many people have been hospitalized for problems related to opioids. It shows a dramatic increase between 2005 and 2014. The rate of inpatient stays increased 64 percent during that time. The rate of emergency room visits increased 99 percent.

Someone who sees the real-life side of these numbers is Traci Green. She is deputy director of the Injury Prevention Center at Boston Medical Center. Welcome to the program.

TRACI GREEN: It's great to be here.

CORNISH: Help us understand. We have the data, but what does this mean on a day-to-day basis for a place like Boston Medical Center?

GREEN: Boston Medical Center is really lucky. They were early to see that our opioid crisis was something that they had the special capacity to address by creating an opioid urgent care center. This setting in a judgment-free environment allows people to - with addiction to get the kind of services and care either after an overdose, after an inpatient stay for a health condition and for people in the community to come and walk in family members and friends of people maybe accompanying people who are looking for treatment. But in - this is an unusual setting.

CORNISH: So as you said, this is atypical. When we look at this data that shows us what's going on across the country, what do you think this means when they're talking about, like, inpatient and emergency room visits being up by these numbers?

GREEN: There is a typical sense of treat and street in the emergency department setting and that an overdose is one such event. People tend to be treated in the - by the ambulance or the first responder staff, transferred for a check-in and an observation for an hour or two before. But then people leave very quickly or are moved out to - after stabilization. So they don't tend to stay very much for an overdose. This is a missed opportunity to do something different.

CORNISH: Now, I understand that you and your team have worked on public health messaging telling people to call for help if an overdose happens, giving out education about naloxone, which can reverse most opioid overdoses. Are people hearing it? I mean is there some silver lining to be seen in these hospital visits?

GREEN: There very much is. I think we have - in Massachusetts in particular, the rates have been high, but the help seeking's also been high. So the more that we can do to connect people to prevention, the more likely we are to start to bring some of those numbers down and to standardize the care of overdose and opioid use disorder in the country.

CORNISH: These numbers that we've been talking about showing this increase in hospitalizations for opioids are from 2005 to 2014, so that's even before the election, before politicians were really talking about it nationally. What's your biggest worry now about this epidemic?

GREEN: That it's gotten much, much worse, that these numbers will only have increased, and instead of a handful of states, we will see many more having been affected by enormous increases - all the more reason to be starting to talk further with one another and share best practices and innovations to start to provide more treatment and more naloxone and more innovations in the emergency departments in the hospitals' settings.

CORNISH: I'm surprised that isn't happening already, right? I mean I just feel like this is a part of a national conversation. I mean what are some of the obstacles, do you think, to getting out ahead of this?

GREEN: Stigma is a big one (laughter) - are not well-equipped to address addiction. Just as we've seen for - in the primary care setting that we haven't been well-equipped to deal with pain and addiction, those same challenges are really manifest in the emergency department and the hospital. And we see them.

CORNISH: Meaning doctors don't know what to say or how to identify a problem or admit that they're part of it.

GREEN: All of the above. We also don't tend to have addiction specialties represented in our emergency departments and our hospitals across the country. As a specialty service, this isn't critical, but it should be more of a standard in the current crisis. Every hospital and every emergency department should have the capacity to provide at least basic, minimal screening referral, consistent treatment and lifesaving naloxone in events post-overdose. And we don't currently have this in place.

CORNISH: Traci Green is deputy director of the Injury Prevention Center at Boston Medical Center. Thank you for speaking with us.

GREEN: You're very welcome. Transcript provided by NPR, Copyright NPR.