Overdose-related hospital admissions soar as opioid epidemic escalates

A new report on opioid-related hospital visits shows Pennsylvania's epidemic is only accelerating despite increased focus on doctor prescribing habits and other factors thought to be contributing to abuse of the drugs.

Hospital admissions for heroin overdoses reached 1,524 in 2016, up 66 percent from 2014, according to a Pennsylvania Health Care Cost Containment Council research brief published Wednesday. Admissions for pain medication overdoses reached 1,775 in 2016, according to the report.

“It's shocking that the numbers are that high, but it's also not surprising given the other information that we know,” said Alice Bell, overdose prevention project coordinator for Prevention Point Pittsburgh, an organization that runs a needle exchange and other programs to help addicts.

The report comes on the heels of a Drug Enforcement Agency announcement earlier this month that deaths from opioid overdose increased 37 percent in Pennsylvania in 2016, to 4,642.

The increase in heroin numbers reflects a trend doctors and opioid experts said they are familiar with: people who become addicted to pain pills turn to street drugs because they are cheaper and easier to get. Making that trend even more dangerous is the introduction of the synthetic opioids fentanyl and carfentanil, which are more potent and dangerous than heroin and increasingly mixed with it.

Like other data on opioid use, Wednesday's report shows the drug affects people across different races, economic classes and in both genders. Poor white males were the most likely to overdose on heroin, while pain medication overdoses were more common among black people and women.

Bell said Pennsylvania regulators and hospitals are cracking down on excessive prescribing of pain pills by doctors — considered a driving force behind the epidemic — but are not doing enough to substitute the loss of the drugs and keep people from turning to street drugs. Pennsylvania launched a prescription drug monitoring program last year as part of the state's efforts to track where patients get pain pills.

“We needed to address overprescribing, but it's like we used a hatchet instead of a scalpel,” she said.

Jack Kabazie, Allegheny Health Network's system director for pain medicine, agreed.

“While we have cut down on the number of prescription opioids out there, we haven't done a very good job in stopping the use of heroin or doing anything about the use of heroin,” Kabazie said.

He said the region needs more inpatient treatment beds and better ways to stratify risk — identifying whether a person needs inpatient treatment, medication-assisted treatment with methadone or suboxone or other health services. He said that everyone involved in opioid treatment needs to be more aggressive in their outreach.

“We have to take the fight to where they are, and where they are is where they're using,” he said.

Dr. Michael Lynch, medical director at UPMC Pittsburgh Poison Center, said the health system's leaders are discussing how to address the shift to heroin use, looking for ways to direct people who might lose access to pain medications to other modes of treating their chronic pain or the psychological or addiction issues that may be involved.

“It is a recognized problem that we are actively engaged in solving,” Lynch said.

Both UPMC and Allegheny Health Network have stepped up efforts to connect drug users with someone who can treat them before they leave the hospital, a practice known as a warm handoff.

“Treatment can and does work for a lot of people,” Lynch said. “It may take several times, but it can and does work.”

“We're not just giving them a phone number (upon discharge),” said Kabazie. “We're making that contact for them right then and there and making sure the warm handoff happens.”

Despite the shocking 2016 numbers, Lynch and Kabazie each said they don't think the increase in overdose admissions has peaked.

“This is the single greatest epidemic that I've encountered in my career in health care,” Lynch said.

Wes Venteicher is a Tribune-Review staff writer. Reach him at 412-380-5676, wventeicher@tribweb.com or via Twitter @wesventeicher.