The trend mirrors a statewide decrease in overdose deaths, with improved access to Suboxone and naloxone.
By: Joe Lawlor
Admissions to emergency departments at Maine hospitals for drug overdoses have gradually declined since 2017, according to statistics released recently by the Maine Center for Disease Control and Prevention.
Suspected drug overdose admissions in the first six months of 2019 declined 11 percent over the same period in 2018, dropping from 2,047 last January through June to 1,847 in the first half of this year. The trend began in 2018 when admissions declined 7 percent for the calendar year compared with 2017, from 4,355 to 4,068.
The decline mirrors the slight decrease in drug overdose deaths across Maine during the same time period, with a 14 percent decline in the first quarter of 2019 – the latest data available, going from 86 deaths in the first quarter of 2018 to 74 deaths through March 31 of this year. After several years of increases, drug overdose deaths declined from 417 in 2017 to 354 in 2018.
Gordon Smith, Maine’s director of opioid response, said a number of factors could be at play in emergency department admissions, but there’s still a long way to go to alleviate the opioid crisis.
“We still have a lot of deaths, we still have a lot of drug overdoses, and we still have a lot of substance use disorder,” Smith said.
But he said encouraging signs are emerging, including that about a dozen of Maine’s 33 emergency departments – including Maine Medical Center and Northern Light Mercy Hospital in Portland and MaineGeneral Medical Center in Augusta – now offer Suboxone medication to overdose patients while they are still in the emergency rooms. In early 2018, there were zero emergency departments that gave Suboxone to patients, Smith said. The goal is to have the program available in all emergency departments, and also better connect patients to treatment.
Suboxone and other similar drugs that curb cravings for opioids, combined with therapy is considered the “gold standard” for opioid treatment.
“Substance use disorder is an isolating disease, so the goal is to follow up with the patients after they get out of the ED, offer them services, and hopefully they will come back later for treatment,” Smith said.
Another possible reason for the decline could be the increased availability of naloxone, a life-saving antidote to opioid overdoses. Smith said he has heard a lot more patients who have been revived by naloxone are refusing to be transported to emergency departments. The Mills administration also has worked at an overall expansion of access to substance use disorder treatment. Medicaid expansion, which started in January, will give about 70,000 previously uninsured adults access to substance use treatment.
Dr. Michael Baumann, chief of emergency medicine at Maine Med, said the gradual decline statewide is not surprising since the Portland hospital also is seeing a reduction in overdose patients.
“We have been seeing a general downward trend. There is some seasonality to it. It’s always up this time of year,” Baumann said, explaining that the tourist season brings an influx of people to Maine, and with that comes more visits to emergency departments.
Since 2017, when the Maine Center for Disease Control and Prevention began collecting the data, the second and third quarters of the year – from April to September – have higher emergency department admissions for drug overdoses compared to the first and fourth quarters.
Baumann said “it’s absolutely easier” now for the Maine Med emergency department to connect patients with substance use disorder treatment compared to two years ago, but there could still be significant improvements. He said starting next week, a new MaineHealth treatment center will open in South Portland, so that should help meet the demand.
“We are now treating patients in the ED and getting them into recovery programs,” Baumann said.
This article appears in the Kennebec Journal and Morning Sentinel.