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The Drug Overdose Epidemic Affects All Communities

As a country, the overdose epidemic continues to change and worsen. ‌It is now driven by fentanyl, fentanyl analogs, methamphetamine, and cocaine, often in combination or in contaminated forms, in all 50 states. ‌A total of 107,000 deaths occurred in the United States from‌ ‌December‌ ‌2020‌ ‌to‌ ‌December‌ ‌2021.

As‌ ‌if‌ ‌the‌ ‌death‌ ‌rate‌ ‌weren't awful enough, the Centers for Disease Control and Prevention (CDC) estimate that prescription opioid misuse costs $78.5 billion annually in medical expenses and lost productivity.

One of the most disturbing facts is that a rapidly growing class of opioid victims had no say at all. ‌The number of newborns born with Opioid withdrawal symptoms in 2016 was estimated to be 31,765 - one every 15 minutes -‌ ‌a‌ ‌condition‌ ‌is known‌ ‌as‌ ‌Neonatal Abstinence‌ ‌Syndrome‌ ‌(NAS). ‌The rate of NAS has doubled in rural areas compared with metropolitan areas according to a study by the University of Michigan and Vanderbilt University.

In other words, opioid addiction is not only confined to big cities, despite what you see on TV and in movies. ‌As a result of the opioid epidemic, rural communities are more affected than urban ones, where employment opportunities are fewer and isolation is more prevalent. ‌In rural areas, opioid death rates have quadrupled among 18-to-25-year-olds and tripled among females between 1999 and 2015.

According to the most recent data available, here are the top ten overdose death rates for opioids according to‌ ‌overdose‌ ‌death‌ ‌rate‌ ‌per‌ ‌100,000‌ ‌individuals:

  • West Virginia — 49.6

  • Ohio — 39.2

  • District of Columbia — 34.7

  • New Hampshire — 34

  • Maryland — 32.2

  • Maine — 29.9

  • Massachusetts — 28.2

  • Kentucky — 27.9

  • Delaware — 27.8

  • Connecticut — 27.7

On the other hand, it's vital to note that these drug overdoses do not discriminate based on race, ethnicity, region, or socioeconomic level. ‌Due to the consequences of drug overdose, families, communities, and healthcare systems are all negatively impacted.

Strategies for Preventing Opioid Overdose

Healthcare‌ ‌has a vital role to play in the treatment and prevention of addiction. However, its outreach education resources are limited, especially‌ ‌in‌ ‌rural‌ ‌areas.

As a result, Cooperative Extension Services, administered by land-grant universities in all 50 states, have a unique capacity to offer free or low-cost prevention education activities aimed at improving mental and physical health and reducing pain at the local level. ‌By taking such measures, opioid prescriptions may be reduced, and the possibility of subsequent abuse could be reduced.

The HEAL Initiative, led by NIH, aims to address the national opioid epidemic by enhancing pain treatment and treating addiction. ‌Research being conducted by NIMHD with 10 other NIH institutes and centers will focus on health disparity populations, such as African Americans, Alaska Natives, and Native Americans living‌ ‌in‌ ‌rural‌ ‌areas.

More locally, in 2019, the Department of Health and Social Services (DHSS) recently launched its START Initiative. Through the Delaware Treatment and Referral Network (DTRN), a web-based application will automate the current referral process by providing secure connections between Delawareans and Behavioral Health care providers. It eliminates the need to call back and forth between multiple treatment centers to place patients that need it. ‌A referral will be sent electronically to a provider, 24 hours a day, 7 days a week when the Network determines the most suitable and available level of care.

The CDC has also identified the following evidence-based strategies that states and jurisdictions can take today in order to prevent overdoses in the future.

  • Targeted Naloxone Distribution. Narcan is a non-addictive, life-saving agent for opioid overdoses. ‌Naloxone distribution programs aim to train and equip people most likely to witness or encounter an overdose with kits they can use in an emergency to save lives. This includes people who use drugs and first responders.

  • Medication-Assisted Treatment (MAT) and Medication for Opioid Use Disorder (MOUD). ‌Medication-Assisted Treatment for opioid use disorder is a proven treatment. ‌It relies on FDA-approved medications. ‌As a result of activating opioid receptors in the brain, methadone and buprenorphine can relieve pain, withdrawal symptoms without euphoria, and naltrexone blocks opioid effects.

  • Academic Detailing. ‌During this process, trained professionals make structured visits to healthcare providers. ‌During these visits, they assist healthcare providers by providing structured training and technical assistance.

  • 911 Good Samaritan Laws. These laws vary from state to state, but they all aim to make it easier for overdose victims to call 911. In those cases, the victim may receive limited immunity from criminal charges related to the overdose, as well as from other criminal or judicial consequences associated with calling first responders.

  • Syringe Services Programs. ‌Community-based prevention programs, such as SSPs, can provide a range of services, including coordinating substance use disorder treatment, providing access to and disposing of sterile syringes and injection equipment, conducting tests, treating infectious diseases, and linking people to medical and mental health‌ ‌services.

The CDC also recommends;

  • Naloxone Distribution in Treatment Centers and Criminal Justice Settings

  • MAT in Criminal Justice Settings and Upon Release

  • Initiating Buprenorphine-based MAT in Emergency Departments

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