January 6, 2023

Number of overdose cases seen in emergency departments remains large

Madison, Wis. – 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 percent 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.

Emergency departments are built to handle overdose cases, but they do take a toll on providers, patients and their families, according to Dr. Collin Michels, emergency medicine physician, UW Health, and assistant professor of emergency medicine, University of Wisconsin School of Medicine and Public Health.

“Weekly, we see the tragedy of the opioid epidemic firsthand in the ED,” he said. “Families are being torn apart by these drugs that are just so addictive and deadly.”

The rise in overdoses is being driven by a changing drug supply in the United States, according to Dr. Elizabeth Salisbury-Afshar, addiction medicine physician, UW Health, and associate professor of family medicine and community health, UW School of Medicine and Public Health.

“Fentanyl and other illicitly manufactured synthetic drugs continue to infiltrate the illicit drug supply in the nation, and here in Wisconsin it has led to a steady rise in overdoses and deaths,” she said.

Often people aren’t aware the drugs they are taking are mixed with fentanyl, putting them at high risk for overdose, while others may be aware they are using fentanyl, but have no way to know the potency of the fentanyl they are using, Salisbury-Afshar said.

“People may not know whether the substance they are using is 5 percent fentanyl or 95 percent fentanyl, making it difficult to know how much is a non-lethal amount,” she said.

Sadly, 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 percent, 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 our hope to support more people who struggle with substance use disorders to gain access to treatment, Salisbury-Afshar said.

In the Dane County area, Public Health Madison & Dane County provides naloxone, a medication that can reverse opioid overdose, and education (pdf) to help people prevent overdose. 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.