Deaths from opioid overdoses nearly doubled between 2009 and 2015 in the United States, according to a new study in the Annals of the American Thoracic Society, and the need for emergency care related to opiate addiction have outstripped the available supply.
The paper is believed to be the first to quantify the impact of opioid abuse on critical care resources across the country. For the study, researchers from Harvard Medical School, the University of Chicago, and Ben-Gurion University of the Negev analyzed nearly 23 million hospital admissions over a seven year period, at 162 hospitals in 44 states.
Almost 22,000 patients were admitted to intensive care units (ICUs) because of overdose from opioids—including prescription medications, methadone (which can be used to treat opiate addiction) or heroin. From 2009 to 2015, the number of opioid-related ICU admissions increased by 34%.
Massachusetts and Indiana had the highest overall rates of opioid-related ICU admissions in the country over those seven years total, while Pennsylvania experienced the sharpest increase in opioid admission rates over that time. Illinois, California, New York, and Indiana also experienced significantly increased admission rates due to opioids.
During that same period, the number of ICU patients who died from opioid-related causes nearly doubled. The death rate rose at roughly the same rate per month throughout the study period, but climbed higher beginning in 2012. In other studies, the researchers note, similar increases have been linked to more prescriptions being written for painkillers—which may lead to more addiction and overdoses in the following years.
The average cost of treating each person admitted to the ICU for an overdose also rose from $54,517 to $92,408 over those seven years—an increase of 58%. Much of that rise came from expensive treatments like dialysis to treat kidneys damaged by the opioids.
The authors point out that their estimates may be on the low side, because they only looked at hospital admissions that were coded as opioid overdoses—some opioid-related emergencies aren’t classified as such, or were treated in places other than hospitals. In addition, their sample only included adults 18 and older.
Other research has found that the U.S. death rate from drug overdoses has risen more than 137% since 2000, with opioid-related deaths making up a large portion. And because many people who become addicted to opioids also turn to illegal opiates that are often cheaper and easier to get, herion use in the United States has also increased significantly during this time.
The authors can’t say whether the increase in ICU admissions is a positive or negative trend in terms of responses to opioid overdoses. It could mean that many lives were saved in the ICU that would have otherwise been lost—or it could indicate that emergency response needs to improve, so that fewer patients need intensive care in the first place. “We would propose that any admission to the ICU for opioid overdose is a preventable admission,” they wrote in the paper.
"Our findings raise the need for a national approach to developing safe strategies to care for ICU overdose patients,” the researchers concluded, “to providing coordinated resources in the hospital for patients and families, and to helping survivors maintain sobriety following discharge.”
Read more: Why We Need Drugs to Treat Opioid Addiction
On August 10, President Trump declared the opioid epidemic a national emergency and said his administration was drafting paperwork to make the declaration official. But according to the New York Times, those papers have yet to be filed.