Hospital overdose admissions up for heroin, down for pain medication in Pennsylvania

(Undated) — Heroin overdose hospital admissions continued to rise last year, according to a study released Wednesday by the Pennsylvania Health Care Cost Containment Council. Yet the rate of this increase was the lowest it’s been in recent years. 

The study found that heroin overdose admissions in the state increased 12.7 percent in 2017, as average annual increases were around 24 percent between 2011 and 2016

The PHC4 study found that the number of hospital admissions for overdose of pain medication decreased by just over 2 percent between 2016 and 2017 in Pennsylvania. 

“There is no clear answer as to why these hospitalizations declined,” said Joe Martin, PHC4’s executive director. “There have been tremendous efforts to combat this epidemic. But we cannot call this a trend without more data.”

One effort has been the Prescription Drug Monitoring Program, said Dr. John Gallagher, chair of the Pennsylvania Medical Society’s Opioid Task Force.  

Under this program, doctors must file patient information into a database to make sure there are no other existing prescriptions or history of “doctor shopping,” Gallagher said. 

As for the heroin OD admissions, the report showed that nearly one in 10 patients died in the hospital. That rate, 9.6 percent, is up slightly from 9.3 percent in 2016. 

For pain medication overdose patients, one in 20 died, making that 5 percent of those hospital admissions, and up from 2.9 percent in 2016.

“These findings continue to stress the alarming impact the opioid problem has on Pennsylvania families,” Martin said.  

The common age of patients admitted for heroin overdose was 33, verses 53, which was the average age of those treated for pain medication overdoses.

“Pain medications have historically been more prevalent among older Pennsylvanians and heroin among the younger populations,” Martin said. “But more older people are now turning to heroin and younger to pain meds like Oxycontin and Vicodin.”

Martin said riddled in all these results is a trend among the economic status of the patients. The study showed that statewide, there were 64.6 admissions per 100,000 Pennsylvania residents hospitalized for opioid overdose, combining both heroin and pain medication incidents. 

The rate for lower-income residents was 122 — almost double the statewide rate — and the rate was 113.7 for residents living in areas where less than 10 percent of the population has a bachelor’s degree, according to the findings. 

“These are likely areas that have been hard hit economically and where addiction becomes more prevalent,” Martin said. “This is a nationwide problem.”

Martin said he hopes to continue seeing the opioid numbers decrease, but noted that the mortality rate is increasing, somewhat for heroin but a lot for pain medications.

“We are very concerned about the impact of increased use of synthetics, especially fentanyl which are becoming more widely available and much, much more deadly,” Martin said. 

Other findings in the study included: 

• Hospital admissions for opioid overdose amounted to an estimated $32 million in hospital payments in 2017 — an estimated $16.4 million for heroin overdose and $15.6 million for overdose of pain medication.
• On average, heroin overdose patients and pain medication overdose patients stayed in the hospital 3.4 days and 4.4 days, respectively–for a total of 13,642 days in the hospital in 2017. 
• Of the 1,753 hospital admissions for heroin overdose in 2017, Medicaid was the anticipated payer for 63 percent, commercial insurance for 18.9 percent and Medicare for 10.3 percent, with 7.7 percent of the patients having no insurance or another type of insurance.
• Of the 1,747 hospital admissions for pain medication overdose, Medicare was the anticipated payer for 42.1 percent, Medicaid for 33.6 percent and commercial insurance for 19.3 percent, with 5 percent of patients having no insurance or another type of insurance.
• Males had a higher rate (77.8) than females (52.1).
• The rates for black (non-Hispanic), white (non-Hispanic), and Hispanic residents were 67.5, 65.9 and 50.4, respectively.

Hospitalizations for opioid overdose per 100,000 county residents, 2016 to 2017, are as follows: 

Adams County 

Number of hospitalizations 2016: 26

Number of hospitalizations 2017: 18

Rate per 100,000 in two-year period: 51.5  

Franklin County

Number of hospitalizations 2016: 34

Number of hospitalizations 2017: 21

Rate per 100,000 in two-year period: 43.8

Lebanon County

Number of hospitalizations 2016: 39

Number of hospitalizations 2017: 27

Rate per 100,000 in two-year period: 58.7

York County

Number of hospitalizations 2016: 104

Number of hospitalizations 2017: 145

Rate per 100,000 in two-year period: 68.7