Medical care for opioid overdoses in isles increases

Hawaii’s opioid-related emergency room visits and hospitalizations doubled over the past decade as more patients overdosed on heroin or prescription drugs.

In 2016, state hospitals billed more than $110.7 million in charges for the treatment of 4,017 patients with opioid-related problems, compared with $48.7 million for 2,797 in 2010, according to the Hawaii Health Information Corp., an independent nonprofit that collects health care data to improve policymaking.

The problem, billed as a national epidemic, has gained significant attention with the latest report released Tuesday by the Agency for Healthcare Research and Quality, citing 1.3 million U.S. emergency room visits or hospitalizations for opioid-related problems in 2014.

“The opioid pain medication epidemic is definitely an issue that has grown in Hawaii. We definitely feel it,” said Dr. Rick Bruno, associate chief medical officer of The Queen’s Medical Center. “The ERs are all crowded at baseline in the state and we have too much diversion of ambulances. In general, the ERs in the state are feeling the pressure of more demand. This would be one aspect of it.”

Drug poisonings, or overdoses, overtook motor vehicle accidents for the first time in recent years as the leading cause of fatal injuries in Hawaii.

The number of deaths involving opioid pain relievers, including oxycontin, fentanyl and other synthetics — except heroin — has gone up and down over the past decade from 43 to 64 deaths per year based on death certificate records from the state Health Department.

There were 131 ER visits and 145 hospitalizations statewide per 100,000 residents in 2016 compared with 51 and 71 in 2005, respectively, the data show.

“That’s a stunning number,” Bruno said. “It’s so much bigger here than it was a decade ago. My personal experience is it cuts across age, socioeconomics and gender. There’s not a person who I would say this is one I’m worried about. We see all kinds of folks who have issues with opiates.”

Nationally, there were 178 ER visits and 225 hospitalizations per 100,000 residents in 2014, the latest statistics available.

“As a population we’re more likely to be hospitalized for some type of opioid misuse, overuse or abuse,” said Dr. Jill Miyamura, vice president and senior research officer for the Hawaii Health Information Corp. “While our opioid-related utilization is lower than national statistics, we still are increasing and that’s a direction we don’t want to go.”

The problem locally has prompted the Department of Health to ramp up efforts over the past year to develop a strategic plan to prevent and treat opioid addiction.

“That’s our primary focus right now,” said DOH epidemiologist Daniel Galanis. “It’s one of the leading causes of injury-related mortality.”

State Sen. Josh Green, an emergency room doctor on Hawaii island, said state efforts to monitor prescription drugs need to be more vigilant. Only about 10 percent to 20 percent of medical providers who are required by the state to sign up for a database drug-monitoring program actually use the program to check how many drugs are prescribed to patients, he said.

“We need every provider that prescribes to use that,” he said. “Even a few overdoses are too many. If you’re the parents of an 18-year-old who overdoses on pills he got in high school from his friends … it’s a crisis.”