Under the current wave of opioid epidemics sweeping the nation, Connecticut is slowly making headway in preventing opioid-related deaths and reducing the circulation of fentanyl, a fatally potent synthetic opioid often found mixed with cocaine.
According to the state medical examiner’s office, Connecticut saw 917 opioid overdose deaths last year, a figure consistent with an upward trend that began in 2012. The state also ranked fifth among 30 states in the rate of opioid-related emergency room visits as well as seventh among 44 states in the rate of inpatient stays due to opioid abuse, according to a January report by the Agency for Healthcare Research and Quality, a branch anchored under the U.S. Department of Health and Human Services.
New Haven itself is also mired in an opioid crisis, which reached a tragic peak last June when 12 individuals were rushed to Yale New Haven Hospital with symptoms consistent with opioid overdose. Three of those 12 individuals died. Gail D’Onofrio, YNHH’s emergency medicine chief and a Yale School of Medicine professor, said that tight cluster of overdose cases was a highly unusual outlier. But she noted that YNHH still treats patients who overdose on opioids on a daily basis.
D’Onofrio said that though she cannot accurately foresee the trend for opioid-caused hospital visits or deaths in 2017, the data from the state medical examiner’s office do not bode well. She added that most current medical efforts in the state to combat the crisis seek to prevent patients from dying rather than treating their underlying physical or mental illnesses.
“We are trying to put the tourniquet on the hemorrhage right now,” D’Onofrio said. “I think we need to do a lot of prevention, and that’s going to take a fairly long time.”
D’Onofrio, who helped co-author last October’s Connecticut Opioid Response report — a document commissioned by Gov. Dannel Malloy to recommend policies to reduce opioid use — said current initiatives are focused on increasing access to naloxone, a drug that reverses the symptoms of fentanyl overdose. She added that the state is using the Good Samaritan Law, which provides immunity from civil damages for an individual who helps an injured or ill person, to encourage bystanders to report overdose patients, promising that the drug users will not be arrested even if they are carrying drug paraphernalia. Physicians are also being more cautious when prescribing painkillers that often lead to addiction, D’Onofrio said.
David Fiellin, a medical school professor and another co-author of the Connecticut Opioid Response report, said the report targets short-term policy recommendations such as distributing naloxone to those with high risk of overdose, sharing data across state agencies and stakeholders to inform policy decisions and addressing the underlying social stigma surrounding opioid overdoses.
He stressed that although naloxone should be given to high-risk patients and their families to use in the event of emergencies, the drug does not deal with the patients’ chronic medical disorders that might have led them to use fentanyl in the first place. Thus, he said the next step to reviving overdose patients is to send them to treatment facilities. In fact, D’Onofrio said many local treatment facilities are accepting patients from hospital emergency rooms to address more chronic illnesses. Fiellin added that past research indicates the most efficient treatment to opioid addiction is a combination of medicine intake to stabilize bodily chemical reactions and therapy sessions.
D’Onofrio said Yale New Haven Hospital is staffed with a team of doctors who are prepared around the clock if another cluster of overdose cases were to occur in New Haven and that her team is also working to train more doctors. She added that media outlets and public service announcements have been effective in warning the public about fentanyl-contaminated drugs, which could easily lead to overdoses because individuals might not be used to such a high-potency opioid.
“Our mantra is when you are prepared there is no emergency,” D’Onofrio said. “So we are prepared for other cases. Certainly around the country, we are seeing more and more fentanyl [overdoses].”
The governor of Maryland has declared a state of emergency in his state because of opioid overdoses.