For the first time, the Delaware Division of Public Health has developed a demographic picture of the Delawareans who died from drug overdoses in 2017.
The findings show many overdose victims are young, white, single males who had worked in a construction or repair field. Many suffered previous overdoses or had contact with drug treatment and/or emergency services. Many had been in the criminal justice system.
The department released the Drug Overdose Mortality Surveillance Report, Delaware, 2017 today.
The fifth highest death rate
Delaware currently ranks fifth-highest among drug overdose mortality rates in the nation.
The Drug Overdose Mortality report followed one of the recommendations in the Johns Hopkins Bloomberg School of Public Health’s July 2018 report, “A Blueprint for Transforming Opioid Use Disorder Treatment in Delaware.”
Of the 346 Delaware residents who died of a drug overdose in 2017, DPH identified 343 for the report’s study population. Overall, drug overdose decedents were primarily males (67%), between the ages of 25 and 54 years (76%), non-Hispanic white (79%), never married (59%), and had a high school diploma or General Educational Development (GED) (55%).
The top two occupational industries among males who died of drug overdoses were construction (36%) and the install, maintain, and repair industry (9.1%- mechanics, HVAC repair, engine repair, maintenance, and other occupations).
The top two occupational industries among females were food service (14.7%) and office support (12.8%); however, 33% were not employed.
Opioids cause of 84% of deaths
Opioids, a class of drugs that includes heroin, fentanyl, oxycodone, hydrocodone, codeine, and others, accounted for the majority of drug overdose deaths (84%). Synthetic opioids other than methadone (e.g. fentanyl, tramadol, etc.) were responsible for the highest mortality rates among opioid drug overdose deaths (age-adjusted rate: 21.9 deaths per 100,000 population).
Eighty-one percent, of those who died of a drug overdose in 2017 had contact with a Delaware health service in the year prior to their deaths.
“I am thrilled that so many state agencies were able to pull together and provide critical data related to behavioral health for this report,” said Lt. Gov. Bethany Hall-Long, who chairs Delaware’s Behavioral Health Consortium. “This was one of the BHC’s goals and the results will allow us to focus our efforts, reduce stigma around the disease of addiction and save lives.”
“There is no question that we have more work to do up and down our state to reduce the toll that the opioid epidemic has taken on thousands of people in our state and their families,” said DHSS Secretary Dr. Kara Odom Walker, a practicing family physician. “But now we have more data to inform our path forward and to help us identify critical touchpoints where intervention can make a difference.”
Deeper dive into findings
A deeper look at the drug overdose decedents’ health system interactions shows:
- One in two drug overdose decedents (54.2%) visited a Delaware emergency department in the year prior to their death and 70% visited the ED within two years prior to their death. Not all visits in the year prior to death were related to the decedents’ drug use. In the year prior to their death, 23% of fatal drug overdose victims who had visited the ED had mental-health-related diagnoses, 10 percent had a previous drug overdose ED visit, and 6.7% had a pain diagnosis related to their ED visit. Drug overdose and pain diagnoses were more often recorded among females than males.
- Nearly half of those who died from overdoses (43.1%) had a history of emergency services (ambulance) encounter not related to the death event in the year before their death. Twenty-three (6.7%) had an EMS encounter for a non-fatal drug overdose. Naloxone was administered to 39.1% of those decedents with a non-fatal overdose EMS encounter.
- Among the ranks of those who died from overdoses, 164 (47.8%) had a prescription drug in the year prior to death. Nearly one in four Delaware drug overdose victims (23.6%) had a prescription for an opioid such as oxycodone, codeine or morphine in the year prior to their death. Twenty-two percent had a prescription for a benzodiazepine (often used to treat seizures or anxiety). Twelve percent of decedents had prescriptions for both in the year prior to their deaths – but prescriptions did not necessarily overlap.
- One in four opioid drug overdose deaths were people released from incarceration within one year prior to death. There were 103 drug overdose decedents (30%) who were on probation and parole in the year that preceded their deaths; 76 (22.2%) of those who died were on probation and parole at the time of death. Nearly half of the 343 drug overdose victims (45.8%) had a record of a misdemeanor, 32.7% had a record of a felony, 25.4% violated parole, and 20.4% had drug-related offenses.
- Within the year prior to death, one in four decedents (26.8%) received Division of Substance Abuse and Mental Health services. Approximately 10% were receiving services from DSAMH at the time of death. Of decedents who had received services from DSAMH, 25.3% were considered homeless.
- Approximately 12% of those who died from overdoses were hospitalized in the year prior to their deaths. Nearly 10% of drug overdose decedents were hospitalized with a diagnosis of a mental, behavioral, or neurodevelopmental disorder.
Report indicates the state on right track with response
“Another key facet of this report is that through this historical look at data, we were able to determine that as a state we were on the right track with many of our current and ongoing initiatives,” said state Division of Public Health Director Dr. Karyl Rattay, who presented the report’s key findings. “It will help us continue to focus our efforts and allow us to move forward in a thoughtful and meaningful way.”
To view the full 2017 Drug Overdose Mortality Surveillance Report, visit https://www.dhss.delaware.gov/dhss/dph/files/dedrugoverdosemortsurvrpt2017.pdf.
Those seeking substance use or mental health resources are encouraged to visit www.HelpisHereDe.com or call the 24/7 Crisis Services Hotline. In New Castle, call 1-800-652-2929. In Kent and Sussex counties, call 1-800-345-6785.
