At least 515 people died of accidental drug overdoses in 2021: a 15 percent increase over the previous year. Delaware is now third in the nation for overdose deaths per capita, behind only West Virginia and Kentucky.
The majority of overdose deaths occurred in New Castle County, but the largest increases in deaths were in Kent and Sussex County.
Division of Substance Abuse and Mental Health director Joanna Champney says her agency is attempting to expand access to overdose prevention and treatment in areas that lack the transportation or housing options needed to support people recovering from addictions. Those areas include parts of rural western Sussex County, where a pilot program is now providing transportation to and from medical appointments for people recovering from substance abuse disorders.
But the state’s treatment providers are still adjusting to the arrival of fentanyl, which has appeared both as a substitute for weaker opioids like heroin and an additive in drugs like cocaine. In the final three months of 2021, more than 80 percent of overdose deaths involved fentanyl.
Champney says that shift has left treatment, outreach and prevention providers playing catch-up.
"Being able to keep up with that evolving black market availability and how widely manufactured fentanyl is now has made it difficult for the state to keep up," she said.
Dave Humes, a board member with the advocacy group AtTacK Addiction, says that the average age of those dying is also starting to shift compared to pre-pandemic years.
“I think the profile of the most affected was [in previous years] a 43-year-old male who lives in New Castle County," he said. It appears to me, looking at the numbers, that that’s gone down.
Joshua Stout, a member of AtTacK Addiction advisory board, argued that Delaware has focused much of its efforts to address the addiction and overdose crisis on medication-assisted treatment (MAT): the use of medications like methadone or buprenorphine to mitigate withdrawal symptoms for people recovering from opioid addiction.
"The focus has been on providing access to MAT," Stout said. "I am absolutely supportive of MAT, but the focus has created a hole in funding for other already limited services. It leads to a pinch in long-term recovery treatment services, detoxification centers and clinics, peer support and other recovery services."
But Champney says that shortage of housing and treatment providers presents a larger hurdle to the state’s response to the crisis.
“It’s not necessarily that there aren’t enough dollars to go around; it’s that there aren’t enough providers to go around," she said.
One possible way to increase the number of providers, Champney noted, is to increase Medicare reimbursement rates for addiction treatment services; current rates don't match the cost of caring for a patient, which disincentivizes treatment providers from expanding their services. Champney noted that a change to reimbursement rates is already in the works.
Meanwhile, a bill sponsored by State Sen. Stephanie Hansen (D-Middletown) would allow emergency responders to administer new FDA-approved overdose reversal drugs.
The state currently allows responders to administer only the overdose reversal drug Naloxone. The Senate’s Health and Social Services committee released the bill last week.
