Delaware’s Department of Health and Social Services provides its latest quarterly update on the state’s opioid crisis response.
The First State recently recorded a decrease in drug overdose deaths for the first time in a decade, and at Monday’s briefing, Division of Forensic Science Director John Evans says the numbers continue to trend down in the first quarter of 2024.
“There were 102 suspected drug deaths in the first quarter of ‘24, as compared to 138 suspected drug deaths in the first quarter of ‘23," Evans says. "So again, this is a slight decrease and very encouraging.”
Evans says fentanyl was found in more than 80 percent of all accidental drug overdose deaths in the state last year, and xylazine was found in over 40 percent of 184 post-mortem cases tested from September 2023 to the end of the year.
But the state continues to combat the opioid crisis through a series of strategies including blanketing communities with Narcan. Division of Substance Abuse and Mental Health (DSAHM) Director Joanna Champney says the state distributed more than 32,000 kits last year and are on track to exceed that number this year.
Champney says they are also focusing on the state’s addiction treatment infrastructure, including publicly available resources. That includes finding partners to open additional public detox facilities, noting there is only one in the entire state located in New Castle County, disadvantaging residents from Kent and Sussex.
She adds one challenge in securing a partner is the reimbursement rates for substance use treatment services.
“We are hopeful that July 1, our plan is to increase the reimbursement rate for substance use treatment, just like Medicaid increased their rates last year," Champney says. "So that may incentivize some providers to step forward and consider a state contract.”
The state is also seeing success with a police diversion program – topping 2,000 referrals from state police since it was first implemented in 2020 — and 61 percent were admitted to treatment. The program was adopted statewide by 2022.
Champney says other strategies include reducing stigma through messaging campaigns, finding more screening partners to screen for substance abuse disorders, offering specialized information to healthcare providers about how to use medication to treat opioid use disorder, and outreaching to specific consumer groups, like Hispanic and Hatian Creole populations, and homeless populations living in encampments.
“These individuals may be suffering from the side effects of addiction, including severe skin wounds from the animal tranquilizer xylazine which has infiltrated the drug supply," Champney says.
DPH Substance Use Disorder Epidemiologist Caroline Judd says overdose deaths and emergency visits are highly concentrated in Wilmington more than anywhere else in the state.
“Similar to the death data, Wilmington had the highest rates of non-fatal drug overdoses and emergency visits," Judd says. "In Wilmington zip codes, the suspected opioid overdose emergency visits range from 272 to 658 per 100,000 population. Newark, Claymont, and New Castle also had high rates, and they range from 193 to 320.”
Judd adds that in Kent County, the zip codes with the highest rates of suspected opioid overdose emergency visits were in Felton, Harrington and Magnolia with rates ranging from 123 to 167. In Sussex County, Lincoln, Millsboro, and Seaford were the highest with rates from 172 to 219.
Judd also notes that from 2018 to 2022, some demographics saw sharper increases in overdose deaths, such as the non-hispanic Black population which increased by 27 percent, and people 65 and older saw a 102 percent spike.
State Medical Director for Emergency Medical Services and Preparedness Robert Rosenbaum says opiate overdoses response calls were once greater than the number of cardiac arrest calls.
But the state’s EMS system developed a treatment protocol that allows paramedics to offer Buprenorphine to patients treated for opiate overdose.
“Buprenorphine works to reduce physical symptoms of opiate dependence and to address issues of craving experienced by patients with opiate dependence,' Rosenbaum says. "The new standing order for paramedics was implemented in all counties as of April 2023. Delaware became the first state to offer EMS administered Buprenorphine treatment on a statewide basis.”
Rosenbaum says nearly 400 people have been offered buprenorphine by paramedics in the past year,
He adds even those patients who decline the medication are offered a pathway to treatment when they are ready to accept it.
