Overdose cases spike at hospital
Kent Hospital has seen a dramatic increase in cases of people that have overdosed on alcohol or prescription or illegal drugs that already exceeds totals for all of last year.
Speaking at the Rotary Club of Warwick Thursday, Dr. Michael Dacey said 66 people that had overdosed were admitted to the hospital on ventilators in 2011. As of the first six months of this fiscal year, the total is 75.
A large number is dying of drug-induced cardiac arrest, Dacey, Kent’s senior vice president and chief medical officer, said. He described 70 percent of the cases as being in their late teens or early 20s. Cases that are 35 years old or older are unusual.
A native of Rhode Island, Dacey received his medical degree from George Washington University School of Medicine and Health Sciences. He came to Kent in 2000 because he thought he wanted to work in a large metropolitan hospital. He was surprised by what he found in his home state.
“It’s very challenging here,” he said.On average, he sees at least two people with alcohol problems and another two with drug problems being admitted on a weekend.
“You don’t see this side of the city,” said Dacey.The issue of overdoses and overdose deaths is not limited to Rhode Island, although Dacey said the state ranks fifth in the country for the number of drug overdose per 100,000 of population. According to the data provided by the Centers for Disease Control and Prevention, 36,000 in the nation died from accidental overdoses, a number that exceeds deaths from automobile accidents.
Dacey said national data shows one death per 44 emergency department visits. In the case of persons being admitted for accidental overdoses, the number jumps to one in 12.
What Kent is experiencing is corroborated by a two-year study by RARx (rapid assessment and response) at Rhode Island Hospital. Researchers found 14 deaths in the Warwick area resulting from overdoses in 2009, giving the city the highest rate of fatal overdoses in the state. They are also finding that mixing prescription drugs, largely opiates but often with alcohol, is the cause of many over-dosages.
The National Survey on Drug Use and Health estimates that 6,600 Americans start abusing prescription drugs each day, and a third of these are between 12 and 17 years of age. The 2010 Monitoring the Future report on substance abuse by teens noted that Vicodin and OxyContin (hydrocodone and oxycodone) were among the top prescription drugs abused by teens. Only marijuana was abused more often.
Dacey said the use of drugs for pain management has increased dramatically. In 1997, the per capita use of narcotics was 96mg per year. As of 2008, the amount was 750mg.
In most cases, Dacey said, people get started experimenting with prescription drugs they get from friends or family. According to CDC data, 55 percent of those who abuse painkillers get the drugs from friends and relatives. Dacey said the use of OxyContin is enormous, although, as controls are making it harder to get and causing prices to rise, the hospital is seeing more heroin overdoses.
The heroin we are seeing comes from Afghanistan and is extremely potent, he said. He also said there are significant amounts of synthetic marijuana of dubious origin, which goes by the names of “Spice” and “K-2.” He described one recent hospital admission, a 23-year-old man, who had been in cardiac arrest attributable to synthetic marijuana. He said the man was brain dead and later died.
While the euphoria created by heroin is said to be similar to that of prescription opiates, heroin comes with its own set of special problems, reports the U.S. National Institute on Drug Abuse. First among these is the uncertain potency. NIDA also reports that toxic contaminants or additives have their own destructive effect, clogging blood vessels in the lungs, kidneys, liver or brain. This blockage can cause permanent damage to these and other organs.
“If family members have any suspicion that a loved one is abusing prescription drugs, especially opioids, the right time to get them help is now, before they can switch to heroin,” advised Clark Carr, the president of Narconon International. In 50 locations around the world, Narconon drug and alcohol rehabilitation centers guide addicts through the process of achieving lasting sobriety.
“The Substance Abuse and Mental Health Services Administration reported that an average of 15 years pass between the first substance abuse and first admission to treatment,” In a statement released by Narconon, Carr said, “If a family can get a loved one into treatment in a shorter time, they can help that person avoid enormous physical and mental damage and perhaps even save his life.”
In response to questions, Dacey said conditions are definitely related to the economy. He predicted the level of drug-related medical incidents would get worse before it gets better.
He outlined a four-step program to address the problem, including intensive monitoring of prescription drugs, stricter enforcement of the law, increased education for physicians on the use of prescription drugs for pain management and more efficient means of drug disposal.
State Department of Health director Dr. Michael Fine is promoting a program including these points. In a recent interview with the Beacon, Fine said the program is one of his priorities. Also, Mayor Scott Avedisian said he is working to improve the means for people to dispose of prescription drugs that might otherwise fall into the hands of people who would abuse them.