Indiana ERs see opioid overdose visits increase by nearly 60 percent in 5-year period

Emergency room visits for non-fatal drug overdoses in Indiana increased by nearly 60 percent in a recent five-year period, during which time deadly overdoses rose by an average 3.5 percent each year, according to a report from the Indiana State Department of Health.

The report looked county-by-county at how the opioid epidemic played out in Indiana from 2011 to 2015. In addition to those statistics, the report also found that soft-tissue infections stemming from intravenous drug use more than doubled in that time frame.

While the report will help state officials quantify the toll that the problem takes here, county officials can turn to its detailed profiles to get a better idea of how to address the problem locally, state health officials say.

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“It’s very telling to be able to put the data together in one place,” said Pam Pontones, deputy health commissioner. “I think that really helps to tell the story, especially when looking at trends over time. You can think you have an idea of what may be happening, but it’s very helpful and more objective to look at data points.”

The idea is not to issue rankings for counties to compete against one another but just to help give local officials a “snapshot” of what their county looks like, Pontones said.

But there’s plenty of indication that Indiana has a drug problem.

Monday, the same day that the state issued its county profiles, WalletHub released a study of all the states, looking at where drug abuse is most pronounced. The District of Columbia topped the list, which looked at drug use and addiction, law enforcement, and drug health issues and rehab.

Indiana came in 14th, coming in above Kentucky and Ohio.

In a meeting Monday with the IndyStar editorial board, Gov. Eric Holcomb said he hears about Indiana's drug problem everywhere he goes across the state. When he starts talking about it, people look up from their cellphones and many come over to him afterwards to share their personal experiences.

"This is the one issue where everyone wants to help. They just want to know how," he said.

On Thursday the governor's "drug czar," Jim McClelland, who is coordinating the state agencies' response to the opioid epidemic, is expected to issue his first report.

Here are some insights culled from the state health department's 217-page report and its online Stats Explorer:

• The number of deaths from opioid poisoning varies in the time period studied. In 2011, the state saw 250 such deaths. In 2013 that number dipped to 168. But by 2015, it nearly doubled once more to 274. The count continued to rise in 2016, according to provisional data, when 365 people died from a drug overdose.

• From 2011 to 2015, the statewide number of visits to emergency rooms due to non-fatal opioid overdoses soared, increasing by nearly 60 percent in that time period. In 2011, the state saw 1,856 such visits. By 2015 that number grew to 2,977.

• When you look at death rate and death count county by county, you get two very different pictures. Marion County in 2016 had the leading drug death count (64), according to provisional data. But from 2011 to 2015, it fell into the middle of counties when it came to death rate due to opioids. Scott County, which saw 12 deaths last year according to provisional data, had the highest rate of death overdoses from opioids, at slightly more than 25 per 100,000 population.

• Fayette County led the state in the four-year period covered in the report in emergency room visits for non-fatal overdoses, with 94.1 such visits per 100,000 population. Morgan County came in second with 79.3 non-fatal overdose visits to hospital emergency rooms.

• The data can vary greatly year by year from county to county. For instance, for most of the five-year period in the report, Bartholomew County had fewer emergency room visits for non-fatal overdoses than the state average. But in 2014, that rate number soared from the previous year’s 21.4 up to 81. In 2015, it dipped back down to 43.1.

• Scott County saw the rate number of emergency room visits due to non-fatal overdoses fall beneath the state average for the first time in 2015. Scott County became the first county in 2015 to have a needle exchange program after an HIV outbreak there was linked to intravenous drug use. In addition to clean needles, the needle exchange program hands out naloxone, which can reverse drug overdoses, to those who use drugs. In 2014, Scott County had 84.4 overdoses per 100,000, compared with 25.3 the following year.

• Some counties appear to have a perennial problem. Delaware County, for instance, has seen its emergency room visits due to overdose increase over time, starting with 11.9 such visits per 100,000 in 2011. By 2015, that number had reached 79.6 per 100,000 population. Its chronic and acute hepatitis rates were always higher than the state average. Delaware County officials have said that they do not want to see a needle exchange program in their county.

• Marion County saw a sudden spike in emergency room visits for non-fatal overdoses from 2013 to 2014. In that year, it went from 45 per 100,000 population to 73.5. The number remained high in 2015, at 78.

IndyStar reporter Tony Cook contributed to this report.

Call IndyStar reporter Shari Rudavsky at (317) 444-6354. Follow her on Twitter and Facebook.