From Medscape — HHS Secretary Says Opioid Deaths Starting to Plateau - Medscape - Oct 23, 2018.
By Alicia Ault
Department of Health and Human Services (HHS) Secretary Alex Azar said today that new preliminary government data shows a slowdown of drug overdose deaths in the United States.
Azar, citing data from the Centers for Disease Control and Prevention (CDC), said overdose deaths started flattening out in December 2017 and early 2018 — with some 68,690 deaths provisionally reported in March, a decrease from the 70,780 provisionally counted in November 2017.
“Plateauing at such a high level is hardly an opportunity to declare victory,” said Azar, in a speech at the Milken Institute Future of Health Summit in Washington, DC. “But the concerted efforts of communities across America are beginning to turn the tide,” he said.
The CDC keeps a running provisional tally of overdose deaths. The latest monthly update — for the 12-month period ended March 2018 — predicted a year-end figure of 71,073 deaths. That would be somewhat lower than the 72,000 deaths that were predicted just a few months ago. In 2016 — the last year in which accurate data is available — 63,632 individuals died of an overdose; opioids were involved in 42,249 (66.4%) of deaths. The opioid overdose rate increased almost 30% from 2015 to 2016. Final data is not yet available for 2017.
But in the provisional data, some of the hardest-hit states — Kentucky, Massachusetts, Ohio, Rhode Island, and Vermont — saw decreases in overdose deaths, while many other states had increases. Nebraska had a whopping 48% increase in overdose deaths, and California experienced a 9% increase, to 5490 deaths.
Azar, however, said he saw other positive signs that overdoses are declining. Since January 2017, the number of patients receiving buprenorphine has increased by 21%, and the number of naltrexone prescriptions has risen by 47%, said Azar. Monthly naloxone prescriptions have increased by 368%.
Azar also said that from 2015 to 2017, the number of Americans who misused prescription opioids, and the number who had initiated heroin use, had both significantly declined.
But CDC data show that overdose deaths due to fentanyl, cocaine, and psychostimulants with abuse potential (such as methamphetamine) have continued to increase.
At the conference, Azar announced a new HHS-sponsored opioid initiative. Under the Maternal Opioid Misuse (M-O-M) model, the Center for Medicare and Medicaid Innovation (CMMI) will partner with state Medicaid programs to help develop coordinated and integrated care that includes physical healthcare, behavioral healthcare, and wrap-around services.
CMMI will enter into up to 12 cooperative agreements with states. Those awardee Medicaid agencies will establish integrated programs with local partners. The Centers for Medicare and Medicaid Services (CMS) will award a total of $64.5 million to the states over a 5-year period, and it expects to start seeking applications in early 2019.
The program is considered a crucial new way to help reduce neonatal abstinence syndrome (NAS) and help pregnant and postpartum women, according to CMS. The agency noted that infants exposed to opioids before birth have a higher risk of being born preterm, having a low birth weight, and experiencing NAS.
Medicaid is the biggest payer of hospital charges for maternal substance use; it also shoulders the majority of the $1.5 billion annual cost of NAS, CMS said.