Hospital stays for opioid overdoses are decreasing around Pa., but still high in Philadelphia

The number of Pennsylvanians admitted to hospitals after overdosing on opioids dropped by nearly 25% last year, a new report from the Pennsylvania Health Care Cost Containment Council (PHC4) has found.

Researchers said that it may be a sign that efforts to curb the tide of fatal overdoses — including distributing thousands of doses of the overdose-reversal drug naloxone — are working.

Data on hospital admissions don’t show the full picture of overdoses. PHC4’s analysis did not include overdoses that were reversed in the field by bystanders or paramedics. Nor does it count people who were treated for overdoses in emergency departments but did not stay in the hospital.

Opioids caused most of the overdoses requiring hospitalization. But overdoses involving other drugs are on the rise. Hospital admissions for overdoses on stimulants like cocaine and amphetamines have spiked in the last three years. Cocaine overdose hospitalizations increased from 949 to 1,204 between 2016 and 2018 — a 26.9% increase. Methamphetamine overdose hospitalizations increased by 66.1%, from 189 in 2016 to 314 in 2018, the report found.

But the opioid overdose hospitalization declines are encouraging, said Joe Martin, PHC4’s executive director. “A great deal of work and resources, private and public sector, has gone into fighting the opioid epidemic and it’s starting to show results,” he wrote in an email.

After increasing between 2016 and 2017, hospitalizations for heroin overdoses dropped by 36.4%, to 1,115, the report found. Though hospital admissions for opioid painkiller overdoses have been decreasing since 2016, they still outstrip hospitalizations for heroin overdoses, with 1,552 Pennsylvanians admitted to hospitals for opioid prescription-drug overdoses in 2018.

That’s likely because painkillers were more widely available than heroin, and, in some cases, overprescribed, Martin said. “Heroin is a more dangerous, but less common, problem,” he said.

The report found that people living in lower-income areas, with lower levels of education — places where less than 10% of the population has a bachelor’s degree — are more likely to be hospitalized for an opioid overdose. Black patients were also more likely than other groups to be hospitalized for an opioid overdose.

Though Philadelphia’s opioid overdose hospitalization rate dropped in 2018, it still had the highest rate of any county in the state, the report found.

“As the number of overdose deaths in Philadelphia dropped in 2018 from the 2017 watermark and naloxone became more prevalent in the community, we expect that the number of hospital admissions would go down; more people are surviving overdoses,” James Garrow, a spokesperson for Philadelphia’s health department, wrote in an email. “This is great news because it means that these folks have another chance to get into treatment.”

Still, he added, Philadelphia’s historically high overdose fatalities — 1,116 people died here in 2018, a rate higher than anywhere else in Pennsylvania — mean that it’s not surprising the city leads the state in hospitalizations.