In a 50-plus page report issued Wednesday, the Delaware Health and Social Services Division of Public Health detailed the concerning rise of deaths in the First State tied to drug use--a more-than-140% increase over just the last five years. 

Death data from 12 multi-agency datasets was combed through to produce insight into the 18-year trends--from 2000 to 2017--of drug overdose mortality rates.  The report examined who's dying from the drugs, what sociodemographic characteristics victims possessed, and the statewide efforts  undertaken to begin addressing the steep increase.

DPH number of overdose deaths

 “Too many Delaware families are impacted by the opioid crisis,” said Governor John Carney. “We are working across agencies to address this epidemic, and the data from this report will help us make informed decisions that guide us in developing effective interventions — with the ultimate goal of saving more lives.”

From 2012 to 2017, drug overdoses grew from 142 to 343 cases annually with men twice as likely as women to be the victims of a fatal drug overdose in 2017. 

“There is no question that we have more work to do up and down our state to reduce the toll that the opioid epidemic has taken on thousands of people in our state and their families,” said DHSS Secretary Dr. Kara Odom Walker, a practicing family physician. “But now we have more data to inform our path forward and to help us identify critical touchpoints where intervention can make a difference.” 

Non-Hispanic white men between the ages of 25 and 54, who had never been married and achieved a high-school- or GED-level education, were the most frequent victims of substance abuse disorders. The top occupation held by those men was construction. For women, that occupation was food service. 

However, among the decedents, 11% of men and 33% of women were unemployed. 

Of the deceased, 81% had visited a Delaware emergency room, required EMS service, taken part in a prescription monitoring program, received assistance from the Division of Substance Abuse and Mental Health, or were discharged from a Delaware hospital a year before they died. 

DPH ER visits

One in four had been released from prison the year prior to death, according to the report; more than 40% had achieved freedom in the previous five years. Those on probation and parole accounted for 30% of the dead. More than a quarter had a Hepatitis C infection, past or present. More than 60% were eligible for Medicaid, and close to three out of every four, male or female, had a claim for a mental, behavioral, and/or neurodevelopmental disorder in the year prior to death. 

New Castle County alone accounted for 238 of the 343 deaths in 2017, and Wilmington accounted for 50 of those, which was more than Kent County's 40, but just shy of Sussex County's 64 overdose deaths. In each county, opioids were responsible for more than 80% of overdose deaths. That number reached as high as 90% in Wilmington. 

DPH Opioid deaths by area, county

In 2009, prescription opioids were responsible for almost all overdose deaths. By 2018, fentanyl and other synthetic opioids account for 72% of the 400 overdose deaths. 

Beginning with a dramatic increase in opioid prescriptions dating back to the 1990s, the DPH broke out opioid-related deaths into three waves in an effort to display exactly how toxic those types of drugs have become to the community: 

DPH death by opioids

To treat the systemic issues faced by Delaware residents suffering from substance abuse disorders, health officials said prevention is a crucial first step. Earlier access to intervention could save time, money, and lives. 

Using data gathered during this study, officials will be targeting "outlier prescribers," and integrating their information with Electronic Health Records systems in the state to improve awareness and educational programs for prescribers, including surgeons and dentists. 

Delaware had already increased access to those who need treatment 500%, from 1,000 individuals receiving assistance in 2006 to 5,000 receiving treatment in 2017. Strengthening Delaware's options through the Substance Use Treatment and Recovery Transformation initiative and the Delaware Treatment and Referral Network are priorities for DHSS.  

Increasing access to Naloxone also helps to save lives. In 2018, First State first responders administered the overdose-reversal drug 3,728 times, up 30% from the 2,861 administrations in 2017. 

“I am thrilled that so many state agencies were able to pull together and provide critical data related to behavioral health for this report,” said Lieutenant Governor Bethany Hall-Long, who chairs Delaware’s Behavioral Health Consortium. “This was one of the BHC’s goals and the results will allow us to focus our efforts, reduce stigma around the disease of addiction and save lives.”

Check out the full report: