In the first episode of Hulu’s docudrama Dopesick, an attorney questions Dr. Samuel Finnix, a general practitioner in a small mining town in Virginia played by Michael Keaton.
He asks Finnix, “Did more than 1% of your patients become addicted to OxyContin?”
Finnix answers, “I can’t believe how many of them are dead now.”
It’s hard to believe, but the more than 2,300 people in Delaware who have died of drug overdoses since 2016 exceeds the number of people who have died of COVID-19 in Delaware since the beginning of the pandemic. Yet, because it is a slower-moving epidemic, the opioid crisis in our state has not received the same level of attention. This is even though in 2019, Delaware had the second-highest number of overdoses per capita in the U.S. after West Virginia.
Shockingly, drug overdose deaths in the United States rose nearly 30% in the past year, according to provisional data recently released by the National Center for Health Statistics. More than 100,000 people died from a drug overdose between April 2020 and April 2021, up from 78,000 the year before and nearly double the deaths five years ago. Delaware’s overdose rates actually increased at a higher rate than the national average from 2016 to 2019.
So, what’s to be done here? Certainly, the state has mobilized its resources by creating a Behavioral Health Consortium headed by Lt. Gov. Bethany Hall-Long; standing up a helpline and website — https://www.helpisherede.com — and Bridge Clinics to increase access to services; passing laws directing more resources to treatment through taxing opioids; and successfully suing pharmaceutical companies to obtain some compensation to assist in funding treatment services.
Consultants have studied the system of care and made recommendations; more are coming. Yet, the one key recommendation of the Pew Charitable Trust’s 2019 “Substance Use Disorder Treatment Policy Recommendations for the State of Delaware” has not been acted upon. That is, “to fund reimbursement for care coordination for Substance Use Disorder treatment with a rate comparable to surrounding states and informed by evidence of the full cost of such services.”
Although a rate study has finally been completed, it hasn’t been published, and no action has been taken to increase the rates for the levels of care that, by law and by contracts with the managed care organizations) that fund most services, are supposed to be available for treatment. Inaction on reimbursement rates has resulted in the loss of treatment capacity in the state, and it threatens to further reduce options for treatment. In the last year, the state of Delaware lost 80 residential treatment beds in two facilities that provided care designed to assist Medicaid patients whose substance use disorder was so out of control that they needed 24-hour treatment. Up to 820 Delawareans with the highest level of need for treatment were able to be served in these facilities each year prior to their closures.
The tragic consequences of the state’s failure to provide adequate funding for community-based SUD treatment are seen in the obituary pages of our newspapers. Too many families have suffered the loss of loved ones; too many of them have given testimony in Legislative Hall about deaths of sons, daughters, and other family members that could have been prevented if treatment had been available when it was needed.
The time for action has come. The rate study needs to be published and the General Assembly should appropriate the resources to ensure that it is fully funded. Anyone living in Delaware who is ready for treatment should be able to get the services that are most appropriate to their needs, so that we can stem the tide of deaths in our state.
C. Thomas Cook is executive director of the Ability Network of Delaware.
This article originally appeared on Delaware News Journal: A slow-moving epidemic: Drug overdose deaths in Delaware