Pubdate: Wed, 04 Jan 2017
Source: Times-Picayune, The (New Orleans, LA)
Copyright: 2017 The Times-Picayune


Fewer people are being hospitalized for opioid-related conditions in
Louisiana, according to a new federal study. (txking)

Louisiana was one of only four states to show a decline in the rate of
opioid-related hospital stays between 2009-2014, new federal data shows.
During that same time period, opioid-related hospitalizations nationwide
increased by a rate of nearly 24 percent.

The report, published by the Agency for Healthcare Research and Quality, a
division of the U.S. Department of Health and Human Services, said
Louisiana showed a 6.4 percent decline in hospitalizations due to the
misuse of prescription pain relievers and the use of illicit opioids like
heroin and fentanyl.

Kansas, Maryland and Illinois showed similarly small declines, though many
states experienced a drastic increase in the rate of opioid-related
inpatient stays. From 2009-2014, Oregon saw the highest uptick with 89
percent, followed by North Carolina with 82 percent and South Dakota with
74 percent.

In 2014, Louisiana ranked the 14th lowest in the U.S. for opioid-related
hospitalizations with 136 per 100,000 people. Maryland, driven by surging
rates of opioid overdose in Baltimore, ranked highest with 362 inpatient
stays for every 100,000 people.

Experts offered various theories for why opioid-related stays dropped in
Louisiana between 2009-2014, despite the fact that opioid overdoses rose
33 percent during that same period.

Anne Elixhauser, a senior research scientist at AHRQ and one of the
authors of the report, said increased use of the opioid antidote naloxone
may have played a role. Though ambulance crews have carried the antidote
since the 1990s, a state law signed in 2014 put it into the hands of all
first responders in Louisiana.

Sreyram Kuy, chief medical officer for Louisiana Medicaid at the state
health department, credited the state's prescription drug monitoring
program, which went live in 2009. The program allows doctors and
pharmacists to monitor whether their patients are receiving prescriptions
from other doctors or pharmacies, cracking down on the phenomenon of
"doctor shopping."

"I think this data is an indication that Louisiana is on the right track,"
Kuy said in an interview, adding that the number of doctors who used the
database increased between 2009 and 2014. The decrease in inpatient stays
"is something for us to build upon and improve and expand," she said.

But Arwen Podesta, a psychiatrist who heads the New Orleans addiction
treatment center Odyssey House, attributed the decline in part to the loss
of hospital beds for those suffering from opioid overdose, dependence or
other forms of misuse. In 2012, Interim LSU Public Hospital shut down its
20-bed chemical detox unit in response to $34 million in budgets cuts
ordered by Gov. Bobby Jindal's administration.

For Podesta, the decline in hospital stays did not reflect "less need for
services," but rather "less use of that level of services because of less
availability." In the absence of LSU's detox unit, she said, patients
struggling with opioid and heroin addiction have turned instead to
substance abuse treatment centers like Odyssey House, which the AHRQ study
did not qualify as hospitals.

Whatever the cause of the decline in statewide inpatient stays, the data
provides an illuminating overview of who is being hospitalized for
opioid-related issues in Louisiana.

In 2009, for example, men in Louisiana were much more likely than women to
stay in the hospital for opioids, with 156 out of 100,000 men compared to
119 out of 100,000 women. By 2014, however, that gap had narrowed
significantly, with 139 out of every 100,000 men versus 130 women per
100,000, mirroring national trends.

State residents between the ages of 25 and 44 were twice as likely to be
hospitalized for opioids than those between 45 and 64. Nationwide,
however, data showed that those two age groups were equally likely to be
hospitalized for opioid overdoses and other forms of misuse between

Louisiana also bucked national trends in terms of the wealth of those
admitted to the hospital for opioid-related problems. In the U.S. as a
whole, those in the lowest income quartile had the biggest risk of being
hospitalized on account of opioids, while those in the highest income
quartile had the smallest risk. That pattern held steady between 2005 and

In Louisiana, however, an unusual shift occurred. In 2008, the state
matched national trends, with the poorest quarter of residents being most
likely to be hospitalized for opioids, and the richest quarter being least
likely to suffer a similar fate. By 2014, however, the wealthiest
Louisianans were the most likely to be hospitalized for opioids, and the
poorest were the least likely.
- ---
MAP posted-by: