Delaware Division of Public Health Announces Availability of Free Mail-Order Naloxone

DOVER, DE (DEC. 11, 2020) – The Delaware Department of Health and Social Services’ (DHSS) Division of Public Health (DPH) announced Friday that Delawareans struggling with addiction can now order free naloxone by mail. Increasing access to naloxone is critical to preventing overdose deaths as more people are struggling with anxiety, depression, and financial stress stemming from the COVID-19 pandemic. Receiving in-person support and treatment is more challenging due to social distancing, which prevents meeting at in-person support groups.

Mail-order naloxone is available through a Memorandum of Understanding between DHSS and the New York-based harm-reduction nonprofit NEXT Distro. NEXT Distro operates in 35 states and has distributed free naloxone to 16,000 households in the United States since 2018. The life-saving medication, also known by its brand name Narcan, can reverse opioid drug overdoses by restoring someone’s breathing that has become suppressed from an overdose.

“DPH’s agreement with NEXT Distro could not come at a better time,” said DPH Director Dr. Karyl Rattay. “Delaware is experiencing a simultaneous increase in COVID-19 cases and drug overdose deaths. Those who need naloxone the most can now order it privately and conveniently, avoiding any stigma that could be a barrier to accessing the life-saving medication. Holding outside distribution events is also becoming more challenging because of the cold weather, making this an ideal option to get naloxone in the hands of those who need it the most.”

A total of 316 suspected overdose deaths have occurred through early December this year in Delaware, which is higher than the number of suspected overdose deaths for the same period in 2019, according to preliminary data from the Delaware Division of Forensic Science (DFS). Since overdose deaths typically spike in December, that number is expected to grow. In 2019, 431 people died from drug overdoses in Delaware, according to DFS.

“We know that the COVID-19 pandemic is difficult for all of us mentally and emotionally, but none more so than Delawareans struggling with addiction, mental illness or both,” said DHSS Secretary Molly Magarik. “Because the holidays can add to that existing stress level and may be a trigger point for people with substance use disorder, this new initiative is coming at a particularly critical time. Families in our state can best help their struggling loved ones by ordering naloxone and connecting them to treatment.”

According to the Delaware Overdose Fatality Commission 2018 Annual Report, 79 percent of the overdoses studied occurred in a residence, and naloxone was not available 93 percent of the time. Through a statewide campaign that launches in January, DPH’s Office of Health Crisis Response (OHCR) reminds people that with Narcan they have “The Power to Save a Life.” The campaign encourages Delawareans to save lives by having Narcan available and to download the free OpiRescue DE app on their Apple or Android smartphones for step-by-step instructions on its use. Delawareans will soon see and hear ads on the radio, in bus shelters, on social media, and on gaming apps.

“As the COVID-19 pandemic rages on, so does the opioid epidemic,” said Lt. Governor Bethany Hall-Long. “Putting naloxone directly into the hands of Delawareans is another tool for families, friends and employers to help those who are battling substance use disorder. Delivering it to their front door will save lives. No question. Thank you to the partners who are making this happen.”

Delawareans who want to place a mail order for naloxone should visit the “Overdose Prevention” page on HelpIsHereDE.com and access NEXT Distro’s Delaware program. Customers must watch a video, take a short quiz, and complete a request form. DPH will receive the request from NEXT Distro’s virtual platform and will mail individuals free naloxone. People will receive their naloxone within a few days. All contact information will be kept confidential.

Delawareans can still obtain Narcan or naloxone without a prescription at pharmacies, and Narcan at overdose prevention trainings and naloxone distribution events. Since January 2020, community partners hosted 80 such events, 62 of which were held car-side after COVID-19 emerged as a health crisis in the spring. During the first three quarters of 2020, OHCR’s Community-based Naloxone Access program distributed 6,263 naloxone kits through its community partners, including Community Response Teams in each county.

For more information about mail-order naloxone, Narcan, OpiRescue DE, or virtual resources designed to help those struggling with addiction, visit HelpIsHereDE.com.

The website offers information on virtual support groups, a searchable real-time database on treatment options and availability, and free counseling via the 24/7 Delaware Hope Line. HelpIsHereDe.com also provides directions for the disposal of unused prescriptions and a list of 28 prescription drop boxes available throughout the state. Visitors can also find prevention information including Narcan and the OpiRescue DE app. A HelpisHereDE.com awareness campaign began this month and will run throughout the year on billboards, radio, and social media; in bus shelters; and at 39 grocery stores and pharmacies statewide.

During addiction or mental health emergencies, call DHSS’ 24/7 Delaware Hope Line at 1-833-9-HOPEDE. For an in-depth study of overdose deaths in Delaware for 2017, read DPH’s Drug Overdose Mortality Surveillance Report.

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A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware’s Department of Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, drink almost no sugary beverages.


Delaware Officials Issue Warning after 6 Suspected Overdose Deaths During Holiday Weekend

NEW CASTLE (Sept. 3, 2019) – Health and public safety officials are urging people in active use of heroin or other opioids and their families to seek immediate treatment and to acquire the overdose-reversing medication naloxone in the wake of six suspected overdose deaths, including four in Sussex County, during the holiday weekend.
The six suspected overdose deaths happened in Sussex and New Castle counties between Friday, Aug. 30, and Sunday, Sept. 1, the Division of Forensic Science reported. Preliminary data show that first responders in Sussex County – police, fire and EMS – responded to 25 suspected overdose incidents between Aug. 30 and Sept. 2, a substantial increase over a typical four-day period.
The five deaths from suspected overdoses on Aug. 30-31 brought the monthly total for August to 33 deaths. As of today, Sept. 3, the Division of Forensic Science has reported a total of 194 suspected overdose deaths in Delaware this year. There is always a lag in terms of both toxicology analyses and death determinations. In 2018, there were 400 overdose deaths across the state, an increase of 16 percent from the 2017 total of 345 deaths.
“Until the Division of Forensic Science determines the particular chemical make-up of the substances involved in these deaths, it is critical that people be aware of the dangers,” said Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a practicing family physician. “Five of these deaths happened at residences, so it’s important that people have naloxone in their homes if they know or suspect their loved one is using opioids. If you see someone overdose, call 9-1-1 immediately, begin rescue breathing and administer naloxone, which can reverse the effects of an opioid overdose, and save the person in distress.”
“Naloxone saves lives,” said Division of Public Health Director Dr. Karyl Rattay. “We urge anyone who needs access to naloxone to connect with Brandywine Counseling & Community Services, which operates the syringe services program for the Division of Public Health or go to a participating pharmacy to buy the overdose-reversing medication. We also urge Delawareans to download OpiRescue Delaware, a new smartphone app that provides lifesaving step-by-step instructions on how to respond to an overdose, including administration of naloxone.” For more information, go to HelpIsHereDE.com, and click on the overdose prevention tab.
In 2018, first responders administered 3,728 doses of naloxone, compared with 2,861 doses in 2017, a 30 percent increase.
Elizabeth Romero, director of the Division of Substance Abuse and Mental Health (DSAMH), urged individuals in active substance use to see a medical provider immediately, come to a DSAMH Bridge Clinic in Sussex or New Castle counties, or call DHSS’ 24/7 Crisis Services Helpline to be connected to trained crisis professionals who can discuss treatment options.
The Sussex County Bridge Clinic, in the Thurman Adams State Service Center, 546 S. Bedford St., Georgetown, is open from 8:30 a.m.to 4 p.m. Monday through Friday. For more information, call 302-515-3310. The New Castle County Bridge Clinic, 14 Central Ave. (just off U.S. 13) near New Castle, is open from 9 a.m. to 4:30 p.m. Monday through Friday. For more information, call 302-255-1650. The Kent County Bridge Clinic is expected to open this fall.
In Kent and Sussex counties, the DSAMH Crisis Helpline number is 1-800-345-6785. In New Castle County, the number is 1-800-652-2929. Individuals and families also can visit DHSS’ website, www.HelpIsHereDE.com, to find addiction treatment and recovery services in Delaware and nearby states.
Romero encouraged anyone who is using or suffering from addiction to call for help, see a medical provider, or ask a police officer or another first responder for help. “Too many times, our police officers, EMTs and other first responders see first-hand the dangers of overdoses,” she said. “Our first priority is to save lives.”
Under Delaware’s 911/Good Samaritan Law, people who call 9-1-1 to report an overdose and the person in medical distress cannot be arrested for low-level drug crimes.
In 2018, the Division of Forensic Science confirmed the presence of fentanyl in 296 of the 400 total fatal overdoses, a 41 percent increase over 2017. Fentanyl is a synthetic pain reliever that is up to 50 times more potent than heroin.
Drug dealers sell fentanyl in a variety of ways, according to the Drug Enforcement Administration (DEA). Dealers sell pure fentanyl in white powder form to users who often assume they are buying heroin. They lace cocaine or heroin with fentanyl. And they press fentanyl into pills and pass them off as Oxycodone.
When users ingest fentanyl or a drug laced with fentanyl, it affects their central nervous system and brain. Because it is such a powerful opioid, users often have trouble breathing or can stop breathing as the drug sedates them. If someone is too drowsy to answer questions, is having difficulty breathing, or appears to be so asleep they cannot be awakened, call 9-1-1 immediately, start rescue breathing and administer naloxone if you have it at home.


DPH Releases First Drug Overdose Mortality Surveillance Report

WILMINGTON  – For the first time, the Delaware Division of Public Health (DPH) through the integration of 12 multi-agency datasets, has developed a demographic picture of the Delawareans who died from drug overdoses in 2017. DPH released the Drug Overdose Mortality Surveillance Report, Delaware, 2017, in Wilmington on Wednesday, Aug. 14, 2019.

In addition to providing an overview of drug overdose mortality trends, the report provides an in-depth look of the individuals who died of drug overdoses in Delaware in 2017. The report addresses the types of drugs used; if, how, and when the decedents interacted with Delaware health systems; and a description of key statewide efforts to address the drug overdose and substance use crisis. Health system interactions include: Emergency Department (ED) visits; Emergency Medical Services (EMS) encounters; prescriptions in the Prescription Monitoring Program (PMP); treatment through the Delaware Department of Health and Social Services’ (DHSS) Division of Substance Abuse and Mental Health (DSAMH) contractors; and hospital discharges. Expanded analysis of health system interactions includes data on Department of Correction (DOC) interactions and Medicaid eligibility and claims.

“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.”

The Drug Overdose Mortality report followed one of the recommendations in the Johns Hopkins Bloomberg School of Public Health’s July 2018 report, “A Blueprint for Transforming Opioid Use Disorder Treatment in Delaware.” The Hopkins team recommended that Delaware use data to guide and monitor progress by linking multi-agency data to more fully understand individuals with substance use disorders and their utilization of Delaware’s systems.

Key Findings:
Of the 346 Delaware residents who died of a drug overdose in 2017, DPH identified 343 for the report’s study population. Overall, drug overdose decedents were primarily males (67%), between the ages of 25 and 54 years (76%), non-Hispanic white (79%), never married (59%), and had a high school diploma or General Educational Development (GED) (55%).

The top two occupational industries among males who died of drug overdoses were construction (36%) and the install, maintain, and repair industry (9.1%; includes mechanics, HVAC repair, engine repair, maintenance, and other occupations). The top two occupational industries among females were food service (14.7%) and office support (12.8%); however, 33% were not employed.

Opioids, a class of drugs that includes heroin, fentanyl, oxycodone, hydrocodone, codeine, and others, accounted for the majority of drug overdose deaths (84%). Synthetic opioids other than methadone (e.g. fentanyl, tramadol, etc.) were responsible for the highest mortality rates among opioid drug overdose deaths (age-adjusted rate: 21.9 deaths per 100,000 population).

Eighty-one percent, or four out of five, persons who died of a drug overdose in 2017 interacted with a Delaware health system in the year prior to their deaths.

State officials say quantifying this information is critical as it helps those addressing the drug epidemic in Delaware to identify critical moments to engage those with substance use disorder (SUD) into treatment.

“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.”

“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.”

A deeper look at the drug overdose decedents’ health system interactions shows:

ED: One in two drug overdose decedents (54.2%) visited a Delaware ED in the year prior to their death and 70% visited the ED within two years prior to their death. Not all visits in the year prior to death were related to the decedents’ drug use. In the year prior to their death, 23% of drug overdose decedents who had visited the ED had mental-health related diagnoses, 10 percent of decedents had a previous drug overdose ED visit, and 6.7% had a pain diagnosis related to their ED visit. Drug overdose and pain diagnoses were more often recorded among females than males.

EMS: Nearly half of decedents (43.1%) had a history of an EMS encounter not related to the death event in the year before their death. Twenty-three (6.7%) drug overdose decedents had an EMS encounter for a non-fatal drug overdose. Naloxone was administered to 39.1% of those decedents with a non-fatal overdose EMS encounter.

PMP: Among drug overdose decedents, 164 (47.8%) had a prescription in the PMP in the year prior to death. Nearly one in four Delaware drug overdose decedents (23.6%) had a prescription for an opioid such as oxycodone, codeine or morphine in the PMP in the year prior to their death. Twenty-two percent had a prescription for a benzodiazepine (often used to treat seizures or anxiety). Twelve percent of decedents had prescriptions for both in the PMP in the year prior to their deaths – but the prescriptions did not necessarily overlap.

DOC: One in four opioid drug overdose decedents (25%) were released from incarceration within one year prior to death. There were 103 drug overdose decedents (30%) who were on probation and parole in the year that preceded their deaths; 76 (22.2%) of decedents were on probation and parole at the time of death. Nearly half of the 343 drug overdose decedents (45.8%) had a record of a misdemeanor, 32.7% had a record of a felony, 25.4% violated parole, and just 20.4% had drug-related offenses.

DSAMH: Within the year prior to death, one in four decedents (26.8%) received DSAMH services. Approximately 10% of decedents were receiving services from DSAMH at the time of death. Of decedents who had received services from DSAMH, 25.3% were considered homeless.

Hospitalizations: Approximately 12% of drug overdose decedents were hospitalized in the year prior to their deaths. Nearly 10% of drug overdose decedents were hospitalized with a diagnosis of a mental, behavioral, or neurodevelopmental disorder.

“Another key facet of this report is that through this historical look at data, we were able to determine that as a state we were on the right track with many of our current and ongoing initiatives,” said DPH Director Dr. Karyl Rattay, who presented the report’s key findings. “It will help us continue to focus our efforts and allow us to move forward in a thoughtful and meaningful way.”

In the section on Addressing the Health Crisis, the report describes how Delaware is doing so through a comprehensive and multipronged approach including: (1) prevention; (2) treatment; (3) harm reduction; (4) criminal justice; and (5) epidemiology, data, and surveillance. The section discusses the state’s efforts to engage emergency department physicians, prescribers, and EMS personnel. It also provides information on the expansion of treatment facilities and processes, and the utilization of naloxone by not only first responders but also Corrections staff and the community to save lives.

“This report provides crucial information to help us identify gaps in our treatment system,” said Elizabeth Romero, director of the Division of Substance Abuse and Mental Health. “It also confirms that the efforts we have made under the START Initiative are moving our system of care in the right direction.”

Delaware currently ranks fifth-highest among drug overdose mortality rates in the nation.

To view the full 2017 Drug Overdose Mortality Surveillance Report, visit https://www.dhss.delaware.gov/dhss/dph/files/dedrugoverdosemortsurvrpt2017.pdf.
Those seeking substance use or mental health resources are encouraged to visit www.HelpisHereDe.com or call the 24/7 Crisis Services Hotline. In New Castle, call 1-800-652-2929. In Kent and Sussex counties, call 1-800-345-6785.

*Data note: There may be slight differences in the drug overdose mortality data reported by the Delaware Division of Public Health (DPH) compared to the data reported by the Delaware Division of Forensic Science (DFS). DHSS utilizes data from DFS to communicate preliminary annual drug overdose death totals based on information from the Delaware Medical Examiner’s Office. These data are considered preliminary until the final statistical death file is closed by the Delaware Health Statistics Center within DPH.

 

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.