Is Delaware the New Center of the OD Crisis?

February 3, 2020

One of the smallest states in the US is increasingly being hit the hardest by fatal overdoses as the rest of the county seems to be making notable progress on stopping opioid-related overdose deaths. New data shows that Delaware is facing one of the highest fatal overdose rates that’s only increasing.

Delaware’s overdose crisis had been on the rise for six years, reaching a high of 400 deaths in 2018. The state’s small population—roughly the size of Washington, D.C.—saw 43 deaths per 100,000 people, the second highest rate in the nation, just behind West Virginia’s 51 per 100,000, according to a January 30 report from the Center for Disease Control and Prevention. Point increases were not given.

Most of the deaths in 2018 were reported out of the county home to Wilmington, the largest city in the state that’s majority Black, though overall mostly white people (81 percent) saw deadly overdoses. Black Delawareans comprised 15 percent of all deaths, according to the state’s Forensic Science Division. The Delaware Drug Overdose Fatality Review Commission found that almost a third (30 percent) of the 56 cases they studied had been incarcerated in state prison, with half of them overdosing within the first three months after release.

People who use opioids are at a high risk of overdosing following incarceration due to decreased tolerance and a lack of accessible treatment options. One study from North Carolina found that formerly incarcerated people were 74 times more likely than the norm to overdose within the first two weeks of their release. But in 2019, Delaware rolled out a medication-assisted treatment program in its state prisons with treatment linkage post-incarceration to combat the overdose crisis.

Delaware’s overdose deaths were preventable, the Commission also found. Many (79 percent) involved a witness at the time of the overdose. But since most deaths happened in homes, bystanders apparently didn’t respond by attempting to reverse the overdose. Almost all of the decedents (93 percent) did not have naloxone present in the home at the time of death. Delaware officials have stepped up distribution efforts in 2019.

Four other states that haven’t been considered hotspots of the crisis—California, Missouri, New Jersey, and South Carolina—also saw increasing death rates in 2018, though most of them were not among the highest in the country.

Photograph of Wilmington, Delaware by Bjoertvedt via Wikimedia Commons/Creative Commons

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