LEWES, Del. - In an update Wednesday, officials from the Department of Health and Social Services and Beebe Healthcare shared that at least 11 people have been placed on ventilators in the past week due to a spike in "unusual" and severe overdoses.
OVERDOSE PATIENTS
Healthcare workers at Beebe facilities have treated over 30 people with overdoses since Thursday, compared to a typical average number of five during a similar timespan. Around 50 overdoses are suspected, as officials Wednesday referred to this sudden increase as a "fast-moving situation."
"These patients are unique in that they are much more critically ill than most patients and require long-term, intensive care," said Paul Cowen, an emergency medicine doctor at Beebe. "It's a very disturbing trend."
"One of the concerns and troubling aspects of this set of ingestions is the severity of the patients and the significant amount of agents that are needed to try to reverse [these overdoses], the amount of Narcan," said Paul Sierzenski, chief physician executive for Beebe Healthcare,"as well as the fact that a number of these patients, to date more than 11, have required mechanical ventilation and intubation with ICU stays."
HEALTH SYSTEM RESPONSE
In response to rising concerns and greater need, Joanna Champney, director of the Division of Substance Abuse and Mental Health, said the state has ramped up Narcan distribution in Sussex County. So far, 1,300 kits have been delivered to Beebe for distribution throughout the Beebe Healthcare system and 200 doses have been sent directly to the hospital's emergency department.
Officials say they're unsure of the type of substance being consumed by patients and tests are still ongoing. The Poison Control Center issued a bulletin noting synthetic opioid derivatives are in the eastern part of Delaware, and that they carry similar symptoms such as agitation and delirium, severe sedation and coma, respiratory depression and movement abnormalities attributed to seizures.
The Overdose Response Center issued guidance on Tuesday that there is currently a potential increased risk in Sussex County of more severe overdose effects. Xylazine and fentanyl test strips may be requested with Division of Substance Abuse and Mental Health-supplied Narcan kits, according to Champney, and treatment providers and community agencies are asked to encourage patients and clients to not use drugs alone and test their substances before using them.
WHERE ARE OVERDOSES HAPPENING?
According to the state's health officials, there have been no patterns when it comes to age, sex, race or geographic location within Sussex County or throughout the state when it comes to where these overdoses are occurring. Cases so far have been spread widely throughout Sussex County, in the "same spots as where people are already obtaining drugs."
"Addiction gets to a point where patients are trying to satisfy the need to address the feelings, the substance abuse cravings, that they're having," said Dr. Rob Rosenbaum, medical director for Emergency Medical Services and Preparedness at the Division of Public Health. "They may not be aware or able to identify exactly what they've taken."
HOW TO GET NARCAN
According to the Division of Public Health, Narcan is free by mail and can be purchased without a prescription at participating pharmacies throughout Delaware, including many CVS, Walgreens, Rite Aid, Walmart and Giant locations. It's also available at statewide distribution and training events and through certain clinics. More information on how to access Narcan is available at HelpisHereDE.com.
WHAT IF NARCAN DOESN'T WORK?
Health officials emphasized Wednesday that Narcan, a medicine used to reverse the effects of an opioid overdose, is used to restore normal breathing, not to necessarily wake someone experiencing an overdose up. Opioid overdose symptoms can vary widely depending on which substance or substances were used. Potential signs include loss of consciousness, constricted pupils, breathing difficulties or respiratory arrest, choking or gurgling sounds, blue or purple lips or fingertips and general unresponsiveness to loud noises or shaking according to the American Addiction Centers.
During Wednesday's update, health officials noted that resistance to Narcan in the recent increase of overdoses isn't universal. If a first dose doesn't work to restore normal breathing, they recommend waiting two minutes, making sure 911 has been called, and give a second dose.
HOW TO USE NARCAN
- Narcan should not be primed or tested prior to use, as each package contains a single dose of naloxone and cannot be reused.
- The bottle can be held with the thumb on the bottom and first and middle fingers on either side of the nozzle.
- Lay the patient on their back and support their neck, tilting the head back.
- Insert the nozzle tip into one nostril and press the plunger firmly to give the dose.
- Move the patient on their side and get emergency medical help immediately.
- Watch the patient closely. Additional doses may be given every two to three minutes until the patient responds or emergency services are available.
A list of Narcan trainings and community overdose prevention events where Narcan is distributed is available online at HelpisHereDE.com.
An update from Delaware State Police Thursday revealed there have been two suspected overdose fatalities and 73 suspected overdoses in Sussex County, with the majority taking place in the greater Georgetown, Millsboro and Milford areas. Drug testing samples have come back and show xylazine, which is a tranquilizer, as well as bromazolam, fentanyl, quinine and caffeine. A full update is available here.
