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Insights

Throughout February, MHA released a series of resources to help the public understand the consequences of delayed care and support hospitals in sharing the message. Monday, MHA released the most recent edition focusing on substance use disorders and neonatal abstinence syndrome. As with the earlier releases, the research is troubling.

Prior to the COVID-19 pandemic, Missouri had a significant opioid and substance use challenge. In 2018, one out of every 56 deaths in Missouri were due to opioid overdose, resulting in 1,132 opioid deaths. Between 1999 and 2015, drug-induced deaths increased by 273% in Missouri.

According to the Centers for Disease Control and Prevention, overdose deaths were accelerating before the pandemic, in part due to the increase in the powerful synthetic opioid, fentanyl. Recent research from the CDC found that, in the 12 months leading to June 2020, 81,003 Americans died from drug overdose — the highest number ever recorded over a 12-month period.

Although this problem remains, COVID-19 has influenced patterns of care that provide an opportunity for SUD identification and treatment. The new research finds that between March and October 2020, emergency department treatment for opioid and substance use declined by 5.6%, or 621 fewer ED visits in the state. Similarly, 7.5% fewer inpatient visits — representing 576 fewer individuals — occurred.

One could reasonably expect an increase in care for substance use and behavioral health issues throughout the COVID-19 pandemic. Yet, the data indicate that less care and treatment interventions occurred. And, unfortunately, this reduced opportunity to identify SUD and help patients begin a path to recovery could be one factor contributing to the recent increase in both national and Missouri drug overdose prevalence.

We know that substance use issues are often identified in a clinical environment, including prenatal visits. Conversations with expectant mothers can create an opportunity to identify these issues, and establish a treatment and recovery plan to protect the mother and child. During the COVID-19 pandemic, identified cases of NAS increased 20.9% when comparing 2019 to 2020. At the same time, there is evidence that NAS is unrecognized and underreported, which could mean that this challenge is even greater than the data indicate.

Tuesday, MHA co-sponsored a Neonatal Abstinence Syndrome Summit with the Missouri Department of Health and Senior Services. Among the 188 participants, stakeholders included clinicians, social workers, certified peer specialists, insurance care coordinators and partners from agencies throughout the state.

Our ability to identify the need for treatment, and work with patients to support their journey to recovery, will likely increase post-COVID-19. We know that COVID-19 didn’t eliminate substance use disorders. Nonetheless, it likely has limited hospitals and our partners’ ability to identify them. This is a reminder for all Missourians that, if they have a member of their family, a neighbor or friend with a substance use disorder, they should encourage them to pursue care.

Let me know what you think.

Herb B. Kuhn
MHA President and CEO

In This Issue

Committee Advances Bill On Medicaid Managed Care Regulation
MLN Connects Provider eNews Available
SAMHSA Releases Evidence-Based Guide For MAT Use In Emergency Departments
CMS Extends OQR Q3 2020 Reporting Deadline
Fulton Medical Center Changes Name
Saint Francis Healthcare System Promotes Vaccination Clinics On Facebook Live