The first real-time tracker of opioid abuse in Minnesota has found an unexpected trend: a summertime increase in overdoses and other drug-related health problems that end up in the hospital.
The observation is the first of many that Hennepin County leaders are hoping they will produce through a new dashboard in order to improve their response to the opioid epidemic.
"Up until now we have been reliant on data that is often two to three years old to make decisions about funding and interventions and to understand where we are at in this crisis," said Dr. Tyler Winkelman, a Hennepin Healthcare physician.
The dashboard is the product of a new consortium of hospitals that are sharing instant data to better identify and address public health problems. It debuted earlier this month with drug-related data from all Hennepin County hospitals that could be sorted by drug type, age, gender and race.
The opioid epidemic has evolved over the past decade from one fueled by prescription painkillers to one dominated by fentanyl, a powerful and often illicit synthetic drug. In 2016, when pop singer Prince died of an overdose involving fentanyl, the synthetic drug was responsible for 37 of 149 opioid overdose deaths. The most recent death data shows that fentanyl was involved in 320 of 340 opioid overdose deaths in 2021.
Hennepin County data suggests the epidemic is worsening; a record 965 people needed inpatient or emergency hospital care this May for opioid-related health problems, including 237 nonfatal overdoses.
Summer wasn't the flashpoint for opioid-related problems when the epidemic emerged a decade ago, but July produced the most opioid-related hospital visits for five years in a row.
Why is a mystery, said Winkelman, who is leading the state hospital data consortium. Hospitals in Boston have reported more winter activity, probably because opioid users are more isolated and have less access to the overdose rescue drug naloxone, he said.
On the other hand, research in Europe has found more risky drug use in the summer. Minnesota also sees summer spikes of violence, crime, domestic abuse and other problems.
"Trauma and accidents increase every summer, and what we may be picking up is an increase in accidents and trauma that involve a substance," Winkelman said.
Opioid-related hospital visits declined after May's record to 822 in June, according to the latest dashboard data. July visits will be posted next month and will likely increase if recent seasonal trends hold. Emergency and inpatient visits include nonfatal overdoses and other consequences of drug use, including accidents, psychosis or soft-tissue injuries from injections.
The dashboard will be improved over time so, among other things, it can compare opioid hospitalizations and deaths to see if there are any trends in those who die from overdoses vs. those who survive, Winkelman said.
Opioid-related hospital visits in Hennepin County are more likely to involve men, Native Americans and people ages 25 to 34 — putting the drug in a different age class than others that also are tracked. Visits related to cocaine and alcohol are more common in people 45 to 64, and cannabis-related visits are more common in people 18 to 24.
The 10,000 opioid-related hospital visits per year in Hennepin County are only a third of the annual visits related to alcohol, but the number treated for drinking-related problems has declined since 2019.
Cannabis was linked to 6,000 to 7,000 hospital visits per year, according to the dashboard, which was launched a month before the drug becomes legal for recreational use in Minnesota. Fewer of these visits were related to nonfatal overdoses compared with opioids and alcohol.
Any successes in reducing alcohol-related visits may not apply to opioids, at least not in the fentanyl era when one use can be fatal, said Julie Bauch, Hennepin County's opioid response coordinator. "The finality of fentanyl is very different than an alcohol-use disorder."
The dashboard shows a need for culturally specific opioid response strategies for American Indians and a small but growing problem in teenagers, she added.
"Youth are accessing our hospital system more for opioid use year over year," she said. While young people are not the population with the largest number of deaths, their deaths "are always devastating."