Here’s how much overdoses are costing South Carolina hospitals — and you

The opioid epidemic in South Carolina isn’t just hurting those who overdose, it’s putting a serious toll on hospitals and other patients as well.

In 2016, total overdose admissions and emergency department visits cost South Carolina hospitals an estimated $58.6 million, according to a report from the Medical University of South Carolina.

The report, which was submitted to the S.C. Department of Health and Environmental Control earlier this month, was funded by an overdose prevention grant from the Centers for Disease Control and Prevention.

Kit Simpson, professor of health care leadership and management at MUSC, spent three months analyzing hospital admission data for every patient in the state from 2014 through 2016.

According to her findings, hospital admissions and ER visits for overall overdoses — those due to opioids, heroin, other medications or a mix of drugs — rose from $50 million in 2014 to $58.6 million in 2016. That represents an increase of nearly 16 percent over three years.

The report states that overdose admissions attributed solely to opioids cost South Carolina hospitals $11 million in 2016. Heroin overdoses cost the state $5.2 million during that year,

Comparatively, in 2014, opioid overdoses cost state hospitals $9.1 million and heroin overdoses cost $1.5 million, according to the report.

The number of overdose patients during each year was not available in the MUSC report. But according to a report by the Healthcare Cost and Utilization Project, opioid-related emergency department visits increased by 50 percent in South Carolina from 2009-2014 and opioid-related inpatient visits rose by 31.7 percent.

Simpson said one effect of the high overdose admission rates is that many patients do not have insurance, so the hospitals have to absorb the costs.

“It’s a big issue for the hospitals, but also insurers, because Medicare, Medicaid and private insurers all face what are really avoidable costs if we just manage to stem this epidemic,” she said.

Before studying the effects of opioid overdoses, Simpson spent years researching the HIV epidemic. Unlike with HIV, she said the opioid crisis will be easier to deal with.

“If we do a concerted effort, I think we have the chance to get this under control in the next five to seven years,” she said. “But we have to do two things here. We have to prevent new people from becoming dependent on the drug and we have to provide support for those who are already addicted. A prevention attack and a treatment attack need to be tackled at the same time.”

Mark Lockett, associate professor of surgery at MUSC, is leading the prevention charge by encouraging health care providers to decrease the amount of medications they prescribe.

“We’re starting to see more and more data that suggests what we prescribe as surgeons, dentists and other specialists after operations is higher than it needs to be,” he said.

According to 2016 data from the Centers for Disease Control and Prevention, South Carolina issued about 90 painkiller prescriptions for every 100 people.

“The problem is, some of those patients will progress from dependence on opioids to misuse to opioid addiction and eventually transition to IV drugs such as heroin and fentanyl,” Lockett said. “Our hope is that we can stop patients from getting on that trajectory and ultimately cut the number of overdoses over time.”

State lawmakers are currently considering a bill that would limit patients’ post-surgery prescriptions to five days. Lockett said the limit may help curb the problem but that he would rather health care providers focus on creating better prescribing practices.

At an MUSC hospital-wide surgical meeting earlier this year, leaders asked each department and division to look into their prescribing patterns and, where it is reasonable, cut the number of pills they’re giving patients, according to Lockett.

“If we can cut back on how much we’re prescribing, the hope is that we can impact those patients before they get into a pattern of misuse,” he said.

In Beaufort County, 24 people died due to a drug overdose in 2017 — triple the number of such deaths in both 2015 and 2016, and more than the past two years combined.

Earlier this month, the county filed a lawsuit against more than 30 drug manufacturers, distributors and physicians for their role in the local effects of the national opioid epidemic.

The suit is being filed by a group of three law firms without any expense, attorney fees or financial contributions by the county.

County Councilman Mike Covert said that the opioid crisis has not only cost the county to spend money on extra resources such as emergency services and paramedics, but also a loss of revenue and business production.

“Look at Beaufort Memorial Hospital. Whether you have insurance or not, they will help them (an overdose patient) and that’s a good thing. But unfortunately someone has to pay for that,” Covert said. “With opioid abuse, with pill abuse, someone has to pay for the consequences, whether that’s the county, the taxpayers, it’s costing all of us in many different ways.”

The suit states that Beaufort County “has been required to spend millions of dollars each year in its efforts to combat the public nuisance” created by the drug companies’ “deceptive marketing campaigns.”

John Parker of the Healthcare Distribution Alliance, a national trade organization representing some of distributors named in the county’s lawsuit, sent the following statement to The Island Packet and The Beaufort Gazette:

“... Given our role, the idea that distributors are responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and is regulated. Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation.”

This story was originally published February 21, 2018 at 3:21 PM with the headline "Here’s how much overdoses are costing South Carolina hospitals — and you."