Emergency rooms in Maine have seen the impact of the nation’s opioid crisis more acutely than anywhere but Massachusetts.
Data from the Healthcare Cost and Utilization Project reveal that trend and a more detailed look at opioid-related hospital visits by age, sex, location and income levels, showing that lower-income Mainers have higher rates and that rural ER visits are about on par with urban areas.
The figures include visits caused by heroin and other synthetic opioids such as fentanyl.
The data show Maine was second-highest, out of 32 states, for the rate of opioid-related ER visits in 2014, after topping the nation in 2009 and 2010. The 2014 data is the most recent available for most states and Maine.
Maine has been near the top for opioid-related ER visit since 2006, when it was ranked fifth in the country by its ER visit rate. In 2014, that rate was more than 3 out of every 1,000 Mainers.
The data show about 4,250 people went to a Maine emergency room for opioid-related illness and Maine hospitals admitted about 4,000 as inpatients.
The figures count each visit and not each patient, so one person could be counted in the data multiple times. The report does not count an ER visit if the patient is later admitted to the hospital.
The total of 8,250 combined ER visits and inpatient stays works out to an average of 22.6 hospitalizations per day in Maine.
Maine and Massachusetts were also outliers in 2014 for having more ER visits than inpatient admissions for opioid-related illnesses. Nevada and Vermont were also in that group and Ohio was close to even by that measure.
For the rate of inpatient admissions, Maine ranked 10th out of 45 states, in 2014.
The government data published Tuesday doesn’t describe causes for the trends and leaves out states that have not yet submitted tallies to researchers.
Females were more likely to get inpatient treatment in Maine. Males were more common in the ER.
The number of males showing up in Maine emergency rooms for opioid-related illnesses spiked in 2014, averaging a little more than 6 visits per day for the year. The rate for females was closer to 5 per day.
The trend flipped for inpatient admissions.
The epidemic affects people in their prime, between ages 25 and 44.
The data show that people ages 25 to 44 have the highest rates of inpatient and ER visits by far in Maine, in line with national trends. While inpatient rates for that group declined in 2014 from 2013, ER visit rates jumped dramatically.
Rural admissions were about as common as those in urban areas.
The data shows little divide between the impact of opioid-related illnesses in Maine’s urban and rural areas through 2013, though ER visits in the state’s biggest cities spiked in 2014.
ER visits were more common than inpatient treatment in those urban areas and at the state’s rural hospitals. Hospitals in smaller metro areas delivered more inpatient care than ER care in 2014.
ER visits became more common for people of all incomes, but rates are much higher in low-income areas.
Patients from the state’s lowest-income ZIP codes had generally higher rates of ER visits and were more likely to go the ER than be treated as an inpatient for opioid-related illnesses.
The data showed ER and inpatient rates rose across all income levels (defined by median household income of the patient’s ZIP code), but rates remained highest in lower-income areas.