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Page Wants To Require Doctors In St. Louis County To Report Non-Fatal Overdoses

The emergency department at SSM Health St. Mary's in Clayton is one of several facilities in St. Louis County that County Executive Sam Page would like to have report non-fatal overdoses to the St. Louis County Department of Public Health.
Sarah Fentem | St. Louis Public Radio

County Executive Sam Page plans to ask the County Council to require doctors to report nonfatal overdoses to the health department.

Many people who overdose on opioids are surviving, thanks to the increased use of the opioid-reversal drug naloxone. Knowing how many people overdose — not just how many die — can help the county understand who needs help the most, Page said.

Health workers and law enforcement are starting to understand addiction and overdoses as a public health, not a criminal, issue, Page said. Other health crises, such as measles or flu epidemics, require physicians to report cases to the government. Overdoses should be no different, he said.

“It’s just like any epidemic, whether it’s the Zika virus or another infection,” Page said. “We care about people who die from this epidemic, but we also care about near-misses, because you can learn a lot from the near-misses.”

In a June 7 request, Page asked the County Council to pass a law that requires doctors and others to report overdoses to county health officials.

Such reporting could help officials determine who could benefit from a rescue kit containing naloxone, learn who might benefit from treatment referrals and evaluate how well overdose-prevention efforts are working in the county, the letter said.

County health officials would like for all health care facilities to be required to report such deaths, Page said. But it will initially focus on emergency departments as that is where most people who overdose go, he said.

Page also would like hospitals to collect basic demographic information, such as the sex and location or overdose victims, what they overdosed on, and whether they had overdosed before.

Overdose deaths are tracked using information from medical records and death reports. There were 760 opioid-related fatalities last year in St. Louis, St. Louis County and eight surrounding counties. That’s a 7 percent increase from 2016.

Many people who overdose don’t go to the emergency room because they fear potential bills or criminal prosecution, said Brandon Costerison, policy coordinator at the National Council for Alcohol and Drug Abuse. But tracking nonfatal overdoses can offer the health department and other addiction-treatment agencies a missing piece of information.

“It’s never going to be possible to get a complete picture, but we are doing everything we can,” Costerison said. “This is a way to get some additional clarity on what’s going on.”

Reporting nonfatal overdoses could offer a glimpse into disparities in care, he said. For example, it could help determine who is unlikely to call an ambulance or seek help from a doctor.

“If there’s someplace where more people are overdosing but fewer people are dying – why is that? Having that info can help us identify and address disparities,” Costerison said.

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Sarah is the health reporter at St. Louis Public Radio.

Send questions and comments about this story to feedback@stlpublicradio.org.