MDHHS says Michigan opioid overdoses involving cocaine are on the rise

A new data brief published by the Michigan Department of Health and Human Services (MDHHS) shows a rising trend of opioid overdoses involving cocaine laced with fentanyl.

 

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The rate of Emergency Medical Services (EMS) responses to opioid overdose with cocaine involvement was nearly one-third greater in 2021 compared to 2020. The brief says that this suggests the increasing simultaneous use of opioids and cocaine in the state, whether they’re intentional or unintentional. 

The brief also notes that the rate of EMS response to opioid overdoses with the use of cocaine between 2020 and 2021 was significantly greater than the rate of EMS response to opioid overdoses without cocaine involvement.

The graph below shows the number of EMS responses to probable opioid overdoses with cocaine involvement in Michigan by month from January 2019 to April 2022.

 

Image: Michigan Department of Health and Human Services

 

According to the data brief, multiple opioid overdose events have also been increasing statewide. A multiple opioid overdose event is an event where EMS treats more than one person for an overdose when they arrive at the scene.  

In 2021, Michigan EMS responded to an average of 3 multiple opioid overdose events per week. As of April 2022, that number has risen to 4 multiple opioid overdose events per week. 

In 2021, patients experiencing an opioid overdose by using what they thought was cocaine accounted for about 20.5% of EMS narratives for these multiple opioid overdose events. As of April 2022, this percentage has increased to 30.2% of EMS narratives. 

The graph below shows the weekly count of EMS responses to these multiple opioid overdose events and the rolling 4-week average of these events in Michigan.

 

Image: Michigan Department of Health and Human Services

 

The brief also notes that from Jan. 1st to April 30th, 2022, the Southeast and Southwest Lower Peninsula of the state accounts for over 95% of these multiple opioid overdose events.

In order to combat these rising rates of opioid overdoses involving cocaine, MDHHS recommends that organizations work to raise awareness of cocaine containing fentanyl, which can cause opioid overdoses. 

“Fentanyl is deadly and widespread in the illicit drug supply. Central nervous system (CNS) stimulants such as cocaine and CNS depressants such as opioids, when used together, can be a lethal combination, masking the effect of a single drug and leading to overdose,” the brief states. “For example, if the stimulant is faster-acting and wears off first, the full effect of the opiate can cause a person to stop breathing.”

MDHHS also recommends that organizations educate and raise awareness about the symptoms of opioid overdose and how to use naloxone to counteract an overdose.

“People intending to use cocaine may not know the signs of an opioid overdose or how to use naloxone,” the brief states. “Beyond naloxone training, prepare bystanders to use CPR, rescue breathing, and/or chest compression in cases where naloxone is not available or is not working yet to sustain life until EMS arrives.”

Organizations should also promote harm reduction messages, the widespread distribution of naloxone, fentanyl test strips, and the expansion of the EMS Leave-Behind Naloxone Program, a program allowing EMS professionals to leave naloxone kits with the patient, the patient’s family, and bystanders at the scene of a non-fatal overdose.