BACKGROUND: West Virginia (WV) ranks highest in the nation in opioid drug overdoses. Public health in the state is utilizing a variety of data sources to combat the state’s opioid epidemic. Launched in August 2016, WV’s Electronic Surveillance System for the Early Notification of Community Based Epidemics (ESSENCE) allows the state to conduct daily active surveillance of syndromes such as injuries, including drug overdose.
METHODS: Utilizing the free text option, queries containing International Classification of Diseases, 10th revision (ICD 10) discharge diagnostic codes information were designed to include information related to opioid use, abuse, dependence, poisoning by and adverse effect of opium/heroin/methadone/other opioids (codes used: F11.1, F11.2, F11.9, F19.2, T40.0X, T40.1X, T40.2X, T40.3X, T40.6) The query string searched patient information based on county of residence. Monthly searches were conducted for WV’s 42 participating facilities between the months of April to December 2016. The resulting time series were analyzed by algorithms structured into ESSENCE, then downloaded into Microsoft Excel for descriptive analysis by gender, race, and age, ICD 10 code and patient’s county of residence.
RESULTS: Twenty-one (50%) of WV’s 42 participating facilities reported a total of 1,948 patients identified as having opium, heroin, methadone, and other opioids present in their discharge diagnostic information. Forty-three (78%) of WV’s 55 counties are represented in the sample, with majority of patients residing in Cabell County (n=230) and Ohio County (n=147). A steady increase of patient visits were noted during the months of June (n=234) and July (n=272), peaking in August (n=285). F11.1 (opioid abuse), F11.2 (opioid dependence) and T40.1X (poisoning by and adverse effect of opium) were the most common listed ICD 10 discharge diagnosis codes listed in the sample (n=362, n=517, and n=547, respectively). Majority of patients were White/Non-Hispanic (95%), male (n=54%), and between the ages of 20-29 (44%).
CONCLUSIONS: Through collaborations with various public health partners, WV is increasing its capacity to conduct opioid overdose surveillance throughout the state of WV. A recent grant was awarded to enhance state surveillance of opioid- involved morbidity and mortality with information gained through ESSENCE. WVBPH plans utilize ESSENCE to provide monthly opioid surveillance reports to various public health partners to support local proposed preventive measures. Onboarding of additional facilities not currently using ESSENCE will provide WV with a comprehensive syndromic surveillance system for detection of opioid-related overdoses.