By Dr. Anthony Policastro

The ongoing opioid epidemic has frequently made the headlines. The news tends to be in general. It looks at specific groups but usually not by age.

A recent letter to the Journal of the American Medical Association (JAMA) pointed out that we need to look at it that way.

In 2010 there were 518 overdose deaths in adolescents between the ages of 14 and 18. That number remained fairly steady over the next few years. In 2019 there were 492 deaths.

However, in 2020 deaths almost doubled to 954. The number increased by an additional 20 percent in 2021.

More than 77 percent of the deaths were due to Fentanyl. An additional six percent were due to prescription opioids. And two percent more were due to heroin. Thus 85 percent of all overdose deaths in adolescents were opioid related.

It did not appear to be related to more adolescents using drugs. The total number of users was about the same.

This meant that the drugs they were using were more likely to be lethal. That is attributed to the decrease in legally prescribed opioids.

That decrease led more individuals to look for illegal sources of drugs. Those illegal sources are not regulated. Therefore, they can contain any amount of drug. That amount can easily be enough to kill someone.

An additional reason is that street drugs are often contaminated with dangerous substances. The result is a situation in which the buyer has no clue what the actual drug is. The buyer has no clue as to what the contaminates are. The buyer has no clue as to how lethal the preparation is.

Adolescents are not the only ones using more street drugs. Other populations face the same risk when they buy something that is not regulated.

We have seen the same thing happen with marijuana over the years. Current batches of marijuana are much more potent than they used to be years ago. That is why comparing effects now with effects in the past makes no scientific sense whatsoever.

It is kind of a classic case of “Let the Buyer Beware.” Many adults have learned this lesson. Adolescents may not have yet done so.

COVID update- After weeks of Sussex County in the low risk zone for COVID hospitalizations, we have moved into high risk status. That then is associated with a suggestion to wear masks indoors in public places.

The high risk status is mainly driven by Beebe Hospital inpatients. At this point 93.5 percent of their ICU beds and 98.5 percent of their total beds are full. Nanticoke has 78.2 percent of its total beds full. That puts it in the yellow risk zone. Milford Hospital had 47.8 percent of its beds full and remains in the green risk zone.

The masking suggestion is more important in situations with many people. It is more important when the people are in close quarters. It is more important when the length of time is extensive. 

It is not a huge surprise that the number of hospitalizations have increased. The total number of new cases in Sussex County last week was 607. This was up from 258 for the previous week. It is the highest number of new cases that we have seen since the beginning of February.

Nationally, the numbers have increased as well. They reached 619,000. That is the highest that they have been since the middle of February.

The numbers are not yet as high as they were during the Delta and Omicron surges. However, the potential is there to reach that point over the next few weeks.

We also need to remember that there are many cases that are not being counted because of home testing. So the numbers are likely higher than those actually being formally reported.

Given the rise in numbers, it makes sense to review the current quarantine procedures. Individuals who are diagnosed with COVID-19 need to isolate for five days after either a positive test or start of symptoms. That day is day 0. So the quarantine is for five full days after that. For the subsequent five days, they need to be masked when around others.

For those exposed to someone with COVID-19 the recommendations vary with vaccine status. Those individuals who have received a booster need to wear a mask around others for 10 days. They should be tested at the five day point whether they have symptoms or not. If the test is positive, they need to follow the guidance for positive patients as listed above.

Those who are not boosted should isolate at home for five days (this is the main difference between boosted and not boosted). They should then get tested on day five. They will need a mask for an additional five days after that if the test is negative. If the test is positive, they need to follow the guidance for positive patients as listed above.