The Delaware Drug Overdose Fatality Review Commission released its third report Tuesday, examining 148 of the estimated 515 fatal overdoses that occurred in 2021.
The findings, which came from death certificates, medical and legal records and treatment history, highlight trends that continue to this day.
Most deaths analyzed in the report occurred in New Castle County, with the majority of overdoses happening outside of the person’s home. The commission also determined that the average person sampled was a 42-year-old single white male with a high school diploma who worked in construction.
Almost 95% of the overdoses involved the synthetic opioid fentanyl – the same drug found in many of the 527 fatal overdoses recorded in 2023. The Delaware Division of Forensic Science reported that cocaine was also involved in many overdoses in 2021.
BACKGROUND: The opioid addiction crisis: How it started, who’s involved and what else you need to know
Overdoses upon reentry from prison
Part of the commission’s mandated job is to provide recommendations to the governor and General Assembly on how to reduce overdoses going forward. Much of this year’s report focuses on one population disproportionately impacted by addiction and overdoses: those involved in the criminal justice system.
Of the 108 people sampled by the commission with complete criminal justice data available, 38% were previously incarcerated, with 73% incarcerated for less than a year. Among those incarcerated for less than a year, 74% were arrested for drug-related offenses.
Three percent of this group died within the first week of their release, and 27% died within the first three months.
For those incarcerated for longer than a year, a third fatally overdosed within three months of their release, according to the report.
Given this data, the commission recommended the Department of Correction expands its reentry efforts. Specifically, the commission said the state should provide continued and added funds for the DOC to link people with a “holistic continuum of care” upon their release from prison, including residential treatment and harm reduction services.
The commission also recommended improved support for people on parole or probation, as 11% of those sampled were under the supervision of community correction at the time of their deaths. The suggested steps were twofold: first, incorporate peer-support specialists to help alleviate caseload burdens and better serve the needs of people dealing with addiction; and second, provide treatment and support for people who violate probation or parole for a positive drug test rather than imposing punishments.
In past reports, the commission recommended that the DOC provide the overdose-reversing drug naloxone to all individuals upon release and make medications for opioid use disorder available in all prisons. Both of these efforts have since been implemented.
MORE: Fatal overdoses in Delaware appear to be going down, but new troubling trends are emerging
Other recommendations from the commission
Another area of concern was resources for families and community members impacted by substance use disorder or overdoses. Nearly a quarter of people who fatally overdosed in 2021 were found by relatives, according to the report, and comprehensive education programs may improve overdose prevention and help families find treatment for loved ones.
Similar programs should also be implemented for the community at large, according to the commission.
Many fatal overdoses are witnessed by others, including other drug users. Almost 2% of people sampled for the report witnessed an overdose at some point, and that number was likely underreported. The commission argued that providing support to those experiencing this trauma could help reduce future overdoses.
The broadening of other overdose reduction tactics, like providing naloxone and fentanyl test strips to people actively using drugs, was also recommended. More than a third of the people sampled by the commission had a recorded non-fatal overdose in the past; of this group, 43% had an overdose less than three months before their deaths.
To prevent further overdoses, the commission said naloxone and fentanyl test strips should be given to anyone who overdoses upon discharge from the hospital. These resources should also be made available in “high-need areas” like gas stations, buses and liquor stores.
OPIOID CRISIS: From patent to Percocet: How this powerful opioid got its start in Delaware
Housing: The recurring theme
One issue area has been part of the commission’s reports every year since the group’s inception: housing.
Nearly half of the sampled 148 people who fatally overdosed were identified as housing insecure or unstable, meaning they had no identified residence. The commission said the state needs to make a “coordinated, comprehensive, systemwide effort” to address it.
The commission noted “significant restraint across the state” to the recommended housing first model, which provides people with housing without any sobriety requirements. Instead, the commission said Delaware continues to favor a treatment-first model, which provides housing only if someone remains completely sober and meets program requirements.
“We challenge the pervasive and pernicious posture of various stakeholders that abstinence should be a prerequisite for housing,” the commission wrote.
The commission noted that housing inequality is “disproportionately concentrated” in Sussex County, and recommended that the state prioritize its efforts there.
“We believe the recommendations outlined in this report are the necessary steps that must be taken to continue to make progress to end the opioid epidemic and save the lives of those Delawareans struggling with substance use disorders,” said commission Chair Erin Booker. “This work can’t be done independently and we look forward to working with stakeholders across the state to continue the fight against addiction as we strive to ensure the implementation of these recommendations.”
Read the full report here.
MORE: Water damage, money issues: Why New Castle County is suing former manager of Hope Center
How to find help
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Delaware Hope Line: 833-9-HOPEDE for free 24/7 counseling, coaching and support, as well as links to mental health, addiction and crisis services. Resources also can be found on the Help is Here website.
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Suicide and Crisis Lifeline: 988
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SAMHSA National Helpline: 800-662-HELP (4357) for free 24/7 substance abuse disorder treatment referral services. Treatment service locators also are available online at findtreatment.samhsa.gov or via text message by sending your ZIP code to 435748.
Send story tips or ideas to Hannah Edelman at hedelman@delawareonline.com. For more reporting, follow them on X at @h_edelman.
This article originally appeared on Delaware News Journal: Delaware drug overdoses: What 148 deaths reveal about state’s crisis
