Dec. 17—Changes in trends in substance use disorder proved slight across Gaudenzia's entire treatment system during the pandemic, however, according to the nonprofit's first-ever public data report, spikes and dips were more dramatic and varied within specific counties.
Among clients in Northumberland and Union counties, the rate of alcohol cited as the primary substance diagnosis and increased, the report found, however, opioids continued to be the prevalent class of abused substances.
Stimulants, including methamphetamine and cocaine, were most often cited as the primary substance diagnosis in Snyder County. Gaudenzia's report did not include Montour County.
Though the report focuses, in part, on primary diagnoses, Gaudenzia CEO Dr. Dale Klatzker and Chief of Staff Dr. Patricia McKernan each noted the abuse of multiple substances is commonplace.
"More people are becoming addicted to more types of substances and more people are dying because of it," Klatzker said, referring to the record-high 100,000-plus fatal overdoses in the U.S. over 12 months beginning in April 2020.
Gaudenzia Inc. operates 117 programs across 51 facilities in Delaware, Maryland and Pennsylvania, the state with its largest presence by far. It served more than 14,000 clients between July 2020 and June 2021, the period for its inaugural Frontline Report — a look at data and demographics by county, state and system-wide.
The report shows that across its entire system, alcohol as a primary substance of abuse rose 2%, opioids dropped 2% and stimulants remained flat. The three are the most common categories, accounting for a combined 87% of primary substance use disorder diagnoses.
Klatzker and McKernan said COVID-19 complicated treatment by isolating patients, infecting staff and ultimately factoring into the closure of three programs. They called on increased funding, especially for services through Medicaid, along with comprehensive solutions and evidence-based approaches connecting prevention, treatment and recovery supports.
"Gaudenzia is really struggling with the recruitment of people into our workplace," McKernan said, noting the nonprofit has a vaccine mandate.
"We have beds that we are not using because we can't recruit enough staff to safely operate services," Klatzker said.
"We had to cease admissions in some programs where we didn't have enough staff," McKernan said.
In Northumberland County, Gaudenzia operates an outpatient clinic in Sunbury and an outpatient program and inpatient treatment facility in Coal Township. There were 968 clients served in-county in fiscal 2021.
Frontline Report data shows alcohol as a primary diagnosis jumped 4%. Among those with alcohol as a leading substance of abuse, 23% reported stimulants as a secondary substance use disorder.
Opioids dropped 4% as a primary diagnosis, however, that category of substances including fentanyl and heroin remained the most prevalent among diagnoses at 39%, followed by alcohol at 31%.
Opioids fell 8% and alcohol fell 2% as a primary diagnosis in Snyder County. Increases were reported for stimulants like cocaine and methamphetamine, hallucinogens, benzodiazepines and other drugs at a combined 10%.
Gaudenzia has an outpatient program in Middleburg, where 101 clients were served. Unlike its neighbors along and across the Susquehanna River, stimulants are the most prevalent category for primary substance abuse at a rate of 37% of cases.
For Union County, alcohol jumped 5% and benzodiazepines, which include Xanax and Ativan, rose 2%. Diagnoses fell slightly for the other categories except for opioids, which remained flat. A Gaudenzia outpatient clinic is located in Lewisburg, with 108 clients served. At 36% of cases, opioids is the substance most often cited as a primary diagnosis.
Local officials react
The trends cited in Gaudenzia's report fell in line with what local drug and alcohol professionals are observing.
Barbara Gorrell is the drug and alcohol administrator for CMSU Behavioral Health Programs. The rise of alcohol use and prevalence of polysubstance abuse isn't a surprise, she said. It's been noted by case managers, as has the dip in opioid use.
"Although not county-specific, our warm handoff data parallels the trends noted in this report related to primary SUD diagnosis. The demographic information pertaining to race, gender and age groups seems to remain consistent over the years with marginal increases in individuals over the age of 55," Gorrell said.
Most common demographic
The most common demographic seeking treatment are white males from age 25 to 44, according to Gaudenzia's report.
"In reviewing the data presented, it very much aligns with what our data shows in Northumberland County regarding demographics and substances," said Manny Giorgini, director of Northumberland County Drug and Alcohol.
Giorgini noted how the Gaudenzia officials said treatment for stimulant use is difficult since there are no medication-assisted treatments like there are for opioids and alcohol. He agreed with their assessment about the need for a comprehensive treatment approach.
"We also need to continue to focus on recognizing underlying causes of substance use like mental health and trauma and treat those underlying concerns. Continuing to enhance our prevention programming and education in our schools is also crucial," Giorgini said.