Patients presenting to the ED with nonfatal drug overdose: Self-reported history of overdose and naloxone use.

Autor: Pappalardo FS; Department of Emergency Medicine, Warren Alpert Medical School of Brown University, 55 Claverick St, Providence, RI 02906, USA. Electronic address: Francesco_pappalardo@brown.edu., Krieger M; Department of Epidemiology, School of Public Health of Brown University, Providence, RI, USA., Park C; Department of Epidemiology, School of Public Health of Brown University, Providence, RI, USA., Beaudoin FL; Department of Epidemiology, School of Public Health of Brown University, Providence, RI, USA., Wightman RS; Department of Emergency Medicine, Warren Alpert Medical School of Brown University, 55 Claverick St, Providence, RI 02906, USA; Department of Epidemiology, School of Public Health of Brown University, Providence, RI, USA.
Jazyk: angličtina
Zdroj: The American journal of emergency medicine [Am J Emerg Med] 2024 Aug; Vol. 82, pp. 21-25. Date of Electronic Publication: 2024 May 08.
DOI: 10.1016/j.ajem.2024.05.007
Abstrakt: Background: In the context of polysubstance use and fentanyl detection in non-opioid drugs supplies (e.g., cocaine, methamphetamine), it is important to re-evaluate and expand our understanding of which populations are at high risk for fatal drug overdoses. The primary objective of this pilot study was to gather data from the ED to characterize the population presenting with drug overdose, including demographics, drug use patterns and comorbidities, to inform upstream overdose prevention efforts.
Methods: A consecutive sample of ED patients undergoing treatment for non-fatal overdose were prospectively recruited for study participation at the time of ED visit. Participants reported history of substance use over the past six months, recent and lifetime overdose, and naloxone receipt and administration history.
Results: A total of 76 eligible participants were enrolled over the course of seven months. Participants reported high rates of opioid (56%), stimulant (56%), and cannabis use (59%). Self-reported polysubstance use, defined as self-reported use of more than one substance, was 83%. Of enrolled participants, 64% reported at least one overdose and 39% reported three or more lifetime overdoses prior to their index overdose ED visit. Participants with no self-reported intentional opioid use (n = 32) in the past six months had fentanyl positive urine drug screen 84% of the time versus 89% in the overall study population (n = 74). Participants who did not report opioid use in the past six months were less likely to possess (34% vs. 55%) or to know how to acquire (50% vs. 74%) naloxone compared to participants with self-reported history of opioid use.
Conclusion: This study demonstrated high rates of fentanyl exposure on toxicology testing at time of overdose across all participants including study participants without self-reported intentional opioid use. Data gathered in the ED at time of overdose can be used to inform upstream naloxone distribution and public health initiatives.
Competing Interests: Declaration of competing interest Research reported in this publication is supported by the National Institute of General Medical Sciences of the NIH under grant number P20GM125507. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This data has been presented at the North American Conference of Clinical Toxicology in Montreal, Canada in September 2023.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: