Trends in recurrent overdose and treatment initiation following emergency department visits for opioid overdose between 2016 and 2021.

Autor: Yangchen T; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA., Rodriguez M; Substance Use Epidemiology Program, Rhode Island Department of Health, Providence, RI, USA., Baird J; Department of Emergency Medicine, Brown University, Providence, RI, USA., Hallowell BD; Substance Use Epidemiology Program, Rhode Island Department of Health, Providence, RI, USA., Daly MM; Research, Data Evaluation, and Compliance Unit, Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals, Providence, RI, USA., Berk J; Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA., Gaither R; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA., Wightman RS; Department of Emergency Medicine, Brown University, Providence, RI, USA., Beaudoin FL; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA., Chambers LC; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA. Electronic address: laura_chambers@brown.edu.
Jazyk: angličtina
Zdroj: Drug and alcohol dependence [Drug Alcohol Depend] 2024 Sep 01; Vol. 262, pp. 111379. Date of Electronic Publication: 2024 Jun 24.
DOI: 10.1016/j.drugalcdep.2024.111379
Abstrakt: Background: Overdose remains a pressing public health concern in the United States, particularly with the emergence of fentanyl and other potent synthetic opioids in the drug supply. We evaluated trends in recurrent overdose and opioid use disorder (OUD) treatment initiation following emergency department (ED) visits for opioid overdose to inform response efforts.
Methods: This retrospective cohort study used electronic health record and statewide administrative data from Rhode Island residents who visited EDs for opioid overdose between July 1, 2016, and June 30, 2021, a period with fentanyl predominance in the local drug supply. The primary outcome was recurrent overdose in the 365 days following the initial ED visit. OUD treatment initiation within 180 days following the initial ED visit was considered as a secondary outcome. Trends in study outcomes were summarized by year of the initial ED visit.
Results: Among 1745 patients attending EDs for opioid overdose, 20 % (n=352) experienced a recurrent overdose within 365 days, and this percentage was similar by year (p=0.12). Among patients who experienced any recurrent overdose, the median time to first recurrent overdose was 88 days (interquartile range=23-208), with 85 % (n=299/352) being non-fatal. Among patients not engaged in OUD treatment at their initial ED visit, 33 % (n=448/1370) initiated treatment within 180 days; this was similar by year (p=0.98).
Conclusions: Following ED visits for opioid overdose in Rhode Island from 2016-2021, the one-year risk of recurrent overdose and six-month treatment initiation rate remained stable over time. Innovative prevention strategies and improved treatment access are needed.
Competing Interests: Declaration of Competing Interest All authors declare that they have no conflicts of interest.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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