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Opioid Overdoses Responsible for About 136,000 Emergency Visits in 2010

Most overdoses involved prescription drugs, authors find

Researchers at the Stanford University School of Medicine in California and at two hospitals in Rhode Island have found that prescription opioids, including methadone, were involved in 135,971 emergency department (ED) visits –– or 67.8% of total ED visits –– in the U.S. in 2010, with the highest proportion of opioid overdoses occurring in the South.

In addition, several concurrent health conditions were identified as common among overdose victims. These conditions included chronic respiratory diseases and mental health or mood disorders, suggesting that opioids should be prescribed with caution to patients with pre-existing medical conditions.

The new findings were published online in JAMA Internal Medicine.

“Opioid overdose takes a significant toll on the health care system in the United States, both in terms of finances and resources,” said senior researcher Traci Green, PhD, MSc. “To date, there have been minimal studies and related national data about opioid overdoses in emergency departments.”

According to the Centers for Disease Control and Prevention, deaths from drug overdose have been rising steadily over the past two decades. Every day in the U.S., 114 people die because of a drug overdose. Opioid overdose, which includes medications such as oxycodone, hydrocodone, and methadone, is the leading cause of accidental death in U.S. adults.

Led by Michael Yokell, ScB, the opioid overdose research found that the number of ED visits resulting in death was highest for overdoses involving multiple opioids and was lowest for prescription opioids.

Overall, the death rate was less than 2% among overdose patients who visited an ED, highlighting the need to ensure access to emergency medical services (EMS) for overdose victims. One approach to increase EMS utilization for these individuals is the adoption of Good Samaritan Laws, which allow limited legal protection for drug-related charges when an overdose or witness calls 911 during an overdose, the authors say. One such law, the Good Samaritan Overdose Prevention Act, became law in Rhode Island in 2012.

“Our research indicated that there are high rates of several co-morbidities among patients who overdosed,” Green said. “This suggests that opioid analgesic prescriptions for patients with co-morbidities should be handled with care, and health care providers should counsel all their patients about overdose risks.”

“Further,” Green adds, “acute benzodiazepine intoxication was recorded in 22.2% of all overdose patients. That shows a need for health care providers to exercise caution when prescribing opioids to patients in conjunction with other sedating medications.”

The study involved an analysis of the 2010 Nationwide Emergency Department Sample. ED visits were tabulated by opioid type; by ED-aggregated charges and health care utilization data; and by inpatient care of ED opioid-overdose patients. ED, demographic, and clinical patient characteristics were evaluated, as were outcomes for prescription and non-prescription drug overdose events.

In addition to the involvement of prescription opioids in 67.8% percent of all overdoses, the findings showed that heroin played a role in 16.1% of all overdoses; unspecified opioids were involved in 13.4%; and multiple opioid types were involved in 2.7%.

“Because most of the patients we studied overdosed on prescription opioids,” Yokell concluded, “it’s of critical importance that further efforts be made to stem the prescription overdose epidemic.”

Source: MedicalXpress; November 10, 2014.

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