Citation

Lovegrove MC, Dowell D, Geller AI, Goring SK, Rose KO, Weidle NJ, Budnitz DS. Am. J. Public Health 2019; 109(5): 784-791.

Affiliation

Maribeth C. Lovegrove, Andrew I. Geller, and Daniel S. Budnitz are with the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Deborah Dowell is with the National Center for Injury Prevention and Control, CDC. Sandra K. Goring and Kathleen O. Rose are with Northrup Grumman Corporation, Atlanta. Nina J. Weidle is with Eagle Medical Services LLC, Atlanta.

Copyright

(Copyright © 2019, American Public Health Association)

DOI

10.2105/AJPH.2019.305007

PMID

30896999

Abstract

OBJECTIVES: To estimate the number of US emergency department visits for prescription opioid harms by patient characteristics, intent, clinical manifestations, and active ingredient.

METHODS: We used data from medical record-based surveillance from a nationally representative 60-hospital sample.

RESULTS: Based on 7769 cases, there were 267 020 estimated emergency department visits annually (95% confidence interval [CI] = 209 833, 324 206) for prescription opioid harms from 2016 to 2017. Nearly half of visits (47.6%; 95% CI = 40.8%, 54.4%) were attributable to nonmedical opioid use, 38.9% (95% CI = 32.9%, 44.8%) to therapeutic use, and 13.5% (95% CI = 11.0%, 16.0%) to self-harm. Co-implication with other pharmaceuticals and concurrent illicit drug and alcohol use were common; prescription opioids alone were implicated in 31.5% (95% CI = 27.2%, 35.8%) of nonmedical use visits and 19.7% (95% CI = 15.7%, 23.7%) of self-harm visits. Unresponsiveness or cardiorespiratory failure (30.0%) and altered mental status (35.7%) were common in nonmedical use visits. Gastrointestinal effects (30.4%) were common in therapeutic use visits. Oxycodone was implicated in more than one third of visits across intents.

CONCLUSIONS: Morbidity data can help target interventions, such as dispensing naloxone to family and friends of those with serious overdose, and screening and treatment of substance use disorder when opioids are prescribed long-term. (Am J Public Health. Published online ahead of print March 21, 2019: e1-e8. doi:10.2105/AJPH.2019.305007).

Language: en