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Abstract
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INTRODUCTION: There has been a sharp climb in the US death rate among opioid and other substance abuse patients, as well as an increased prevalence of gun violence. We aimed to investigate the association between opioid-substance abuse and gun violence in a national sample of patients presenting to the emergency department (ED).
Methods: We queried the 2019 Emergency Department Sample (NEDS) for patients ≥18 years with opioid and substance abuse disorders using ICD-10-CM codes. Within this sample, we analyzed characteristics and outcomes of patients with firearm-related injuries. The primary outcome was mortality; secondary outcomes were ED charges and length of stay.
Results: Among 25.2 million opioid and substance abuse patients in our analysis, 35,306 (0.14%) had a firearm-related diagnosis. Compared with other opioid-substance patients, firearm-opioid patients were younger (33.3 vs 44.7 years, p < 0.001), more often male (88.6% vs 54.2%, p < 0.001), of lower-income status (0-25th percentile income: 56.4% vs 40.5%, p < 0.001) and more likely to have Medicaid or self-pay (71.6% vs 53.2%, p < 0.001). Firearm-opioid patients had higher mortality (1.4% vs 0.4%, p < 0.001), longer lengths of stay (6.5 vs 4.9 days, p < 0.001) and higher ED charges ($9269 vs $5,164, p < 0.001). Firearm-opioid patients had a 60.3% rate of psychiatric diagnoses. Firearm-opioid patients had 5.5-times greater odds of mortality in adjusted analyses (aOR: 5.5, p < 0.001).
Conclusion: High rates of mortality, healthcare use, and cost related to firearm injuries among opioid-substance abuse patients point to the urgent need for improved screening, treatment, and prevention among this vulnerable group.
Language: en |