Prevalence Of Emergency Department Opioid Exposure And Previous Use Of Opioids And Other Substances In An Urban Emergency Department Population
Posted Date: Jun 7, 2019
- Investigator: Edmond Hooker
- Specialties:
- Type of Study: Observational/Survey
ABSTRACT Objective: The role ED opioid exposure in pathways leading to iatrogenic opioid addiction is controversial and inadequately characterized. The objective of this research was to determine the prevalence of ED opioid exposure in context with patients’ prior use of opioids and other substances in an urban, ED population. Methods: This cross-sectional study involved consecutive adult patients in an urban, academic ED during study periods purposively selected to be representative of a 4-week period from July to August, 2016. Trained research associates administered surveys to patients to assess self-reported prior use of opioids and other substances. Electronic medical records were reviewed to determine opioid exposure during the ED encounter and final disposition from the ED. Results: Of 909 patients present in ED treatment rooms during study periods, 847 could be approached, 625 consented, and 604 (66%) were included in the final analysis, after removing 18 incomplete surveys and three duplicate enrollments. Of the 604 patients, 213 (35%) were administered and/or prescribed opioids during their visit. For 27 (4.5%, 95% CI: 3.0% to 6.3%), this was reported to be a first lifetime exposure and for 186 (30.8%, 95% CI: 27.2% to 34.6%) this was a repeat exposure. Of 375 (62.1%, 95% CI: 58.2% to 65.9%) patients who self-reported prior or current non-medical opioid or benzodiazepine use, illicit drug use, or treatment for a substance use disorder, 136 (36.3%, 95% CI: 31.5% to 41.2%) were administered or prescribed opioids in the ED. Conclusion: Initial and repeat opioid exposures are common in EDs and prior substance use is endemic. ED encounters frequently lead to opioid exposure among patients who are at significant risk for opioid addiction. Research is urgently needed to understand the role emergency care may play in pathways leading to incident iatrogenic addiction.
Criteria:
Emergency Patients At University Of Cincinnati Emergency Department
Keywords:
Opioid, Addiction, Emergency Department
For More Information:
Edmond Hooker
513-588-8961
hookerea@ucmail.uc.edu