This article is more than 5 years old. Information may no longer be current.

Additional research needed for opioid overdoses presenting at EDs

More studies are necessary to identify trends in ED visits for opioid overdose that will help health care workers to better counsel patients when prescribing these drugs, according to recent data.

Researchers conducted an analysis of the 2010 Nationwide Emergency Department Sample using ICD-9 codes. They wrote that 135,971 prescription and nonprescription opioid overdoses were coded in EDs nationwide in 2010.

The investigators’ observations, published in a research letter in the Journal of the American Medical Association Internal Medicine, showed that 67.8% of all overdoses were from prescription opioids, including methadone, 16.1% were from heroin, and 13.4% were from unspecified opioids. In 2.7% of cases, overdoses resulted from the ingestion of multiple opioids.

The greatest number of overdoses occurred in urban areas (84.1%), among women (53%) and in the South (40.2%). Mortality was highest for those who ingested multiple opioids (2.2%) and lowest for prescription opioids (1.1%).

“The low mortality rate among patients presenting to EDs with overdose indicates that medical intervention for this acute condition can be highly effective,” the researchers wrote. “In our opinion, these findings support efforts to increase the use of emergency medical services for overdoses, such as Good Samaritan laws that grant limited immunity for drug-related charges to those who call 911 during an overdose.”

Chronic mental illness (33.9%), circulatory diseases (29.1%) and respiratory illnesses (25.6%) were common comorbidities. The researchers advised health care workers who prescribe opioids to patients with these comorbidities to counsel them about the risk for overdose and suggested concomitant prescriptions for naloxone.

The researchers also showed that the financial burden of ED opioid overdose visits is high, totaling $2.3 billion for their sample.

“These findings suggest that the costs associated with opioid overdose are significant and that strategies to reduce morbidity and mortality resulting from overdose are urgently needed, including enhanced access to substance abuse treatment,” the researchers wrote.

Disclosure: Green reports employment at Inflexxion, a small business that conducts postmarketing surveillance for scheduled medications. No other disclosures were reported.