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Opioid addiction increases risk for death tenfold in large health system

Individuals with opioid use disorder receiving care in a university health system were ten times more likely to die, indicating significant room for improvement in identification and treatment of opioid use disorders in large health care systems.

“The high rates of death among patients with opioid use disorder in a general health care system reported in this study suggest we need strategies to improve detection and treatment of this disorder in primary care settings,” Yih-Ing Hser, PhD, of the University of California, Los Angeles, said in a press release.

Yih-Ing Hser

To assess mortality rates, causes of death, and associated risk factors among individuals with opioid use disorder in a large general health care system, researchers analyzed mortality data linked with electronic health records of 2,576 individuals with opioid use disorder who received care in a large university health system from 2006 to 2014.

Overall, 465 deaths occurred. The corresponding crude mortality rate was 48.6 per 1,000 person-years and standardized mortality ratio was 10.3 (95% CI, 9.4-11.3).

Drug overdose and disorder (19.8%), cardiovascular diseases (17.4%), cancer (16.8%), and infectious diseases (13.5%) were most common causes of death.

Hepatitis C virus (HCV) (HR = 1.99; 95% CI, 1.62-2.46) and alcohol use disorder (HR = 1.27; 95% CI, 1.05-1.55) were clinically significant indicators of overall mortality risk.

Tobacco use disorder (adjusted HR = 2.58; 95% CI, 1.6-4.17) was associated with increased risk for cardiovascular death.

HCV infection (aHR = 2.55; 95% CI, 1.52-4.26) was associated with increased risk for cancer mortality.

HCV (aHR = 1.92; 95% CI, 1.03-3.6) and alcohol use disorder (aHR = 5.44; 95% CI, 2.95-10.05) were associated with liver-related death.

“The findings were surprising because one would potentially expect better health care outcomes for patients being served by a large health care system,” Hser said in the release. “Late identification of opioid use disorder and lack of addiction treatment could contribute to these high rates of serious health conditions and death.” – by Amanda Oldt

Disclosure: Hser reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.