Outcomes in Women with opioid-addiction-associated ED visits in the United States

Oluwasegun Akinyemi, MD, MPH, Terhas Asfiha Weldeslase, MD, Yusra Gimie  BS, Deborah Makanjuola MD,  Eunice Odusanya BS,  Mojisola Fasokun  MD, Waliah Ajisafe  MD, Colon-Santos Lynne ,MD, Luo Guoyang, MD, Ph.D.

 

PURPOSE / OBJECTIVES

Opioid addiction and prescription drug misuse is an epidemic in the United States that has gradually increased in the past two decades.

In 2020, the Centers for Disease Control and Prevention (CDC) estimated the cost of opioid addiction to be nearly $ 1.5 trillion, and the trend is likely to increase in the coming years.

This has become a major public health issue with a significant impact on morbidity and mortality.

The present study aims to determine the profile and outcome in women with opioid-addiction-associated ED visits in the United States.

MATERIAL & METHODS

We analyzed data on Opioid addiction Emergency Departments visits utilizing the Nationwide Emergency Department Sample (NEDS) database from January 2018 to December 2019.

In a multivariate analysis, we determined the association between opioid addictions and ED visits because of attempted suicides, assaults, and unintentional injuries.

We also explore the influence of opioid addiction on health outcomes such as in-hospital mortality, total hospital charges, length of hospitalization, and discharge disposition.

We adjusted for covariates such as patient's age, race/ethnicity, insurance type income quartile, hospital parameters (ownership, region of hospital, hospital urban-rural divide, teaching hospital status), depression, dementia, and preexisting comorbidities (hypertension, diabetes, and obesity). We also adjusted for the mechanism of disease. 

Samples were weighed to generate nationally representative estimates

RESULTS

There were 214,056 opioid-addiction-associated ED visits during the study period.

The median age was 39 years (Interquartile range: 30-52 years). Among these patients, 73.0% were White, 14.8% were Blacks, and 8.5% were Hispanics.

 21,862 (10.2%) of these patients’ ED visits were on account of unintentional injuries, 3,510 (1.6%) were due to attempted suicides, and 1,7,760 (0.8%) were on account of assaults.

There were 1,424 deaths. After adjusting for covariates, opioid addiction remains a significant predictor of attempted suicides (OR=1.60, 95% CI 1.47-1.74, p<0.01), unintentional injuries (OR=2.18, 95% CI 1.96 -2.42, p<0.01) and assaults (OR=1.88, 95% CI 1.67 -2.13, p<0.01).

It also remains a major predictor of in-hospital mortality (OR=2.91,95% CI 2.34-3.63, p<0.001).

SUMMARY / CONCLUSION

This study highlights the significant impact of opioid addiction on women presenting to the Emergency Department (ED) in the United States.

The findings demonstrate that opioid addiction is associated with increased rates of attempted suicides, unintentional injuries, and assaults among female patients in the ED.

Furthermore, opioid addiction is a major predictor of in-hospital mortality and prolonged hospital stay, indicating its contribution to adverse health outcomes.

POLICY IMPLICATION

This study underscores the need for comprehensive interventions to address opioid addiction among women in the United States. Policymakers should prioritize enhanced screening and intervention in ED settings, expand access to evidence-based addiction treatment, foster multidisciplinary collaboration, and implement education and prevention initiatives.

ACKNOWLEDGEMENT

We would like to express our sincere gratitude to the Department of Obstetrics and Gynecology, and the Department of Surgery at Howard University College of Medicine for their invaluable support and generous funding provided for this project.

REFERENCE

1. Centers for Disease Control and Prevention. Understanding Drug Overdoses and Deaths 2023. https://www.cdc.gov/drugoverdose/epidemic/index.html (accessed May 27, 2023).
2. Nitara Osbourne : Sarah Hardey, Ryan Kelley, NREMT. The Effects of Opioid Abuse on Women. American Addiction Centers 2022 https://americanaddictioncenters.org/opiates/the-effects-of-opioid-abuse-on-women. (accessed May 27, 2023).
3. Agency for Healthcare Research and Quality. Nationwide Emergency Department Sample (NEDS) Database Documentation. Healthcare Cost and Utilization Project (User Support) 2023. https://hcup-us.ahrq.gov/db/nation/neds/nedsdbdocumentation.jsp (accessed May 27,

CONTACT

Dr. Oluwasegun Akinyemi, MD, MPH, FMCOG

Senior Research Fellow,

Howard University College of Medicine