Two studies released this morning at the annual meeting of the American College of Emergency Physicians (ACEP) demonstrate the challenges of addressing the needs of opioid overdose patients—and the often deadly consequences of failure.
A study that examined data from Massachusetts patients who had received the overdose reversal drug naloxone found that 9.3% died within a year of their initial recorded naloxone administration, with around 35% of those individuals dying of an opioid overdose. “Patients who survive opioid overdoses are by no means 'out of the woods,'” lead author Scott Weiner, MD, director of the Comprehensive Opioid Response and Education Program at Brigham and Women's Hospital in Boston, said in a news release.
“These patients continue to be at high risk for overdose and should be connected with additional resources such as counseling, treatment and buprenorphine,” Weiner added.
The study examined outcomes for more than 12,000 individuals receiving at least one naloxone administration by emergency personnel in Massachusetts between July 2013 and December 2015. The median age of individuals who died within a year of their first naloxone administration was 54, and 61% were men.
The other study released on Monday, examining results of a quality improvement project for opioid use patients initiated by Indianapolis Emergency Medical Services in Indiana, found that early childhood trauma was common among individuals presenting to the emergency department with opioid-related complaints. A total of 55% of the 82 patients who were enrolled in the Project POINT initiative between February and December of last year had a mental health history.
“In order to truly reach overdose survivors, we need a much better understanding of who they are and the many challenges they face when they seek care,” said lead author Krista Brucker, MD, of the Indiana University School of Medicine. “Designing and implementing effective outreach and referral programs will require listening carefully to patients and taking into account the impact of untreated mental illness, exposure to childhood trauma and many other medical and social determinants of health.”
Depression was the most common comorbid mental health condition in the patient group. Childhood trauma was measured with the Adverse Childhood Events instrument.
Also during today's ACEP meeting, the organization released poll results that illustrate frustration among emergency physicians over how to help overdose victims.
The online survey of more than 1,200 emergency physicians, conducted in late September and early October, found 57% of respondents reporting that detox and rehabilitation facilities for patients with substance use treatment needs were rare or never accessible.
In addition, 87% of emergency physicians reported that the number of opioid-seeking patients in their community has either increased or remained the same, according to the survey.