Trends and outcomes of serious complications associated with non-fatal opioid overdoses in Ontario, Canada. (1st August 2021)

• Record Type: Journal Article
• Authors: Kitchen, Sophie A.; McCormack, Daniel; Werb, Dan; Caudarella, Alexander; Martins, Diana; Matheson, Flora I.; Gomes, Tara
• Is Part Of: Drug and alcohol dependence. Volume 225(2021)
• Publication Date: 2021-08-01
• Subjects: Opioid overdose -- Health services utilization -- Opioid treatment; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2021.108830
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Serious complications associated with opioid overdose increased 67 % from 2010 to 2019. Individuals discharged alive had high health services use in the subsequent year. Nearly 10 % of individuals with serious complications died in 1 year of discharge. A higher proportion of hospitalizations left against medical advice over time. Only 24.8 % of individuals were initiated on opioid agonist therapy within 90 days. Abstract: Background: Non-fatal opioid overdoses can lead to serious complications and consequently, long-term health effects. We sought to characterize trends of hospitalizations for serious complications associated with opioid overdoses in Ontario, Canada and report health services utilization and mortality in the year following hospital discharge. Methods: We conducted a cross-sectional study in Ontario among individuals who experienced a hospitalization for a serious complication (required intubation, rhabdomyolysis, or a brain injury) associated with an opioid overdose between 2010 and 2019. We examined inpatient characteristics at the time of hospital admission, and health services utilization and mortality rates in the year following hospital discharge. Results: The rate of hospitalizations for serious complications associated with opioid overdoses increased by 66.7 % from 1.8 per 100, 000 population in 2010 to 3.0 per 100, 000 population in 2019 in Ontario. Individuals that were discharged alive from hospital experienced high health services utilization in the following year; 71.2 % (N = 953 of 1, 338) visited the emergency department (ED), 34.2 % (N = 458) were admitted to hospital, and 16.4 % (N = 219) were treated in hospital for an opioid overdose. However only a quarter of individuals (N = 332; 24.8 %) initiated on opioid agonist therapy within 90 days. Additionally, 8.0 % (N = 127) of hospitalizations resulted in death within 1 year. Conclusions: This study highlights increasing rates of serious complications associated with opioid overdoses, with a high demand of health services and a high mortality rate in the following year. These findings highlight an ongoing need for support and harm reduction services to allow for early intervention and follow-up care.