Frequent ER Trips May Hike Risk of Death from Rx Drug Overdose

New research has discovered that frequent trips to the emergency room are a powerful predictor of death from a prescription drug overdose.

According to the study from researchers at Columbia University’s Mailman School of Public Health, the risk of dying from a prescription drug overdose was five times the rate for patients who visited the ER twice in the past year, compared to patients with one or fewer trips in the past year.

The risk of death was 17 times greater for patients with three visits, and 48 times for those with four or more visits, according to the new study.

“While ‘doctor-shopping’ — the practice of visiting multiple health care providers to obtain controlled substances — has been shown to be associated with prescription drug overdose in many studies, our investigation demonstrates that the frequency of emergency department visits in the past year is a strong predictor of subsequent death from prescription drug overdose,” said Joanne E. Brady, Ph.D., an adjunct assistant professor of epidemiology and first author of the study.

The study is published in the journal Annals of Epidemiology.

According to the researchers, nearly 60 percent of drug overdose deaths involve prescription drugs. According to data from 2011, 1.4 million ER visits involved the use of prescription drugs in a manner other than for which it was prescribed, the researchers add.

For their study, the researchers analyzed data for the years 2006-2010 from the New York Statewide Planning and Research Cooperative System, a data reporting system that collects emergency department visit data from hospitals in New York State, including patient characteristics, discharge diagnoses, and procedures received.

These records were then matched with mortality data for patients who subsequently died.

By comparing 2,732 patients who subsequently died from prescription drug overdose and 2,732 patients who did not, the researchers found substantially increased risk in patients who were diagnosed with substance use disorders or other psychiatric disorders, and who were male, 35-54 years of age, or white.

Additionally, patients who subsequently died of a prescription drug overdose were more likely to be discharged against medical advice at the initial emergency room visit, the analysis discovered.

“Emergency department visits may serve as an important window of opportunity for identifying patients at heightened risk of prescription drug overdose and for implementing evidence-based intervention programs, such as providing these patients and their families with take-home naloxone and drug treatment referral,” said senior author Guohua Li, M.D., P.H.D, a professor of epidemiology and director of the Center for Injury Epidemiology and Prevention at Columbia.

Source: Columbia University’s Mailman School of Public Health