Hospitalized patients with opioid use disorder die at a rate comparable to heart attack patients

Hospital patients with an opioid use disorder died at a rate comparable to those who had a heart attack within a year of hospital discharge, according to a new study from Oregon Health & Science University.

The study, published in the Journal of Addiction Medicine, found that nearly 8% of patients with an opioid use disorder died within 12 months of their discharge. The authors say their results underscore the need for hospital addiction care and generally improving health systems for those with substance use disorders who also have other conditions.

We need systems that meet the broad needs of people with addiction problems and serious medical illnesses. That means trauma-informed systems that destigmatize addiction in order to make health systems more trustworthy and effective for our patients. “

Honora Englander, MD, lead author, Associate Professor of Medicine (Hospital Medicine) at the OHSU School of Medicine

Researchers entered the study knowing that people with opioid use disorder are seven times more likely to be hospitalized than the general population, but the new study is the first to characterize the rate at which these patients are one year after they are discharged died from the hospital.

The researchers reviewed the data from a total of 6,654 Medicaid patients treated at 62 Oregon hospitals between April 2015 and December 2017.

Of the 522 people who died within a year of hospital discharge, 58% were due to drug-related deaths, including overdoses. The other deaths were attributed to causes other than drugs, including diseases of the circulatory, respiratory and endocrine systems.

“Much of the research has focused on overdose deaths,” said lead author Caroline King, Ph.D., MPH, an MD / Ph.D. Student at the OHSU School of Medicine. “We found that overdoses are just the tip of the iceberg for these patients, accounting for 13% of deaths in the year after discharge.”

The death rate is striking and surprising, she said.

An 8% mortality rate after one year is comparable to conditions such as acute myocardial infarction or heart attack.

“For heart attacks, hospital systems in the US have universally accepted standards, metrics and quality reports that improve performance,” said Englander. “The same should be true for opioid use disorders, where mortality rates are similar.”

King said it is clear that health systems need to better integrate and de-stigmatize the medical care these patients need, starting with facilitating access to proven drug addiction drugs like methadone and buprenorphine.

“Methadone should be easier to access than heroin,” said Englander. “Right now, that’s not the case – the systems are such that people have to work so hard just to get life-saving treatment.”

Source:

Oregon Health & Science University

Journal reference:

King, C., et al. (2021) Causes of Death in the 12 Months Post-Hospital Discharge in Patients with Opioid Use Disorder. Journal of Addiction Medicine. doi.org/10.1097/ADM.00000000000000915.

source https://www.bisayanews.com/2021/09/15/hospitalized-patients-with-opioid-use-disorder-die-at-a-rate-comparable-to-heart-attack-patients/