Citation

Conner KR, Wiegand TJ, Kaukeinen K, Gorodetsky R, Schult R, Heavey SC. J. Stud. Alcohol Drugs 2018; 79(6): 893-898.

Affiliation

Department of Psychiatry, University of Rochester Medical Center, Rochester, New York.

Copyright

(Copyright © 2018, Alcohol Research Documentation, Inc., Rutgers, The State University of New Jersey)

DOI

unavailable

PMID

30573020

Abstract

OBJECTIVE: Research suggests unintentional overdose on prescription drugs and intentional self-harm cases differ fundamentally from unintentional illicit drug overdoses, but there are few data on opioid overdose per se.

METHOD: We analyzed consecutive opioid overdose patients age 13 and over (N = 435) treated by a toxicology consult service to compare three poisoning groups: unintentional illicit drug (illicit, n = 128), unintentional prescription drug (prescription, n = 217), and intentional self-harm (self-harm, n = 90). The groups were compared on key characteristics of the poisoning events (severity, co-ingestion of non-opioid) and the hospital-based treatments required to manage the poisonings (use of antidote, provision of pharmacological support). Logistic regressions yielded incident rate ratios (IRRs) and 95% confidence intervals (CI) adjusted for age and sex.

RESULTS: Compared to the illicit group, the prescription group was more likely to co-ingest a non-opioid drug (IRR [95% CI] = 1.594 [1.077, 2.358], p =.020. Compared to illicit cases, self-harm cases were more likely to co-ingest a non-opioid drug (IRR = 3.181 [1.620, 6.245], p =.001) and had a lower poisoning severity score (IRR = 0.750 [0.564, 0.997], p =.048). There were no statistically significant differences between the self-harm and prescription groups.

CONCLUSIONS: The similarities between the self-harm and prescription poisoning groups suggest that they may benefit from common interventions including appropriate restriction on prescription of opioids and other medications that may be misused (e.g., sedative-hypnotic/muscle relaxants). The characteristics of the illicit poisoning group (use of heroin; more severe overdose events) suggest the need for initiation of intensive substance use treatment interventions during hospitalization.

Language: en