Citation

Choi S, Biello KB, Bazzi AR, Drainoni ML. Drug Alcohol Depend. 2019; 200: 14-18.

Affiliation

Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA; Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA; Evans Center for Implementation and Improvement Sciences, Boston University School of Medicine, Boston, MA, USA; Center for Healthcare Organization and Implementation Research, ENRM VA Hospital, Bedford, MA, USA. Electronic address: drainoni@bu.edu.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.drugalcdep.2019.02.030

PMID

31071494

Abstract

BACKGROUND: Opioid use disorder (OUD) among young adults from ages 18 to 25 years is increasing in the United States. Emergency departments (EDs) are recognized as major sources of care for patients with OUD, but questions remain about ED utilization among this population. We examined the demographics and ED utilization patterns at an urban safety-net hospital with a focus on young adults to inform intervention development.

METHODS: We extracted demographic and clinical data from electronic medical records of patients ages 18 to 64 years diagnosed with OUD between 2013 and 2017. Descriptive statistics were assessed, including race/ethnicity, sex, insurance, other substance use disorder and mental health diagnoses, and ED utilization patterns by age group. Univariable and multivariable logistic regressions were performed to analyze the associations between age and ED utilization patterns.

RESULTS: Among 12,025 OUD patients in the sample, 30% had an ED visit with a primary diagnosis of OUD. Among those who had an ED visit, 48% had at least one additional ED visit within a year. The probability of ED visits (adjusted odds ratio [AOR]:5.04; 95% confidence interval [CI]:4.14-6.13) and repeat ED visits (AOR:3.28; CI:2.53-4.26) were significantly higher among young adults (18-25 years) compared to the oldest age group (56-64 years).

CONCLUSIONS: Compared to older adults, young adults with OUD are more likely to use the ED and to have repeat ED visits. The identification of youth-tailored interventions in the ED within broader efforts to address the opioid epidemic should be an urgent priority.

Copyright © 2019 Elsevier B.V. All rights reserved.

Language: en

Keywords

Emergency service; Opioid use disorder; Opioid-related disorder; Repeated use; Retrospective studies; Young adults