@article{ref1,
title="Overdose and mortality risk following a non-fatal opioid overdose treated by emergency medical services in King County, Washington",
journal="Drug and alcohol dependence",
year="2023",
author="Hood, Julia E. and Aleshin-Guendel, Serge and Poel, Amy and Liu, Jennifer and Collins, Hannah N. and Sadinle, Mauricio and Avoundjian, Tigran and Sayre, Michael R. and Rea, Thomas D.",
volume="253",
number="",
pages="e111009-e111009",
abstract="BACKGROUND: Emergency Medical Services (EMS) agencies respond to hundreds of thousands of acute overdose events each year. We conducted a retrospective cohort study of EMS patients who survived a prior opioid overdose in 2019-2021 in King County, Washington. <br><br>METHODS: A novel record linkage algorithm was applied to EMS electronic health records and the state vital statistics registry to identify repeat overdoses and deaths that occurred up to 3 years following the index opioid overdose. We measured overdose incidence rates and applied survival analysis techniques to assess all-cause and overdose-specific mortality risks. <br><br>RESULTS: In the year following the index opioid overdose, the overdose (fatal or non-fatal) incidence rate was 23.3 per 100 person-year, overdose mortality rate was 2.7 per 100 person-year, and all-cause mortality rate was 5.2 per 100 person-year in this cohort of overdose survivors (n=4234). Overdose incidence was highest in the first 30 days following the index overdose (43 opioid overdoses and 4 fatal overdoses per 1000 person-months), declined precipitously, and then plateaued from the third month onwards (10-15 opioid overdoses and 1-2 fatal overdoses per 1000 person-months). Overdose incidence rates, measured at 30 days, were highest among overdose survivors who were young, male, and experienced a low severity index opioid overdose, but these differences diminished when measured at 12 months. <br><br>CONCLUSIONS: Among EMS patients who survived an opioid overdose, the risk of subsequent overdose is high, especially in the weeks following the index opioid overdose. Non-fatal overdose may represent a pivotal time to connect patients with harm-reduction, treatment, and other support services.<p /> <p>Language: en</p>",
language="en",
issn="0376-8716",
doi="10.1016/j.drugalcdep.2023.111009",
url="http://dx.doi.org/10.1016/j.drugalcdep.2023.111009"
}