In a national study of hospital emergency department visits for opioid overdoses, 67.8% of the overdoses involved prescription opioids (including methadone), followed by heroin, other unspecified opioids, and multiple opioids, according to a study published online by JAMA Internal Medicine.
Michael A. Yokell, Stanford University School of Medicine, Stanford, California, and colleagues analysed the 2010 Nationwide Emergency Department Sample using diagnostic codes to define opioid overdoses. They identified 135,971 weighted ED visits that were coded for opioid overdose.
In addition to 67.8% of overdoses involving prescription opioids, researchers found heroin accounted for 16.1% of overdoses, unspecified opioids for 13.4%, and multiple opioid types in 2.7% of overdoses.
The greatest proportion of prescription opioid overdoses happened in urban areas (84.1%), in the South (40.2%) and among women (53%). The overall death rate was low (1.4%) once patients arrived in the ED, which the authors suggest supports increased use of emergency services for overdoses.
Many patients who overdosed shared common co-existing illnesses, including chronic mental health, circulatory and respiratory diseases, so healthcare providers who prescribe opioids to patients with these pre-existing conditions should do so with care and counsel the patients, the authors noted.
“Opioid overdose exacts a significant financial and healthcare utilisation burden on the US healthcare system,” the authors wrote. “Most patients in our sample overdosed on prescription opioids, suggesting that further efforts to stem the prescription opioid overdose epidemic are urgently needed.”