Why Do Hospitalized Patients Rarely Receive Drug Intervention After Surviving An Overdose?
New research has found that hospitalized patients who survive an opioid overdose are often not given a drug intervention to help them recover from their addiction. According to the paper, for every one overdose death, 30 others survive. And thus:
“Nonfatal overdoses that receive medical attention represent intervention opportunities for clinicians to mitigate risk by reducing opioid prescribing or advocating addiction treatment.”
The research, which was published in the Journal of the American Medical Association, examined data from patient Medicaid claims in Pennsylvania from 2008-2013. More specifically, it focused on the rates of medication-assisted treatment (MAT) and prescription painkiller use both before and after the overdose event.
Researchers also cited two other studies that “suggest these potential interventions are underutilized.” A 2000-2012 study revealed high rates of opioid prescribing among patients after suffering a non-fatal overdose, and another study of patients with opioid use disorder found low rates of buprenorphine treatment after surviving an overdose.
Importantly the study noted that Medicaid recipients have three times the risk of overdose.
The data collected from MAT numbers honed in on patients who had been prescribed buprenorphine, methadone, or naltrexone. All of these are approved by the FDA to treat opioid dependence.
Researchers discovered that there not a reduction in opioid prescription or a notable increase in addiction treatment among those who had experienced an overdose.
Moreover, MAT increased by just 3.6%, and prescriptions for opioids decreased by just 3.5% among those who had suffered a heroin overdose. And only 15% of those who experienced a prescription opioid overdose and 33% of those who overdosed on heroin were prescribed buprenorphine, methadone, or naltrexone in the six months following the initial overdose.
In 2015, the last year data were available, more than 52,400 people died from substance-related overdoses. Most of those were related to heroin, fentanyl, prescription drugs, and other opioids, or opioids consumed in combination with other depressants, such as benzodiazepines or alcohol.
The study did not, however, address potential reasons for the missed opportunities for intervention.