Lewei Allison Lin1, Talya Peltzman2, John F McCarthy3, Elizabeth M Oliva4, Jodie A Trafton4, Amy S B Bohnert5. 1. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan; Center for Clinical Management Research, Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, Michigan. Electronic address: leweil@med.umich.edu. 2. Serious Mental Illness Treatment Resource and Evaluation Center, VA Office of Mental Health and Suicide Prevention, Ann Arbor, Michigan. 3. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan; Center for Clinical Management Research, Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, Michigan; Serious Mental Illness Treatment Resource and Evaluation Center, VA Office of Mental Health and Suicide Prevention, Ann Arbor, Michigan. 4. Program Evaluation and Resource Center, VA Office of Mental Health and Suicide Prevention, Menlo Park, California; Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California. 5. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan; Center for Clinical Management Research, Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, Michigan.
Abstract
INTRODUCTION: To inform overdose prevention, this study assessed both recent trends in opioid overdose mortality across opioid categories and receipt of prescription opioid analgesics among Veterans who died from overdose in the Veterans Health Administration. METHODS: Using Veterans Health Administration records linked to National Death Index data, annual cohorts (2010-2016) of Veterans who received Veterans Health Administration care were obtained and were examined by opioid overdose categories (natural/semisynthetic opioids, heroin, methadone, and other synthetic opioids) on (1) overdose rates and changes in rates adjusted for age, sex, and race/ethnicity; and (2) Veterans Health Administration prescription opioid receipt. Analyses were conducted in 2018. RESULTS: The overall rate of opioid overdose among Veterans increased from 14.47 per 100,000 person-years in 2010 to 21.08 per 100,000 person-years in 2016 (adjusted rate ratio=1.65, 95% CI=1.51, 1.81). There was a decline in methadone overdose (adjusted rate ratio=0.66, 95% CI=0.51, 0.84) and no significant change in natural/semisynthetic opioid overdose (adjusted rate ratio=1.08, 95% CI=0.94, 1.24). However, the synthetic opioid overdose rate (adjusted rate ratio=5.46, 95% CI=4.41, 6.75) and heroin overdose rate (adjusted rate ratio=4.91, 95% CI=3.92, 6.15) increased substantially. Among all opioid overdose decedents, prescription opioid receipt within 3 months before death declined from 54% in 2010 to 26% in 2016. CONCLUSIONS: Opioid overdose rates among Veterans Health Administration Veterans increased because of increases in heroin and synthetic opioid overdose rates. Prescriptions of opioids declined among patients who died from all categories of opioid overdose; by 2016, only a minority received an opioid analgesic from Veterans Health Administration within 3 months of overdose. Future prevention efforts should extend beyond patients actively receiving opioid prescriptions. Published by Elsevier Inc.
INTRODUCTION: To inform overdose prevention, this study assessed both recent trends in opioid overdosemortality across opioid categories and receipt of prescription opioid analgesics among Veterans who died from overdose in the Veterans Health Administration. METHODS: Using Veterans Health Administration records linked to National Death Index data, annual cohorts (2010-2016) of Veterans who received Veterans Health Administration care were obtained and were examined by opioid overdose categories (natural/semisynthetic opioids, heroin, methadone, and other synthetic opioids) on (1) overdose rates and changes in rates adjusted for age, sex, and race/ethnicity; and (2) Veterans Health Administration prescription opioid receipt. Analyses were conducted in 2018. RESULTS: The overall rate of opioid overdose among Veterans increased from 14.47 per 100,000 person-years in 2010 to 21.08 per 100,000 person-years in 2016 (adjusted rate ratio=1.65, 95% CI=1.51, 1.81). There was a decline in methadoneoverdose (adjusted rate ratio=0.66, 95% CI=0.51, 0.84) and no significant change in natural/semisynthetic opioid overdose (adjusted rate ratio=1.08, 95% CI=0.94, 1.24). However, the synthetic opioid overdose rate (adjusted rate ratio=5.46, 95% CI=4.41, 6.75) and heroinoverdose rate (adjusted rate ratio=4.91, 95% CI=3.92, 6.15) increased substantially. Among all opioid overdose decedents, prescription opioid receipt within 3 months before death declined from 54% in 2010 to 26% in 2016. CONCLUSIONS:Opioid overdose rates among Veterans Health Administration Veterans increased because of increases in heroin and synthetic opioid overdose rates. Prescriptions of opioids declined among patients who died from all categories of opioid overdose; by 2016, only a minority received an opioid analgesic from Veterans Health Administration within 3 months of overdose. Future prevention efforts should extend beyond patients actively receiving opioid prescriptions. Published by Elsevier Inc.
Authors: Charles M Cleland; Alex S Bennett; Luther Elliott; Andrew Rosenblum; Peter C Britton; Brett Wolfson-Stofko Journal: Drug Alcohol Depend Date: 2019-11-14 Impact factor: 4.492
Authors: Christian A Betancourt; Panagiota Kitsantas; Deborah G Goldberg; Beth A Hawks Journal: J Behav Health Serv Res Date: 2022-09-29 Impact factor: 1.475
Authors: Friedhelm Sandbrink; Elizabeth M Oliva; Tara L McMullen; Amy R Aylor; Michael A Harvey; Melissa L Christopher; Francesca Cunningham; Taeko Minegishi; Thomas Emmendorfer; Jenie M Perry Journal: J Gen Intern Med Date: 2020-11-16 Impact factor: 5.128
Authors: Pooja Lagisetty; Claire Garpestad; Angela Larkin; Colin Macleod; Derek Antoku; Stephanie Slat; Jennifer Thomas; Victoria Powell; Amy S B Bohnert; Lewei A Lin Journal: Drug Alcohol Depend Date: 2021-02-13 Impact factor: 4.492
Authors: Gary R Bond; Monirah Al-Abdulmunem; Robert E Drake; Lori L Davis; Thomas Meyer; Daniel M Gade; B Christopher Frueh; Ross B Dickman; Daniel R Ressler Journal: J Behav Health Serv Res Date: 2022-01-26 Impact factor: 1.475
Authors: Benjamin A Howell; Erica A Abel; Dongchan Park; Sara N Edmond; Leah J Leisch; William C Becker Journal: J Gen Intern Med Date: 2020-11-11 Impact factor: 5.128
Authors: William C Becker; Erin E Krebs; Sara N Edmond; Lewei A Lin; Mark D Sullivan; Roger D Weiss; Adam J Gordon Journal: J Gen Intern Med Date: 2020-11-03 Impact factor: 5.128