Scott G Weiner1, Olesya Baker1,2, Dana Bernson3, Jeremiah D Schuur4. 1. Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. 2. Center for Clinical Investigation, Brigham and Women's Hospital, Boston, Massachusetts, USA. 3. Office of Population Health, Massachusetts Department of Public Health, Boston, Massachusetts, USA. 4. Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Abstract
Study objective: Prehospital use of naloxone for presumed opioid overdose has increased markedly in recent years because of the current opioid overdose epidemic. In this study, we determine the 1-year mortality of suspected opioid overdose patients who were treated with naloxone by EMS and initially survived. Methods: This was a retrospective observational study of patients using three linked statewide datasets in Massachusetts: emergency medical services (EMS), a master demographics file, and death records. We included all suspected opioid overdose patients who were treated with naloxone by EMS. The primary outcome measures were death within 3 days of treatment and between 4 days and 1 year of treatment. Results: Between July 1, 2013 and December 31, 2015, there were 9734 individuals who met inclusion criteria and were included for analysis. Of these, 807 (8.3% (95% confidence interval (CI) 7.7-8.8%)) died in the first 3 days, 668 (6.9% (95% CI 6.4-7.4%)) died between 4 days and 1 year, and 8259 (84.8% (95% CI 84.1-85.6%)) were still alive at 1 year. Excluding those who died within 3 days, 668 of the remaining 8927 individuals (7.5% (95% CI 6.9-8.0%)) died within 1 year. Conclusion: The 1-year mortality of those who are treated with naloxone for opioid overdose by EMS is high. Communities should focus both on primary prevention and interventions for this patient population, including strengthening regional treatment centers and expanding access to medication for opioid use disorder.
Study objective: Prehospital use of naloxone for presumed opioid overdose has increased markedly in recent years because of the current opioid overdose epidemic. In this study, we determine the 1-year mortality of suspected opioid overdose patients who were treated with naloxone by EMS and initially survived. Methods: This was a retrospective observational study of patients using three linked statewide datasets in Massachusetts: emergency medical services (EMS), a master demographics file, and death records. We included all suspected opioid overdose patients who were treated with naloxone by EMS. The primary outcome measures were death within 3 days of treatment and between 4 days and 1 year of treatment. Results: Between July 1, 2013 and December 31, 2015, there were 9734 individuals who met inclusion criteria and were included for analysis. Of these, 807 (8.3% (95% confidence interval (CI) 7.7-8.8%)) died in the first 3 days, 668 (6.9% (95% CI 6.4-7.4%)) died between 4 days and 1 year, and 8259 (84.8% (95% CI 84.1-85.6%)) were still alive at 1 year. Excluding those who died within 3 days, 668 of the remaining 8927 individuals (7.5% (95% CI 6.9-8.0%)) died within 1 year. Conclusion: The 1-year mortality of those who are treated with naloxone for opioid overdose by EMS is high. Communities should focus both on primary prevention and interventions for this patient population, including strengthening regional treatment centers and expanding access to medication for opioid use disorder.
Entities:
Keywords:
Naloxone; emergency medical services; opioid overdose
Authors: David A Wampler; D Kimberley Molina; John McManus; Philip Laws; Craig A Manifold Journal: Prehosp Emerg Care Date: 2011 Jul-Sep Impact factor: 3.077
Authors: Susan H Busch; David A Fiellin; Marek C Chawarski; Patricia H Owens; Michael V Pantalon; Kathryn Hawk; Steven L Bernstein; Patrick G O'Connor; Gail D'Onofrio Journal: Addiction Date: 2017-08-16 Impact factor: 6.526
Authors: Mark Faul; Peter Lurie; Jeremiah M Kinsman; Michael W Dailey; Charmaine Crabaugh; Scott M Sasser Journal: Prehosp Emerg Care Date: 2017-05-08 Impact factor: 3.077
Authors: Scott G Weiner; Patricia M Mitchell; Elizabeth S Temin; Breanne K Langlois; K Sophia Dyer Journal: Prehosp Emerg Care Date: 2017-02-06 Impact factor: 3.077
Authors: Nazey Gulec; Joseph Lahey; James C Suozzi; Matthew Sholl; Charles D MacLean; Daniel L Wolfson Journal: Prehosp Emerg Care Date: 2017-10-12 Impact factor: 3.077
Authors: Alana M Vivolo-Kantor; Puja Seth; R Matthew Gladden; Christine L Mattson; Grant T Baldwin; Aaron Kite-Powell; Michael A Coletta Journal: MMWR Morb Mortal Wkly Rep Date: 2018-03-09 Impact factor: 17.586
Authors: Rebecca E Cash; Jeremiah Kinsman; Remle P Crowe; Madison K Rivard; Mark Faul; Ashish R Panchal Journal: MMWR Morb Mortal Wkly Rep Date: 2018-08-10 Impact factor: 17.586
Authors: Sara E Hallvik; Nazanin Dameshghi; Sanae El Ibrahimi; Michelle A Hendricks; Christi Hildebran; Carissa J Bishop; Scott G Weiner Journal: Pharmacoepidemiol Drug Saf Date: 2021-05-10 Impact factor: 2.732