Nicola R Jones1, Matthew Hickman2, Sarah Larney3, Suzanne Nielsen4, Robert Ali5, Thomas Murphy6, Timothy Dobbins7, David A Fiellin8, Louisa Degenhardt9. 1. National Drug and Alcohol Research Centre, University of NSW, Sydney, NSW, 2052, Australia. Electronic address: nicola.jones@unsw.edu.au. 2. Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS2 8DZ, UK. Electronic address: matthew.hickman@bristol.ac.uk. 3. National Drug and Alcohol Research Centre, University of NSW, Sydney, NSW, 2052, Australia; Department of Family Medicine and Emergency Medicine, Université de Montréal and Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Canada. Electronic address: sarah.larney@umontreal.ca. 4. Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Melbourne, Australia. Electronic address: suzanne.nielsen@monash.edu.au. 5. National Drug and Alcohol Research Centre, University of NSW, Sydney, NSW, 2052, Australia; School of Medicine, The University of Adelaide, Australia. Electronic address: robert.ali@adelaide.edu.au. 6. National Drug and Alcohol Research Centre, University of NSW, Sydney, NSW, 2052, Australia. Electronic address: tom.murphy@unsw.edu.au. 7. School of Public Health and Community Medicine, UNSW Sydney, Australia. Electronic address: t.dobbins@unsw.edu.au. 8. Yale Schools of Medicine and Public Health, New Haven, CT, USA. Electronic address: david.fiellin@yale.edu. 9. National Drug and Alcohol Research Centre, University of NSW, Sydney, NSW, 2052, Australia. Electronic address: l.degenhardt@unsw.edu.au.
Abstract
BACKGROUND: To examine, among a cohort of opioid dependent people with a history of opioid agonist treatment (OAT), the frequency and incidence rates of non-fatal overdose (NFOD) hospital separations over time, by age and sex. METHODS: Retrospective cohort study of people with a history of OAT using state-wide linked New South Wales (NSW) data. The incidence of NFOD hospital separations involving an opioid, sedative, stimulant or alcohol was defined according to the singular or combination of poisoning/toxic effect using ICD-10-AM codes. Crude incidence rates were calculated by gender, age group and calendar year. RESULTS: There were 31.8 (31.3-32.3) NFOD per 1,000 person-years (PY). Opioid NFOD incidence was higher in women than men: incidence rate ratio (IRR) 1.11 per 1,000PY; 95 %CI: [1.06-1.17]; women had higher sedative NFOD rates than men, IRR 1.27 per 1,000PY [1.21-1.34]. Participants ≤25 years, 26-30yrs, and 31-35yrs had higher incidence of opioid NFOD compared to 46+yrs, with IRRs of: 1.45 per 1,000PY; [1.32-1.59]; 1.20 per 1,000PY; [1.11-1.30] and 1.22 per 1,000PY; [1.13-1.32], respectively. Between 2006-7 and 2016-17, the cohort accounted for 19 % of NSW opioid NFOD episodes, 12 % of sedative, 14 % of stimulant and 5 % of acute alcohol-related NFOD. CONCLUSIONS: Hospital stays due to NFOD are a relatively frequent occurrence among opioid-dependent people. There are clear differences in rates and substances involved by sex, age and over time. Evidence-based interventions that prevent overdose among people who are opioid dependent need to be delivered to scale, including widespread community provision of naloxone.
BACKGROUND: To examine, among a cohort of opioid dependent people with a history of opioid agonist treatment (OAT), the frequency and incidence rates of non-fatal overdose (NFOD) hospital separations over time, by age and sex. METHODS: Retrospective cohort study of people with a history of OAT using state-wide linked New South Wales (NSW) data. The incidence of NFOD hospital separations involving an opioid, sedative, stimulant or alcohol was defined according to the singular or combination of poisoning/toxic effect using ICD-10-AM codes. Crude incidence rates were calculated by gender, age group and calendar year. RESULTS: There were 31.8 (31.3-32.3) NFOD per 1,000 person-years (PY). Opioid NFOD incidence was higher in women than men: incidence rate ratio (IRR) 1.11 per 1,000PY; 95 %CI: [1.06-1.17]; women had higher sedative NFOD rates than men, IRR 1.27 per 1,000PY [1.21-1.34]. Participants ≤25 years, 26-30yrs, and 31-35yrs had higher incidence of opioid NFOD compared to 46+yrs, with IRRs of: 1.45 per 1,000PY; [1.32-1.59]; 1.20 per 1,000PY; [1.11-1.30] and 1.22 per 1,000PY; [1.13-1.32], respectively. Between 2006-7 and 2016-17, the cohort accounted for 19 % of NSW opioid NFOD episodes, 12 % of sedative, 14 % of stimulant and 5 % of acute alcohol-related NFOD. CONCLUSIONS: Hospital stays due to NFOD are a relatively frequent occurrence among opioid-dependent people. There are clear differences in rates and substances involved by sex, age and over time. Evidence-based interventions that prevent overdose among people who are opioid dependent need to be delivered to scale, including widespread community provision of naloxone.
Authors: Thomas D Brothers; Dan Lewer; Nicola Jones; Samantha Colledge-Frisby; Michael Farrell; Matthew Hickman; Duncan Webster; Andrew Hayward; Louisa Degenhardt Journal: PLoS Med Date: 2022-07-19 Impact factor: 11.613