Sara Warfield1, Elizabeth Karras2, Christa Lilly3, Michael Brumage4, Robert M Bossarte5. 1. Center of Excellence for Suicide Prevention, Department of Veterans Affairs, 400 Fort Hill Avenue, Canandaigua, NY, 14424, USA; Department of Epidemiology, School of Public Health, West Virginia University, 64 Medical Center Drive, P.O. Box 9190, Morgantown, WV, 26506, USA; Injury Control Research Center, West Virginia University, 3606 Collins Ferry Rd, Suites 201 & 202, Morgantown, WV 26505, USA. Electronic address: scwarfield@hsc.wvu.edu. 2. Center of Excellence for Suicide Prevention, Department of Veterans Affairs, 400 Fort Hill Avenue, Canandaigua, NY, 14424, USA; Injury Control Research Center, West Virginia University, 3606 Collins Ferry Rd, Suites 201 & 202, Morgantown, WV 26505, USA; Department of Psychiatry, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA. 3. Department of Biostatistics, West Virginia University, 64 Medical Center Drive, P.O. Box 9190, Morgantown, WV, 26506, USA. 4. Injury Control Research Center, West Virginia University, 3606 Collins Ferry Rd, Suites 201 & 202, Morgantown, WV 26505, USA; Department of Occupational Medicine, West Virginia University, 64 Medical Center Drive, P.O. Box 9190, Morgantown, WV, 26506, USA. 5. Center of Excellence for Suicide Prevention, Department of Veterans Affairs, 400 Fort Hill Avenue, Canandaigua, NY, 14424, USA; Department of Epidemiology, School of Public Health, West Virginia University, 64 Medical Center Drive, P.O. Box 9190, Morgantown, WV, 26506, USA; Injury Control Research Center, West Virginia University, 3606 Collins Ferry Rd, Suites 201 & 202, Morgantown, WV 26505, USA; Department of Behavioral Medicine and Psychiatry, West Virginia University, 64 Medical Center Drive, P.O. Box 9190, Morgantown, WV, 26506, USA.
Abstract
BACKGROUND: For over a decade, there has been a surge in opioid-related morbidity and mortality among Veterans. To better understand the impact of the growing epidemic, it is important to identify the cause-specific mortality rates among Veterans with a prior nonfatal opioid overdose. METHODS: We followed 8370 Veterans who received medical care for a nonfatal opioid overdose between 2011 through 2015.Mortality records were linked to clinical records from the Veterans Health Administration (VHA). We compared the mortality rates among those with a nonfatal opioid overdose to a 5 % stratified random sample of patients accessing services during the same time period. SMRs were calculated using age-adjusted cause-specific mortality rates for the l U.S. population obtained from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER). RESULTS: The crude mortality for Veterans with a history of a nonfatal overdose was 370.6 per 10,000 person years. Those with a prior nonfatal overdose had a higher risk of substance-related mortality (aHR [adjusted Hazard Ratio] 5.0), including a higher risk of death from drugs (aHR 6.9) and alcohol (aHR 2.7). Similarly, cause-specific mortalities assessed between Veterans and the U.S. population, SMRs were also highest for deaths associated with substances (114.0). CONCLUSION: Veterans with a prior nonfatal overdose experienced substantially higher mortality rates compared to other Veterans or the general U.S. POPULATION: Causes of death related to substance use and mental health were significantly higher than other causes of death, highlighting the importance of integrated treatment and substance use services. Published by Elsevier B.V.
BACKGROUND: For over a decade, there has been a surge in opioid-related morbidity and mortality among Veterans. To better understand the impact of the growing epidemic, it is important to identify the cause-specific mortality rates among Veterans with a prior nonfatal opioid overdose. METHODS: We followed 8370 Veterans who received medical care for a nonfatal opioid overdose between 2011 through 2015.Mortality records were linked to clinical records from the Veterans Health Administration (VHA). We compared the mortality rates among those with a nonfatal opioid overdose to a 5 % stratified random sample of patients accessing services during the same time period. SMRs were calculated using age-adjusted cause-specific mortality rates for the l U.S. population obtained from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER). RESULTS: The crude mortality for Veterans with a history of a nonfatal overdose was 370.6 per 10,000 person years. Those with a prior nonfatal overdose had a higher risk of substance-related mortality (aHR [adjusted Hazard Ratio] 5.0), including a higher risk of death from drugs (aHR 6.9) and alcohol (aHR 2.7). Similarly, cause-specific mortalities assessed between Veterans and the U.S. population, SMRs were also highest for deaths associated with substances (114.0). CONCLUSION: Veterans with a prior nonfatal overdose experienced substantially higher mortality rates compared to other Veterans or the general U.S. POPULATION: Causes of death related to substance use and mental health were significantly higher than other causes of death, highlighting the importance of integrated treatment and substance use services. Published by Elsevier B.V.
Entities:
Keywords:
Drug mortality; Opioid overdose; Overdose; Veterans
Authors: Amy S B Bohnert; Mark A Ilgen; Rosalinda V Ignacio; John F McCarthy; Marcia Valenstein; Frederic C Blow Journal: Am J Psychiatry Date: 2011-09-28 Impact factor: 18.112
Authors: M W Tyndall; K J Craib; S Currie; K Li; M V O'Shaughnessy; M T Schechter Journal: J Acquir Immune Defic Syndr Date: 2001-12-01 Impact factor: 3.731
Authors: Sarah Larney; Amy S B Bohnert; Dara Ganoczy; Mark A Ilgen; Matthew Hickman; Fred C Blow; Louisa Degenhardt Journal: Drug Alcohol Depend Date: 2014-12-30 Impact factor: 4.492
Authors: Amy S B Bohnert; Maureen A Walton; Rebecca M Cunningham; Mark A Ilgen; Kristen Barry; Stephen T Chermack; Frederic C Blow Journal: Addict Behav Date: 2017-11-16 Impact factor: 3.913
Authors: Aron J Hall; Joseph E Logan; Robin L Toblin; James A Kaplan; James C Kraner; Danae Bixler; Alex E Crosby; Leonard J Paulozzi Journal: JAMA Date: 2008-12-10 Impact factor: 56.272