Sophie A Kitchen1, Daniel McCormack2, Dan Werb3, Alexander Caudarella4, Diana Martins5, Flora I Matheson6, Tara Gomes7. 1. Unity Health Toronto and Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada; Ontario Drug Policy Research Network, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada. 2. Ontario Drug Policy Research Network, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada. 3. Unity Health Toronto and Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada; Division of Infectious Diseases and Global Public Health, UC San Diego, 9500 Gilman Dr, San Diego, CA, 92161, USA; Centre on Drug Policy Evaluation, UC San Diego, 9500 Gilman Dr, San Diego, CA, 92161, USA. 4. Mental Health and Addictions Service, St. Michael's Hospital, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada. 5. Unity Health Toronto and Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada; Ontario Drug Policy Research Network, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada. 6. Unity Health Toronto and Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada; MAP Centre for Urban Health Solutions, St. Michael's Hospital, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada. 7. Unity Health Toronto and Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada; Ontario Drug Policy Research Network, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada. Electronic address: tara.gomes@unityhealth.to.
Abstract
BACKGROUND: Non-fatal opioid overdoses can lead to serious complications and consequently, long-term health effects. We sought to characterize trends of hospitalizations for serious complications associated with opioid overdoses in Ontario, Canada and report health services utilization and mortality in the year following hospital discharge. METHODS: We conducted a cross-sectional study in Ontario among individuals who experienced a hospitalization for a serious complication (required intubation, rhabdomyolysis, or a brain injury) associated with an opioid overdose between 2010 and 2019. We examined inpatient characteristics at the time of hospital admission, and health services utilization and mortality rates in the year following hospital discharge. RESULTS: The rate of hospitalizations for serious complications associated with opioid overdoses increased by 66.7 % from 1.8 per 100,000 population in 2010 to 3.0 per 100,000 population in 2019 in Ontario. Individuals that were discharged alive from hospital experienced high health services utilization in the following year; 71.2 % (N = 953 of 1,338) visited the emergency department (ED), 34.2 % (N = 458) were admitted to hospital, and 16.4 % (N = 219) were treated in hospital for an opioid overdose. However only a quarter of individuals (N = 332; 24.8 %) initiated on opioid agonist therapy within 90 days. Additionally, 8.0 % (N = 127) of hospitalizations resulted in death within 1 year. CONCLUSIONS: This study highlights increasing rates of serious complications associated with opioid overdoses, with a high demand of health services and a high mortality rate in the following year. These findings highlight an ongoing need for support and harm reduction services to allow for early intervention and follow-up care.
BACKGROUND: Non-fatal opioid overdoses can lead to serious complications and consequently, long-term health effects. We sought to characterize trends of hospitalizations for serious complications associated with opioid overdoses in Ontario, Canada and report health services utilization and mortality in the year following hospital discharge. METHODS: We conducted a cross-sectional study in Ontario among individuals who experienced a hospitalization for a serious complication (required intubation, rhabdomyolysis, or a brain injury) associated with an opioid overdose between 2010 and 2019. We examined inpatient characteristics at the time of hospital admission, and health services utilization and mortality rates in the year following hospital discharge. RESULTS: The rate of hospitalizations for serious complications associated with opioid overdoses increased by 66.7 % from 1.8 per 100,000 population in 2010 to 3.0 per 100,000 population in 2019 in Ontario. Individuals that were discharged alive from hospital experienced high health services utilization in the following year; 71.2 % (N = 953 of 1,338) visited the emergency department (ED), 34.2 % (N = 458) were admitted to hospital, and 16.4 % (N = 219) were treated in hospital for an opioid overdose. However only a quarter of individuals (N = 332; 24.8 %) initiated on opioid agonist therapy within 90 days. Additionally, 8.0 % (N = 127) of hospitalizations resulted in death within 1 year. CONCLUSIONS: This study highlights increasing rates of serious complications associated with opioid overdoses, with a high demand of health services and a high mortality rate in the following year. These findings highlight an ongoing need for support and harm reduction services to allow for early intervention and follow-up care.
Authors: Kristy M Scarfone; Nazlee Maghsoudi; Karen McDonald; Cristiana Stefan; Daniel R Beriault; Ernest Wong; Mark Evert; Shaun Hopkins; Peter Leslie; Tara Marie Watson; Dan Werb Journal: Harm Reduct J Date: 2022-01-11