ACEP: Characteristics of patients with opioid overdose

(HealthDay)—Characteristics associated with opioid overdose and doctor-shopping (utilizing more than 10 providers for schedule II to V medications over a one-year period) have been identified, according to two studies presented at the annual meeting of the American College of Emergency Physicians, held from Oct. 14 to 17 in Seattle.

Michael Yokell, from the Stanford University School of Medicine in Palo Alto, Calif., and colleagues described the characteristics of patients presenting to emergency departments with opioid overdose. The researchers found that there were 106,813 emergency department visits for opioid overdose in 2009, 67 percent involving prescription opioids. Thirty-five percent of patients had comorbid mental health disorders, 28.5 percent had circulatory diseases, and 25 percent had respiratory diseases. The risk of mortality was higher for those who overdosed on heroin (19 percent of overdoses) or suffered respiratory failure during their overdose (about 15 percent).

Scott G. Weiner, M.D., M.P.H., from the Tufts Medical Center in Boston, and colleagues used data from 544 patients aged 18 to 64 years who presented with a complaint of back pain, dental pain, or headache and were treated by emergency providers. The researchers found that 8.7 percent of patients were doctor-shoppers. Factors associated with doctor-shopping included reporting allergies to non-narcotics, asking for a narcotic by name, having multiple visits for the same complaint, having a suspicious history, and having pain out of proportion to the examination.

"Knowing the typical characteristics associated with doctor-shoppers will give emergency physicians a better chance to identify patients with high risk for abuse when they come to the emergency room with pain complaints," Weiner said in a statement.