Most emergency department 'super-frequent users' have a substance abuse addiction

May 17, 2014, Henry Ford Health System
Jennifer Peltzer-Jones, R.N., Psy.D., is a clinical psychologist at Henry Ford Hospital's Department of Emergency Medicine and the study's lead author. Credit: Henry Ford Hospital

A vast majority of so-called "super-frequent user" patients who seek care in the Emergency Department (ED) have a substance abuse addiction, according to a Henry Ford Hospital study.

A patient is considered a super-frequent user who visits the ED at least 10 times a year.

ED physicians have long theorized that patients who frequent the ED for their care have a substance abuse addiction. Few studies have actually measured the rate of addiction of these patients.

The study's key findings:

  • 77 percent of patients had a substance abuse addiction.
  • 47 percent were addicted to pain-relief narcotics such as Vicodin and Dilaudid.
  • 44 percent were addicted to "other" illicit drugs such as cocaine or marijuana.
  • 35 percent were addicted to alcohol.

Researchers also found that super-frequent users seeking pain-relief narcotics were more common with women.

The findings are being presented Saturday at the Society for Academic Emergency Medicine (SAEM) annual meeting in Dallas.

"Emergency Departments cannot address the super-frequent users problem without addressing the underlying reason they're here – their substance abuse problem," says Jennifer Peltzer-Jones, R.N., Psy.D., a clinical psychologist at Henry Ford's Department of Emergency Medicine and the study's lead author. "Boosting federal and state funding for programs could help alleviate some of the frequent use of Emergency Departments as sources of addiction care."

According to the federal Drug Abuse Warning Network, an estimated 2.5 million ED visits involved drug misuse or abuse in 2011. ED visits involving drug misuse or abuse increased 19 percent from 2009-11.

Dr. Peltzer-Jones and her team of researchers sought to examine the level of addiction of 255 super-frequent users who sought care at Henry Ford's Emergency Department from 2004-2013 and determine whether imposing prescribing guidelines for narcotics in their ED impacted the level of patients seeking pain-relief narcotics.

In 2004, Henry Ford created the Community Resources for Emergency Department Overuse (CREDO) to more effectively manage the increased frequent users in the ED with individual care plans.

After reviewing and collecting data from each of the patients' electronic medical record, researchers found that CREDO had a significant impact. Before CREDO was initiated, the super-frequent users sought care in the ED 32.4 times a year.

Since then, rate of super-frequent users who sought pain-relief narcotics in Henry Ford's ED dropped to 13.8 visits a year from 32.5. For other super-frequent users, their visits dropped to 11.6 visits a year from 33.

"Emergency Departments that implement case management initiatives can make meaningful progress in addressing their frequent-user patient population," Dr. Peltzer-Jones says. "As our study showed the number of frequent users visiting the ED for narcotics is alarming. A successful remedy to curtailing that problem is implementing case management strategies such as ours. However, if Emergency Departments don't have the resources to create a program, instituting narcotic prescribing guidelines may lead to decreased visits by frequent users."

Explore further: Emergency department physicians growing weary of frequent users

Related Stories

Emergency department physicians growing weary of frequent users

June 3, 2011
Emergency department physicians are frustrated and burned out from treating patients who frequent the ED for their care, according to a Henry Ford Hospital survey of physicians from across the country.

Dispelling an urban legend, new study shows who uses emergency departments frequently

December 3, 2013
While it has often been said that the most frequent users of overburdened hospital emergency departments are mentally ill substance abusers, a study out today (Dec. 3) by researchers from NYU Wagner and the University of ...

Large increase seen in emergency departments visits for traumatic brain injury

May 13, 2014
Between 2006 and 2010, there was a nearly 30 percent increase in the rate of visits to an emergency department for traumatic brain injury, which may be attributable to a number of factors, including increased awareness and ...

Repeat ED visits for opioid overdose raise risk of hospitalization, respiratory failure

March 11, 2014
Patients brought to hospital emergency departments (EDs) more than once in a year for treatment of opioid drug overdoses are more likely to be hospitalized for overdose and to need respiratory support with a mechanical ventilator. ...

Free clinics reduce emergency department visits

January 23, 2013
People who receive primary care from free clinics are less likely to use the emergency department for minor issues, according to a team of medical researchers.

Recommended for you

Marijuana use may not aid patients in opioid addiction treatment

December 4, 2017
Many patients who are being treated for opioid addiction in a medication-assisted treatment clinic use marijuana to help manage their pain and mood symptoms.

For opiate addiction, study finds drug-assisted treatment is more effective than detox

November 23, 2017
Say you're a publicly insured Californian with an addiction to heroin, fentanyl or prescription narcotics, and you want to quit.

Study finds medical cannabis is effective at reducing opioid addiction

November 17, 2017
A new study conducted by researchers at The University of New Mexico, involving medical cannabis and prescription opioid use among chronic pain patients, found a distinct connection between having the legal ability to use ...

Insomnia linked to alcohol-use frequency among early adolescents, says new psychology study

November 8, 2017
Insomnia is linked to frequency of alcohol use among early adolescents, according to new Rutgers University–Camden research.

Large declines seen in teen substance abuse, delinquency

October 25, 2017
More than a decade of data indicates teens have become far less likely to abuse alcohol, nicotine and illicit drugs, and they also are less likely to engage in delinquent behaviors, such as fighting and stealing, according ...

Trying to get sober? NIH offers tool to help find good care

October 3, 2017
The phone calls come—from fellow scientists and desperate strangers—with a single question for the alcohol chief at the National Institutes of Health: Where can my loved one find good care to get sober?

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.