Better strategies to ID people at risk for opioid-related overdose deaths needed, study suggests
Every day, as the opioid epidemic continues to grip the country, more than 115 people in the United States die from overdoses, according to the Centers for Disease Control and Prevention. A new study by Gerardo Gonzalez, MD, associate professor of psychiatry, examines how one health care system may have missed opportunities to prevent overdose deaths, providing a valuable analysis that may give key insight for all providers to help stem the number of fatal overdoses. The findings were published online on Oct. 24 in Psychiatric Services.
Dr. Gonzalez, director of the Division of Addiction Psychiatry, and his team reviewed the clinical characteristics and health services of 112 people who had a documented opioid overdose at UMass Memorial Medical Center in Worcester one year prior to their death, from 2008 to 2012. They found 50 percent of the patients who died from opioid overdose were well identified by their providers as having an active opioid use disorder, or displaying misuse of their prescription opioids. The other half were more likely to have chronic pain and mental health issues, but were not clearly identified as being at any risk related to opioid use, and thus did not receive appropriate attention.
"The implication of these results is that while UMass Memorial Medical Center, prior to the opioid epidemic, was identifying people with an opioid use disorder, there's room to improve the overall therapeutic management of this identified high-risk patient," Gonzalez said. "The other implication of the study is the need to confirm the existence of a possible silent, but still high-risk group and to develop better identification strategies to improve their care."
Gonzalez said his department is implementing new strategies to improve how the health care system and the city of Worcester address the impact of the opioid epidemic in the community. One new program is starting at UMass Memorial Medical Center on Jan. 1, led by Alan P. Brown, MD, professor of psychiatry. Dr. Brown received a grant to implement medication-assisted treatment for patients who come into the emergency department with an opioid overdose or an untreated opioid use disorder.
More information: Christian Rose et al. Mortality Associated With Opioid Overdose: A Review of Clinical Characteristics and Health Services Received in the Year Prior to Death, Psychiatric Services (2018). DOI: 10.1176/appi.ps.201800122