NIH study finds link between emergency dept. overdose visits, suicide risk

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A study from the National Institutes of Health has found that patients who are admitted to hospital emergency departments for drug overdoses are more likely to die by suicide than others in the general population.

The findings, published in the American Journal of Preventive Medicine, found that emergency department patients admitted for opioid overdoses were 100 times more likely to die by drug overdose within a year after their discharge, and 18 times more likely to die of suicide.

The findings point to the need for interventions to reduce the risk of suicide and overdose while patients are in the hospital, the study authors said.

“We knew that nonfatal opioid and sedative/hypnotic drug overdoses were a major cause of disease. What these new findings show is that overdose patients also face an exceptionally high risk of subsequent death—not just from an unintentional overdose, but also from suicide, non-suicide accidents, and natural causes,” said Sidra Goldman-Mellor, Ph.D., lead study author and assistant professor of public health at the University of California, Merced.

By looking at all discharge data for visits to emergency departments in the state of California between 2009 and 2011, and matching that data on cause of death on death records from the California Department of Public Health for all individuals between 2009 and 2012, researchers were able to focus on those who had been admitted for an opioid overdose or for a sedative/hypnotic drug overdose.

Researchers found that the death rate for patients who had visited the emergency departments for sedative/hypnotic drug overdoses and died in the following year was 18,080 per 100,000, while the death rate for those who came to the emergency department with an opioid overdose had a death rate the following year of 10,620 per 100,000 patients. Researchers found that the death rate for a demographically matched group of Californians was 3,236 per 100,000.

For those patients who had visited emergency departments with opioid overdoses and died the following year, the death rate for unintentional overdose was 1,863 per 100,000, 100 times higher than the general population. And the death rate for suicide was 319 per 100,000, 18 times higher than the general population.

The death rate of unintentional death by drug overdose the following year for those who had visited the emergency department for sedative/hypnotic overdose was 342 per 100,000 – 24 times higher than the general population – while the death rate of those who died by suicide was 174 per 100,000 – almost nine times higher than the general population.

“There are already promising emergency department-based interventions that could reduce overdose and other mortality risks, such as suicide, among these patients, but such interventions need to be much more widely implemented,” Goldman-Mellor said. “Moreover, those interventions should target not just patients overdosing on opioids, but also those overdosing on sedative/hypnotic drugs, since their mortality risks were also very high.”

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