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. 2017 Jul/Aug;11(4):315-319.
doi: 10.1097/ADM.0000000000000312.

High Mortality Among Patients With Opioid Use Disorder in a Large Healthcare System

Yih-Ing Hser  1 , Larissa J Mooney, Andrew J Saxon, Karen Miotto, Douglas S Bell, Yuhui Zhu, Di Liang, David Huang
Affiliations

High Mortality Among Patients With Opioid Use Disorder in a Large Healthcare System

Yih-Ing Hser et al. J Addict Med. 2017 Jul/Aug.

Abstract

Objectives: Elevated mortality has been observed among individuals with opioid use disorder (OUD) treated in addiction specialty clinics or programs. Information about OUD patients in general healthcare settings is needed in light of the current effort to integrate addiction services into primary healthcare systems. This study examined mortality rates, causes of death, and associated risk factors among patients with OUD in a large general healthcare system.

Methods: Mortality data were linked with electronic health records of 2576 OUD patients cared for in a large university health system from 2006 to 2014.

Results: There were 465 deaths confirmed (18.1% of the study participants), corresponding to a crude mortality rate of 48.6 per 1000 person-years and standardized mortality ratio of 10.3 (95% confidence interval [CI] 9.4-11.3). Drug overdose and disorder (19.8%), cardiovascular diseases (17.4%), cancer (16.8%), and infectious diseases (13.5%, including 12% hepatitis C virus [HCV]) were the leading causes of death. HCV (hazard ratio [HR] 1.99, 95% CI 1.62-2.46) and alcohol use disorder (HR 1.27, 95% CI 1.05-1.55) were 2 clinically important indicators of overall mortality risk. Tobacco use disorder (adjusted HR [AHR] 2.58, 95% CI 1.60-4.17) was associated with increased risk of cardiovascular death, HCV infection (AHR 2.55, 95% CI 1.52-4.26) with cancer mortality risk, and HCV (AHR 1.92, 95% CI 1.03-3.60) and alcohol use disorder (AHR 5.44, 95% CI 2.95-10.05) with liver-related mortality risk.

Conclusions: Patients with OUD in a general healthcare system demonstrated alarmingly high morbidity and mortality, which challenges healthcare systems to find innovative ways to identify and treat patients with substance use disorder.

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Conflict of interest statement

Declaration of Interest: Authors disclosing relevant financial interests, activities, relationships, and affiliations are:

All other authors report no financial or other possible conflicts of interest.

References

    1. Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, Mortality File. Number and age-adjusted rates of drug-poisoning deaths involving opioid analgesics and heroin: United States, 2000–2014. 2016a Available at: http://www.cdc.gov/nchs/data/health_policy/AADR_drug_poisoning_involving.... Published June 30, 2016.
    1. Centers for Disease Control and Prevention. [Accessed October 10, 2016];Alcohol deaths. 2016b Available at http://www.cdc.gov/features/alcohol-deaths/index.html.
    1. Degenhardt L, Bucello C, Mathers B, Briegleb C, Ali H, Hickman M. Mortality among regular or dependent users of heroin and other opioids: a systematic review and meta-analysis of cohort studies. Addiction. 2011;106(1):32–51. - PubMed
    1. Drug Enforcement Administration. 2016 National Drug Threat Assessment Summary, DEA-DCT-DIR-001-17. DEA Strategic Intelligence Section, U.S. Department of Justice; 2016.
    1. Evans E, Li L, Min J, et al. Mortality among individuals accessing pharmacological treatment for opioid dependence in California, 2006–10. Addiction. 2015;110(6):996–1005. - PMC - PubMed