Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2017 Sep 1:178:130-135.
doi: 10.1016/j.drugalcdep.2017.04.030. Epub 2017 Jun 13.

A retrospective review of unintentional opioid overdose risk and mitigating factors among acutely injured trauma patients

Jannette Baird  1 , Mark Faul  2 , Traci C Green  3 , Jonathan Howland  3 , Charles A Adams  4 , Ann George  5 , Michael J Mello  6
Affiliations
Observational Study

A retrospective review of unintentional opioid overdose risk and mitigating factors among acutely injured trauma patients

Jannette Baird et al. Drug Alcohol Depend. .

Abstract

Background: Opioid medication to treat acutely injured patients is usual care in trauma settings. A higher prevalence of alcohol and other substance misuse in this population compared to the general population increases the vulnerability of such patients to both misuse of their prescribed opioids, and also unintentional opioid overdose. The primary purpose of this study was to assess the prevalence of substance use and unintentional opioid overdose risk among acutely injured trauma patients, and to examine the frequency and predictors of high opioid dose at discharge.

Methods: A retrospective electronic medical record (EMR) review of three-months of data from two Level 1 trauma centers. We assessed the prevalence of substance misuse, unintentional opioid overdose risk, and presence of documentation of clinical strategies to mitigate these risks, such as co-prescription of the opioid agonist naloxone.

Results: In total, 352 patient EMRs were examined. Over 40% of the patients reviewed had at least one indication of substance misuse (42.5% [95%CI: 37.3, 47.7]); at least 1 unintentional opioid overdose risk factor was identified in 240 EMR reviewed (68.2% [95%CI: 63.3, 73.1]). Dose of opioid medication was not significantly different for patients with substance misuse versus those without. There was no co-prescription of naloxone for any of the discharged patients.

Conclusions: Our results indicate that despite the high rates of substance misuse, the potential for misuse, dependence and unintentional overdose risk from prescribed opioid medications are prevalent among acutely injured trauma patients. Prescribing after acute trauma care should address these risk factors.

Keywords: Alcohol and other substance use; Opioid medication; Risk factors; Traumatic injury.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

No conflict declared.

Figures

Fig. 1
Fig. 1
Schematic of the extracted electronic medical record review categories and content.
See this image and copyright information in PMC

References

    1. American Hospital Association. [Accessed 20 May 2016];2016 URL http://www.aha.org/content/16/opiodneedtoknow.pdf.
    1. Bohnert AS, Valenstein M, Bair MJ, Ganoczy D, McCarthy JF, Ilgen MA, Blow FC. Association between opioid prescribing patterns and opioid overdose-related deaths. JAMA. 2011;305:1315–1321. doi: 10.1001/jama.2011.370. - DOI - PubMed
    1. Center for Behavioral Health Statistics and Quality. Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. 2016 (HHS Publication No. SMA 16–4984, NSDUH Series H-51). Retrieved from. http://www.samhsa.gov/data/
    1. Centers for Disease Control and Prevention. Vital signs: overdoses of prescription opioid pain relievers–United States, 1999–2008. [Accessed 05 June 2016];MMWR Morb Mortal Wkly Rep. 2011 60:1487–1492. - PubMed
    1. Centers for Disease Control and Prevention. CDC grand rounds: prescription drug overdoses – a U.S. epidemic. [Accessed 04 January 2016];MMWR Morb Mortal Wkly Rep. 2012 61:10–13. - PubMed

Publication types

MeSH terms

LinkOut - more resources