Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment

Edouard Coupet, Gail D'Onofrio, Marek Chawarski, E. Jennifer Edelman, Patrick G. O'Connor, Patricia Owens, Shara Martel, David A. Fiellin, Ethan Cowan, Lynne Richardson, Kristen Huntley, Lauren K. Whiteside, Michael S. Lyons, Richard E. Rothman, Michael Pantalon, Kathryn Hawk

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND Little is known regarding the sociodemographic and clinical characteristics of emergency department (ED) patients with untreated opioid use disorder (OUD) and the relationship of those characteristics with whether they were seeking a referral to substance use treatment at the time of their ED visit. METHODS Using data collected from 2/2017−1/2019 from participants enrolled in Project ED Health (CTN-0069), we conducted a cross-sectional analysis of patients with untreated moderate to severe OUD presenting to one of four EDs in Baltimore, New York City, Cincinnati, or Seattle. Sociodemographic and clinical correlates, and International Classification of Diseases Tenth Revision (ICD-10) diagnosis codes related to opioid withdrawal, injection-related infection, other substance use, overdose, and OUD of those seeking and not seeking a referral to substance use treatment on presentation were compared using univariate analyses. RESULTS Among 394 study participants, 15.2 % (60/394) came to the ED seeking a referral to substance use treatment. No differences in age, gender, education, health insurance status or housing stability were detected between those seeking and not seeking referral to substance use treatment. Those seeking a referral to substance use treatment were less likely to have urine toxicology testing positive for amphetamine [17 % (10/60) vs 31 % (104/334), p = 0.023] and methamphetamine [23 % (14/60) vs 40 % (132/334), p = 0.017] compared to those not seeking a referral. CONCLUSION Most patients with untreated OUD seen in the EDs were not seeking a referral to substance use treatment. Active identification, treatment initiation, and coding may improve ED efforts to address untreated OUD.

Original languageEnglish (US)
Article number108428
JournalDrug and alcohol dependence
Volume219
DOIs
StatePublished - Feb 1 2021

Keywords

  • Brief intervention
  • Emergency department
  • Opioids
  • Referral
  • Screening
  • Substance use
  • Treatment

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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