The Grapevine

Opioid-Related Overdoses And Deaths Are On The Rise In The ICU: Study

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The rate of opioid hospitalizations and overdose deaths has only gotten worse in the past few years, new research finds. Pixabay, Public Domain

New research presented this week at the American Thoracic Society’s annual meeting suggests that the ongoing opioid crisis is making waves across the country’s intensive care units (ICU) every bit as much as it is inside people’s homes.

The authors analyzed hospital admissions from 2011 to 2015 for adults over the age of 18 in a nationwide healthcare system, Vizient, Inc. Out of 272 hospitals, there were 17.6 million admissions throughout the study period, with 41,369 related to an opioid overdose. While that figure may seem miniscule in the grand scheme of things, the rate of opioid-related admissions has steadily increased 42 percent since 2009. The percentage of people who died from their overdoses also increased, from 3.1 percent in 2011 to 5.1 percent in 2015, and a similar rise in mortality was seen when looking only at ICU admissions. In 2011, there were 3.7 overdose deaths per every 10,000 ICU admissions compared to 7.3 deaths in 2015.

“The national trends in opioid-related overdoses are seen in the rising ICU admissions and mortality among this population in the past 5 years,” concluded the authors.

According to the study’s lead author Dr. Jennifer Stevens, the rise in admissions hasn’t hit all areas of the country equally.

"Pennsylvania and North Carolina have nearly doubled the number of ICU discharges for opioid overdose in the past seven years," said Stevens, a pulmonologist at the Beth Israel Deaconess Medical Center in Boston, in a statement. "This suggests that there may be an opportunity for hospitals and communities in these states to get ahead of the critical care needs of this population and to help first-line responders prevent future admissions to the ICU."

In recent months, public health agencies such as the Centers for Disease Control and Prevention have attempted to curtail opioid abuse, particularly for prescription painkillers. Earlier this April, the CDC issued new guidelines for prescribing the drugs. Some of these include avoiding treatment courses for longer than a week, with three days or fewer being preferred, and only at the lowest possible doses.

But Chief Quality Officer at the University of Chicago Medicine Dr. Michael Howell, a fellow co-author of the study, believes we can do more to help patients who have already succumbed to addiction or other opioid-related health problems.

"Hospitals that are seeing rising volumes of overdose and opioid-dependent admissions can help by increasing training for clinicians in addiction management, and by working to devise strategies that support patients and families in the hospital, and as they transition loved ones from the critical care environment to outpatient addiction treatment," he said. "Greater national funding to support community efforts that help survivors and improve resources for patients and families is essential for these efforts to move forward and succeed."

A study published earlier this May, also from researchers at the Beth Israel Deaconess Medical Center, similarly found that opioid-related hospitalizations have risen 72 percent from 2002 to 2012, with the total price tag coming out to $15 billion in 2012. Elsewhere, research from the CDC released this past December found that overdose deaths reached 47,055, a new high in 2014, with opioids responsible for 61 percent of these deaths.

Source: Stevens J, Wall M, Hsu D, et al. The Critical Care Crisis of Opioid Overdoses in the U.S. Annual Meeting of American Thoracic Society. 2016.

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