![[ Visit Client Website ]](images/banner.png)
BACKGROUND: The use and abuse of opioids, especially prescription opioids, continues to rise and opioid overdose hospitalizations are correspondingly increasing. Naloxone (Narcan) is a safe and effective opioid overdose reversal drug. The purpose of this study is to determine if the timing of naloxone administration affects the discharge disposition for opioid overdose hospitalization patients.
METHODS: Opioid overdose hospitalizations in Utah during 2011 were analyzed for relationships between explanatory variables and discharge disposition. Nominal data analyses were conducted with chi-square tests for significance. Multivariable logistic regression was used to calculate odds ratios for patients being discharged home.
RESULTS: In most cases, patients were not administered naloxone. The biggest disparity in naloxone administration was observed among suicide attempts, where more than half of the individuals (51.9%) were not given naloxone. There was an inverse relationship between age and rates of being discharged home. Suicide attempt (50.4%) was the only characteristic where patients were less likely to be discharged home. A significant interaction existed between naloxone administration and intent. A difference was present for hospitalizations of accidental intent; when naloxone was given to the patient by emergency medical services (EMS), that patient was nearly twice as likely to be discharged home than if they were not given naloxone (OR = 1.93). If naloxone was administered to an accidental overdose patient at the hospital, the patient was less likely to be discharged home than if naloxone had not been given (OR = 0.81). Finally, if an accidental overdose patient is given naloxone by EMS compared to hospital staff, that patient was two and a half times more likely to be discharged home than not (OR = 2.40).
CONCLUSIONS: In Utah during 2011, over half of all opioid overdose hospitalizations were accidents. When naloxone is administered to accidental overdose patients by EMS, the likelihood of the patient being discharged home increases. Prevention efforts should be aimed at increasing opioid overdose awareness and rates of naloxone administration, especially in instances of accidental overdose. Laws that expand authority and provide protection for the administration of naloxone should be passed to improve opioid overdose outcomes.