BACKGROUND: The number of drug overdoses are at an alarming epidemic level in the US. However, little is known regarding trends of emergency department (ED) visits for drug overdose among persons living with HIV/AIDS (PLWHA), even though this population has been shown to have a higher risk for nonfatal and fatal overdose. This analysis examined trends in ED visits for drug overdose among PLWHA in Illinois from 2009-2015.
METHODS: This study used Illinois ED discharge data as well as HIV/AIDS prevalence data from the Illinois HIV/AIDS Surveillance Program to obtain ED visit rates for drug overdose among PLWHA. Overdose is defined according to the updated March 2016 guidance on ICD code provided by CDC’s Prescription Drug Overdose Prevention for States Program. All analyses were broken down by drug type (opioid/heroin vs other drugs), age, race/ethnicity, and sex.
RESULTS: During 2009–2015, PLWHA averaged 278 ED visits each year for drug overdose, with a visit rate of 67 per 10,000 PLWHA. Twenty three percent of these ED visits were for opioid/heroin overdose (15 visits per 10,000 PLWHA). Whereas ED visit rates remained stable from 2009-2015 for non-opioid overdose and from 2009-2014 for opioid overdose, ED visits for opioid/heroin overdose increased by 51 percent in 2015 as compared to the period 2009-2014. This increase was seen across all age and racial/ethnic groups except among Hispanics. ED visit rates for drug overdoses were similar among male and female PLWHA and highest among persons aged 40–59 (72 visits per 10,000 PLWHA), followed by PLWHA aged 20-39 years, 60 or older, and 13-19 years (65, 50, and 49 visits per 10,000 PLWHA, respectively). African-Americans living with HIV/AIDS had significantly higher visit rates for drug overdose for all drug types than their white and Hispanic counterparts (81 vs 65 and 36 visits per 10,000 PLWHA, respectively, p < 0.05). About two-thirds (65%) of ED visits for drug overdose resulted in hospital admission.
CONCLUSIONS: A significant increase in ED visits for opioid/heroin overdose among PLWHA was observed across all age and racial/ethnic groups in 2015 in Illinois. African-Americans living with HIV/AIDS had significantly higher drug overdose ED visits than other racial/ethnic groups. PLWHA aged 40-59 years had higher ED visits for drug overdose than other age groups.