Opioid Abuse And Poisoning: Trends In Inpatient And Emergency Department Discharges

doi:10.1377/hlthaff.2017.0260

. 2017 Oct 1;36(10):1748-1753.

doi: 10.1377/hlthaff.2017.0260.

Opioid Abuse And Poisoning: Trends In Inpatient And Emergency Department Discharges

Dario Tedesco¹, Steven M Asch², Catherine Curtin³, Jennifer Hah⁴, Kathryn M McDonald⁵, Maria P Fantini⁶, Tina Hernandez-Boussard⁷

Affiliations

¹ Dario Tedesco is a postdoctoral scholar in the Department of Medicine, Stanford University, in California.
² Steven M. Asch is director of the Center for Innovation to Implementation at the Veterans Affairs Palo Alto Health Care System and vice chief of the Division of Primary Care and Population Health at Stanford University.
³ Catherine Curtin is an associate professor of surgery at Palo Alto Veterans Affairs Hospital and at Stanford University School of Medicine.
⁴ Jennifer Hah is an instructor of anesthesiology at Stanford University School of Medicine.
⁵ Kathryn M. McDonald is executive director of the Center for Health Policy and the Center for Primary Care Outcomes Research at Stanford University.
⁶ Maria P. Fantini is a professor of hygiene and public health in the Department of Biomedical and Neuromotor Sciences at the University of Bologna, in Italy.
⁷ Tina Hernandez-Boussard (boussard@stanford.edu) is an associate professor of medicine, biomedical data sciences, and surgery at Stanford University School of Medicine.

PMID: 28971919
PMCID: PMC6679922
DOI: 10.1377/hlthaff.2017.0260

Opioid Abuse And Poisoning: Trends In Inpatient And Emergency Department Discharges

Dario Tedesco et al. Health Aff (Millwood). 2017.

. 2017 Oct 1;36(10):1748-1753.

doi: 10.1377/hlthaff.2017.0260.

Authors

Dario Tedesco¹, Steven M Asch², Catherine Curtin³, Jennifer Hah⁴, Kathryn M McDonald⁵, Maria P Fantini⁶, Tina Hernandez-Boussard⁷

Affiliations

¹ Dario Tedesco is a postdoctoral scholar in the Department of Medicine, Stanford University, in California.
² Steven M. Asch is director of the Center for Innovation to Implementation at the Veterans Affairs Palo Alto Health Care System and vice chief of the Division of Primary Care and Population Health at Stanford University.
³ Catherine Curtin is an associate professor of surgery at Palo Alto Veterans Affairs Hospital and at Stanford University School of Medicine.
⁴ Jennifer Hah is an instructor of anesthesiology at Stanford University School of Medicine.
⁵ Kathryn M. McDonald is executive director of the Center for Health Policy and the Center for Primary Care Outcomes Research at Stanford University.
⁶ Maria P. Fantini is a professor of hygiene and public health in the Department of Biomedical and Neuromotor Sciences at the University of Bologna, in Italy.
⁷ Tina Hernandez-Boussard (boussard@stanford.edu) is an associate professor of medicine, biomedical data sciences, and surgery at Stanford University School of Medicine.

PMID: 28971919
PMCID: PMC6679922
DOI: 10.1377/hlthaff.2017.0260

Abstract

Addressing the opioid epidemic is a national priority. We analyzed national trends in inpatient and emergency department (ED) discharges for opioid abuse, dependence, and poisoning using Healthcare Cost and Utilization Project data. Inpatient and ED discharge rates increased overall across the study period, but a decline was observed for prescription opioid-related discharges beginning in 2010, while a sharp increase in heroin-related discharges began in 2008.

Keywords: Opioid epidemic; Pharmaceuticals.

Project HOPE—The People-to-People Health Foundation, Inc.

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Figures

**EXHIBIT 1. Population-based inpatient (1997–2014) and emergency department (ED) (2006–14) discharges for prescription opioid and heroin poisoning in the United States, by diagnostic group**
**SOURCE** Authors’ analysis of data for 1997–2014 from the Healthcare Cost and Utilization Project. **NOTES** Discharge rates were calculated per 1 00,000 population. Annual percentage changes (APCs) over time for the different diagnostic groups were estimated using a full-forward Joinpoint regression. Inpatient prescription opioid APCs showed a significant increase (p < 0.001) between 1997 and 2010 and a significant decrease (p < 0.05) between 2010 and 2014. ED prescription opioid APCs showed a significant increase (p < 0.05) between 2006 and 2010 and a significant decrease (p < 0.05) between 2010 and 2014. Inpatient heroin APCs showed a significant increase (p < 0.001) between 2008 and 2014. ED heroin APCs showed a significant increase (p < 0.001) between 2009 and 2014.

**EXHIBIT 3. Population-based inpatient (1997–2014) and emergency department (ED) (2006–14) discharges for opioid dependence, abuse, and poisonings in the United States**
**SOURCE** Authors’ analysis of data for 1997–2014 from the Healthcare Cost and Utilization Project. **NOTE** Although the exhibit shows discharges per 100,000 people, annual percentage changes (APCs) over time for the different diagnostic groups were estimated using a full-forward Joinpoint regression. Inpatient both, ED both, inpatient dependence only, and inpatient abuse only APCs showed a significant increase (p < 0.001) over the study period. ED dependence APCs showed a significant increase (p < 0.001) between 2006 and 2012. ED abuse APCs showed a significant increase (p < 0.001) between 2008 and 2014.

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References

1. Bosman J Inside a killer drug epidemic: a look at America’s opioid crisis. New York Times. 2017. January 6.
1. Williams AR, Bisaga A. From AIDS to opioids—how to combat an epidemic. N Engl J Med. 2016;375(9):813–5. - PMC - PubMed
1. Murthy VH. Ending the opioid epidemic—a call to action. N Engl J Med. 2016;375(25):2413–5. - PubMed
1. Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry. 2014;71(7): 821–6. - PubMed
1. Phillips DM. JCAHO pain management standards are unveiled. Joint Commission on Accreditation of Healthcare Organizations. JAMA. 2000;284(4):428–9. - PubMed

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[1] Bosman J Inside a killer drug epidemic: a look at America’s opioid crisis. New York Times. 2017. January 6.

[2] Bosman J Inside a killer drug epidemic: a look at America’s opioid crisis. New York Times. 2017. January 6.

[3] Williams AR, Bisaga A. From AIDS to opioids—how to combat an epidemic. N Engl J Med. 2016;375(9):813–5. - PMC - PubMed

[4] Williams AR, Bisaga A. From AIDS to opioids—how to combat an epidemic. N Engl J Med. 2016;375(9):813–5. - PMC - PubMed

[5] Murthy VH. Ending the opioid epidemic—a call to action. N Engl J Med. 2016;375(25):2413–5. - PubMed

[6] Murthy VH. Ending the opioid epidemic—a call to action. N Engl J Med. 2016;375(25):2413–5. - PubMed

[7] Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry. 2014;71(7): 821–6. - PubMed

[8] Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry. 2014;71(7): 821–6. - PubMed

[9] Phillips DM. JCAHO pain management standards are unveiled. Joint Commission on Accreditation of Healthcare Organizations. JAMA. 2000;284(4):428–9. - PubMed

[10] Phillips DM. JCAHO pain management standards are unveiled. Joint Commission on Accreditation of Healthcare Organizations. JAMA. 2000;284(4):428–9. - PubMed

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Opioid Abuse And Poisoning: Trends In Inpatient And Emergency Department Discharges

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Opioid Abuse And Poisoning: Trends In Inpatient And Emergency Department Discharges

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