Risk of non-medical drug overdose following prescription of opioids post-injury: A retrospective cohort study.

IF 2.7 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Health Reports Pub Date : 2022-07-20 DOI:10.25318/82-003-x202200700001-eng

Alex Zheng, Aamir Bharmal, Fahra Rajabali, Kate Turcotte, Larry Thomas, Len Garis, Ian Pike

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Abstract

Background: There has been increasing scrutiny of opioid prescribing following injury because of concerns that prescribed opioids may contribute to addiction and overdose. This study aimed to better understand the relationship between injury, opioids prescribed before and after injury, and non-medical drug poisoning.

Data and methods: Working age (15 to 65 years old) residents of British Columbia's Fraser Health region with an injury that involved an emergency department visit were included. Factors examined included the prescription of opioid and opioid agonist therapy (OAT) medications before and after injury, age, sex, work-related injuries, and socioeconomic status, as well as how they were associated with non-medical drug poisoning risk and post-injury prescriptions.

Results: Opioid-naive individuals (those without an opioid prescription captured before their injury) who were prescribed OAT medication-a marker of opioid use disorder-following their injury had a higher risk of subsequent non-medical drug poisoning (Hazard ratio (HR): 21.4 to 22.4 compared with opioid-naive individuals without an opioid or OAT prescription). Post-injury opioid prescription in these individuals increased poisoning risk (HR: 1.27 compared with those without a prescription). Being of male sex (HR: 1.80), being younger (HR: 0.76 for every 10-year increase in age) and living in the lowest-income neighbourhoods (HR: 1.44 compared with the middle quintile) increased poisoning risk. Compared with injuries sustained outside of work, work-related injuries reduced risk (HR: 0.62).

Interpretation: Among a cohort of British Columbians visiting emergency departments following an injury, opioid prescribing in patients who were opioid-naive appears to be a minor contributor to non-medical drug poisoning, particularly when compared with other patient factors, such as being male, being younger and having a low socioeconomic status.

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损伤后阿片类药物处方后非医疗药物过量的风险:一项回顾性队列研究

背景:由于担心阿片类药物处方可能导致成瘾和过量，对损伤后阿片类药物处方的审查越来越多。本研究旨在更好地了解损伤、损伤前后处方阿片类药物与非医疗药物中毒之间的关系。数据和方法:研究对象为不列颠哥伦比亚省弗雷泽健康区的工作年龄(15至65岁)居民，他们的受伤涉及到急诊室就诊。研究的因素包括阿片类药物和阿片类激动剂治疗(OAT)药物在受伤前后的处方、年龄、性别、工伤和社会经济地位，以及它们与非医疗药物中毒风险和伤后处方的关系。结果:与没有阿片类药物或OAT处方的阿片类药物初始个体相比，在受伤后服用OAT药物(阿片类药物使用障碍的标志)的个体随后发生非医疗药物中毒的风险更高(风险比(HR): 21.4至22.4)。这些人在受伤后服用阿片类药物增加了中毒风险(与没有处方的人相比，HR: 1.27)。男性(HR: 1.80)、年轻(HR: 0.76，每10年增加一次)和生活在最低收入社区(HR: 1.44，与中间五分位数相比)增加了中毒风险。与工作以外的伤害相比，工伤降低了风险(HR: 0.62)。解释:在一组不列颠哥伦比亚省受伤后到急诊室就诊的患者中，未接触阿片类药物的患者开阿片类药物处方似乎是导致非医疗药物中毒的次要因素，特别是与其他患者因素(如男性、年轻和社会经济地位低)相比。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Reports PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

4.00%

发文量

期刊介绍： Health Reports publishes original research on diverse topics related to understanding and improving the health of populations and the delivery of health care. We publish studies based on analyses of Canadian national/provincial representative surveys or Canadian national/provincial administrative databases, as well as results of international comparative health research. Health Reports encourages the sharing of methodological information among those engaged in the analysis of health surveys or administrative databases. Use of the most current data available is advised for all submissions.