Patel Sapan, Sheikh Asad, Nazir Natasha, Monro Shannon, Anwar Ammaar
Epidemiology, Touro College of Osteopathic Medicine, Middletown, USA.
Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA.
Cureus. 2020 Nov 16;12(11):e11498. doi: 10.7759/cureus.11498.
Background The opioid crisis in the United States of America has been worsening due to previous sharp increases in opioid prescriptions and a lack of resources available to those affected. Emergency departments (ED) across the nation have been exhausted with a constant influx of patients related to opioid-related issues. Because of limited resources, it is crucial to efficiently distribute rehabilitation and mental wellness efforts amongst those most susceptible to opioid abuse. By identifying common environments and characteristics of the population presenting to ED's for opioid-related issues, we can (1) lessen the economic burden on the healthcare system while (2) increasing the rate of successful treatment for those affected by opioid addiction. Methods Data was obtained regarding ED visits for opioid-related issues at the level of all 50 states from the Healthcare Cost and Utilization Project's (HCUP) State Emergency Department Databases (SEDD) and nationally from the Nationwide Emergency Department Sample (NEDS). Rates of ED admissions for opioid-related issues were statistically analyzed to identify characteristics of the population that are most at risk for presenting to the ED for opioid-related issues. Results Statistical analysis showed residents of Large Metropolitan areas (M=351.94, p=0.022, CI±42.89), those earning incomes below the 25th percentile (M=359.14, p=0.008, CI ±61.39), and 25-44-year-old population (M=456.71, p=0.001, CI±27.01) to be the most likely subset of the population to report to the ED for opioid-use issues. Conversely, those earning incomes above the 75th percentile were significantly less likely to utilize ED's for opioid-related issues (M=143.10, p=0.026, CI±0.026). Conclusion Results demonstrated that patients between the ages of 25 and 44 were more likely to develop opioid use disorders. This provides an opportunity to educate this population via opioid education centers. Additionally, residents of Large Metropolitan areas would benefit from naloxone distribution centers. Lastly, higher income levels appear to be related to a decrease in ED presentation for opioid abuse. This provides evidence for medication-assisted therapy (MAT) to be provided by low-income insurance plans.
背景 由于之前阿片类药物处方急剧增加以及受影响者可获得的资源匮乏，美利坚合众国的阿片类药物危机一直在恶化。全国各地的急诊科因与阿片类药物相关问题的患者不断涌入而不堪重负。由于资源有限，在最易遭受阿片类药物滥用的人群中有效分配康复和心理健康工作至关重要。通过识别因阿片类药物相关问题前往急诊科就诊的人群的常见环境和特征，我们可以（1）减轻医疗系统的经济负担，同时（2）提高阿片类药物成瘾者的成功治疗率。方法 从医疗保健成本与利用项目（HCUP）的州急诊科数据库（SEDD）获取了关于所有50个州因阿片类药物相关问题的急诊科就诊数据，并从全国急诊科样本（NEDS）获取了全国范围的数据。对因阿片类药物相关问题的急诊科入院率进行了统计分析，以确定最有可能因阿片类药物相关问题前往急诊科就诊的人群特征。结果 统计分析显示，大城市地区居民（M = 351.94，p = 0.022，CI±42.89）、收入低于第25百分位数的人群（M = 359.14，p = 0.008，CI ±61.39）以及25至44岁人群（M = 456.71，p = 0.001，CI±27.01）是最有可能因阿片类药物使用问题前往急诊科就诊的人群子集。相反，收入高于第75百分位数的人群因阿片类药物相关问题使用急诊科的可能性显著降低（M = 143.10，p = 0.026，CI±0.026）。结论 结果表明，25至44岁的患者更有可能患上阿片类药物使用障碍。这为通过阿片类药物教育中心对该人群进行教育提供了机会。此外，大城市地区居民将受益于纳洛酮分发中心。最后，较高收入水平似乎与因阿片类药物滥用前往急诊科就诊的人数减少有关。这为低收入保险计划提供药物辅助治疗（MAT）提供了证据。
