Defining the Correlation Between Heroin Overdose and Length of Hospital Admissions

Abstract

Background:: Heroin has had an overwhelming impact on public welfare and health resources. National surveillance data indicate a 25% increase in drug overdose deaths in Ohio between 2012 and 2017, ranking the state second in terms of drug overdose deaths associated with opioids. Objective:: The primary objective of this evaluation was to determine the length of hospital stay in suspected or confirmed heroin overdose. Methods:: This retrospective analysis evaluated adult patients presenting to the emergency department (ED) at Mercy Health St Vincent Medical Center with confirmed or suspected heroin overdose. Patient data were obtained from the International Classification of Diseases, 10th revision, code reports. The study site is a 462-bed academic medical center with a level 1 trauma designation located in downtown Toledo, OH. Results:: One-hundred and one patients were included in this study: 49 presented to the ED and were subsequently admitted, while 52 were evaluated in the ED and discharged. No statistically significant differences in demographic data were identified. The average length of stay for admitted patients was 4.39 days (range = 0-22 days) with an average of 1.91days in the intensive care unit and 2.48 days on a general medicine floor. Higher average amounts of naloxone administered prior to presentation to the ED were found to predict an admission to the intensive care unit (6.48 mg vs 2.43 mg, P = .0208). The most frequent necessary interventions were central line placement (16/49, 32.7%) and mechanical ventilation (15/49, 30.6%). Seven patients (14.3%) experienced a cardiac arrest. Conclusion:: Heroin overdoses continue to require emergent interventions and consume numerous health care resources. Investment in strategies for prevention of overdose and the subsequent utilization of resources is paramount in controlling the heroin epidemic in Ohio and nationally.

Overdose and take‐home naloxone in emergency settings: A pilot study examining feasibility of delivering brief interventions addressing overdose prevention with ‘take‐home naloxone’ in emergency departments

“…Differences between study sites in relation to overdose management, length of stay and frequency of admissions likely reflect variances in patient cohorts and ED protocols. Many of the overdoses in the present study required ambulance callouts, complex and/or multiple hospital‐based interventions and long hospital stays, reflecting the substantial health burden associated with opioid overdose 28,29 . The COVID‐19 pandemic has the potential to further increase this burden, as has occurred in the United States where opioid overdose‐related ED presentations increased significantly during COVID‐19 lockdowns 30 .…”

“…Many of the overdoses in the present study required ambulance callouts, complex and/or multiple hospitalbased interventions and long hospital stays, reflecting the substantial health burden associated with opioid overdose. 28,29 The COVID-19 pandemic has the potential to further increase this burden, as has occurred in the United States where opioid overdose-related ED presentations increased significantly during COVID-19 lockdowns. 30 This is an opportune time for Australian EDs to prepare for an increase in overdose presentations and strengthen overdose prevention through delivery of THN-BI.…”