The United States witnesses an estimated 91 drug overdose deaths a day, which reflects how serious the opioid crisis has become over the years. It is believed that for every fatal overdose involving an opioid, there are approximately 30 nonfatal overdose deaths. Medical experts point out that hospitals can do more to assist overdose patients generally rushed to emergency departments (EDs), such as gauging if the overdose was due to the overprescription of pain pills or if the patient needs help in accessing addiction treatment.
The available resources on addiction treatment mandate attention to both physical and psychological aspects of health. Despite an incredible increase in ED visits due to the rising number of overdose incidents, EDs are often criticized for not addressing addiction or administering addiction-screening measures on the patients.
As a result, they lose an opportunity to assist a high-risk group vulnerable to future overdose deaths. In addition, the lack of basic knowledge of emergency medicine among hospital staff members, weak collaboration with addiction treatment providers and viewing an overdose case as a toxicological problem than as a disorder result in the failure of addressing the underlying cause behind an overdose. At the end, medical practitioners succeed in targeting just the physical aspect of addiction and fail to identify the psychological aspects of the disorder.
Hospitals fall short in providing addiction treatment
According to a paper published in the Journal of the American Medical Association, nonfatal overdoses that receive medical attention provides a unique opportunity for health care providers to address the opioid crisis either by reducing the dosage of opioid prescriptions or by advocating addiction treatment. However, such interventions, particularly among commercially insured patients, remain underutilized.
The researchers conducted a retrospective cohort analysis of two prior studies to find ways to provide access to addiction treatment to nonfatal overdose victims. Referring to a 2000-2012 study that reported high rates of opioid prescription for patients after they had survived a nonfatal opioid overdose. The other study on individuals with opioid use disorder (OUD) who survived an overdose discovered low rates of buprenorphine treatment post-hospitalization. Buprenorphine is one of the three drugs along with naltrexone and methadone that is approved by the U.S. Food and Drug Administration (FDA) to treat opioid addiction.
The participants were divided into three groups. The first group received only a handout for addiction services. The second group received an interview session where they were provided with information on treatment and assistance to connect with a treatment provider. The third group received the same interview along with their first dose of buprenorphine and had appointments scheduled with a primary care provider who offered buprenorphine treatment within 72 hours.
Thereafter, using claims data from Medicaid patients in Pennsylvania with a history of heroin or prescription opioid overdose and the patients’ rates of medication-assisted treatment (MAT) before and after an overdose, the study found out the following facts:
- Among patients who overdosed on heroin, the filling of opioid prescriptions dropped only by 3.5 percent and MAT increased by a meager 3.6 percent.
- Although MAT is appraised as the gold standard of treatment for opioid addiction, only 33 percent of heroin overdose survivors and 15 percent of prescription overdose victims were dispensed buprenorphine, naltrexone or methadone within six months of an overdose.
- Approximately 78 percent of patients in the third group continued their treatment 30 days later compared to the 45 percent in the second group and 37 percent in the first group.
These findings suggest that hospitals fail to guide people admitted for overdosing by not taking effective screening and addiction treatment measures. This has been corroborated by Julie Donohue, senior study author and associate professor of health policy and management at the University of Pittsburgh, “This is a time when people are vulnerable, potentially frightened by this event that’s just occurred and amenable to advise, referral and treatment recommendations.”
Break the addiction cycle
Given the sheer destruction caused by the opioid epidemic, it would make sense to see a decrease in the filling of prescription drugs or an increase in the treatment rates, particularly MAT, among overdose survivors. However, such a trend is yet to become a reality due to lack of knowledge and sufficient facilities to screen addiction during the time of the first visit.
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