Low rate of naloxone prescribing in US patients with opioid use disorder
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Low rate of naloxone prescribing in US patients with opioid use disorder The rate of naloxone prescribing for the treatment of opioid overdose appears to be low in patients with suspected opioid use disorder (OUD) who visit an Emergency Department (ED) in the US, according to findings of a study published in the American Journal of Emergency Medicine. Data from electronic health records at an academic ED in a region in the US with a high prevalence of OUD were used to investigate the rate of naloxone prvision between January 2018 and November 2019 in 1036 adults 18 years of age and over who were administered buprenorphine in the ED for OUD and/or referred for outpatient substance abuse treatment. The ED was stocked with naloxone kits which were available free-of-charge for ED patients. Naloxone was provided or prescribed to 30.9% of patients overall, including 33.6% of those who were not administered buprenorphine in the ED but were referred for outpatient substance use treatment, 17.6% of those who administered buprenorphine in the ED and were referred for outpatient treatment, and 10.6% of those who administered buprenorphine in the ED and were not referred for outpatient treatment. After adjusting for age, sex, race and previous naloxone treatment, buprenorphine administration significantly decreased the odds of naloxone provision versus referral for outpatient treatment only (adjusted odds ratio 0.06; 95% CI 0.011, 0.33). "Emergency physicians who suspect OUD, as evidenced by active interventions, do not provide naloxone to patients at discharge in the majority of encounters . . . Evidence for association of buprenorphine treatment with lower odds of naloxone provision suggests a treatment "bundle" for suspected OUD may be a helpful conceptual model to promote high-quality, comprehensive ED care for patients with potential OUD," concluded the authors. Lane BH, et al. Naloxone provision to emergency department patients recognized as high-risk for opioid use disorder. American Journal of Emergency Medicine : 11 Nov 803521023 2020. Available from: URL: http://doi.org/10.1016/j.ajem.2020.10.061
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Reactions 12 Dec 2020 No. 1834
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