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1 in 6 OUD Patients Leaving Hospital Before Completing Treatment
One in 6 patients with opioid use disorder (OUD) now leave the hospital before completing treatment, according to a recent study by researchers at the Perelman School of Medicine at the University of Pennsylvania.
Findings from the study were published in JAMA.
The number of patients admitted with OUD and injection-related infections who left the hospital prior to their care team deemed it safe to do so increased significantly from 2016 to 2020, from 9.3% of patients to 17%. The researchers also found that the rate of patients with any opioid-related issues—those presenting with other issues, but who also exhibit opioid dependence—who left the hospital before completing treatment increased by more than half during the same period, from 7.5% of patients to 11.3%.
In both groups, nearly half of discharges before patients were medically advised to leave occurred before the third day of their stay, a period during which withdrawal symptoms are most severe.
The Penn Medicine researchers reviewed nationally representative data from the National Readmissions Database to compare the rate of discharge before medically advised (BMA) in patients admitted for OUD to the BMA discharge rate for non-opioid admissions. Opioid-related admissions were identified as those with opioid use, dependence, abuse, or overdose. Patients with OUD and injection-related infections were included to account for those who were more likely to have severe OUD and fentanyl use.
During the period studied—2016 to 2020—the number of patients admitted with OUD and injection-related infections who left the hospital BMA increased by 82%, and the discharge BMA rate for all opioid-related admissions increased by 50%. Meanwhile, the BMA rate for non-opioid mental health or SUD admissions and all non-opioid admissions increased only marginally.
“These data didn’t allow us to discern which type of opioid that individuals were using when admitted for OUD, but we know that fentanyl, an opioid 25 to 50 times more potent than heroin, has spread in unregulated drug supplies and is now involved in 88% of opioid overdoses in the US,” study lead author Ashish Thakrar, MD, an assistant professor of medicine in Penn Medicine’s division of Internal Medicine.
“Withdrawal symptoms from fentanyl are more difficult to manage than from other opioids like heroin and oxycodone. This study illustrates why we need more research on how to manage individuals withdrawing from fentanyl and other substances in the unregulated drug supply.”
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