Multiple ER Visits Linked to Risk of Prescription-Drug Overdose Death

Researcher sees 'important window' of opportunity for intervention

By Robert Preidt

Thursday, May 14, 2015

THURSDAY, May 14, 2015 (HealthDay News) -- Frequent visits to emergency departments appear to be a predictor of death from a prescription drug overdose, a new study finds.

People with four or more ER visits in the past year were 48 times more likely to die of prescription drug overdose compared to those who visited an ER once or not at all, researchers found. With three visits a year, the risk of overdose death from a prescription drug was 17 times greater.

The study, by researchers at Columbia University's Mailman School of Public Health, was recently published online in the journal Annals of Epidemiology.

"While 'doctor-shopping' -- the practice of visiting multiple health care providers to obtain controlled substances -- has been shown to be associated with prescription drug overdose in many studies, our investigation demonstrates that the frequency of emergency department visits in the past year is a strong predictor of subsequent death from prescription drug overdose," first author Joanne Brady, an adjunct assistant professor of epidemiology, said in a university news release.

Brady's team analayzed data from more than 5,400 people who visited ERs in New York State between 2006 and 2010.

The risk of death from prescription drug overdose was highest among patients with substance abuse disorders or other psychiatric disorders, men, whites and those aged 35 to 54, the study found.

Also, ER patients who later died of a prescription drug overdose were more likely to have been discharged against initial medical advice at the initial ER visit.

Nearly 60 percent of drug overdose deaths involved prescription drugs, according to the news release. In 2011, improper use of prescription drugs led to 1.4 million ER visits in the United States.

"Emergency department visits may serve as an important window of opportunity for identifying patients at heightened risk of prescription drug overdose and for implementing evidence-based intervention programs," study senior author Dr. Guohua Li, a professor of epidemiology, said in the news release. These actions include providing patients and their families with take-home naloxone (Narcan), a drug used to treat overdose, and drug treatment referral, he said.

SOURCE: Columbia University, news release, May 11, 2015

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