Table 2.
Repeat opioid overdosesa among adult Medicaid patients during the first year following a nonfatal overdose.
| Group | Number of Patients N | Person-years at risk | First Repeat Overdose N | Unadjusted Repeat Overdose Rate (per 1000 person-yrs) | Hazard Ratio of Repeat Overdose (95%CI) | Adjusted Hazard Ratio of Repeat Overdoseb (95%CI) |
|---|---|---|---|---|---|---|
|
| ||||||
| Total | 75556 | 48343 | 14263 | 295 | N/A | N/A |
| Age, years | ||||||
| 18–34 | 22399 | 13553 | 3853 | 284 | 1.00 | 1.00 |
| 35–44 | 21411 | 14222 | 4024 | 283 | 1.06 (1.01, 1.11) | 1.06 (1.01, 1.11) |
| 45–64 | 31746 | 20568 | 6386 | 310 | 1.15 (1.10, 1.19) | 1.14 (1.10, 1.19) |
| Sex | ||||||
| Male | 30866 | 19274 | 6095 | 316 | 1.09 (1.06, 1.13) | 1.09 (1.06, 1.13) |
| Female | 44690 | 29069 | 8168 | 281 | 1.00 | 1.00 |
| Race/Ethnicity | ||||||
| Hispanic | 5822 | 3788 | 928 | 245 | 0.80 (0.75, 0.86) | 0.80 (0.75, 0.86) |
| White, non-Hispanic | 52388 | 33107 | 10185 | 308 | 1.00 | 1.00 |
| Black, non-Hispanic | 13030 | 8656 | 2303 | 266 | 0.88 (0.84, 0.92) | 0.87 (0.83, 0.91) |
| Other, non-Hispanicc | 2439 | 1601 | 460 | 287 | 0.95 (0.87, 1.05) | 0.93 (0.84, 1.02) |
| Recent chronic pain condition d | ||||||
| Present | 44508 | 28346 | 9159 | 323 | 1.27 (1.23, 1.32) | 1.25 (1.21, 1.30) |
| Absent | 31048 | 19996 | 5104 | 255 | 1.00 | 1.00 |
| Any recent outpatient visit d | 69993 | 44809 | 13477 | 301 | 1.38 (1.28, 1.48) | 1.36 (1.26, 1.46) |
| Recent clinical diagnoses d | ||||||
| Mental health | 35526 | 22695 | 7431 | 327 | 1.23 (1.19, 1.28) | 1.22 (1.18, 1.27) |
| Substance use | 29011 | 17890 | 6504 | 364 | 1.37 (1.32, 1.42) | 1.38 (1.34, 1.43) |
| Drug use | 26353 | 16251 | 5961 | 367 | 1.36 (1.32, 1.41) | 1.38 (1.33, 1.43) |
| Opioid use | 11998 | 7277 | 2931 | 403 | 1.39 (1.33, 1.45) | 1.47 (1.40, 1.53) |
| Alcohol use | 8954 | 5462 | 1956 | 358 | 1.20 (1.14, 1.26) | 1.19 (1.13, 1.25) |
| Recent MAT c | 1776 | 1054 | 377 | 358 | 1.15 (1.04, 1.28) | 1.17 (1.05, 1.30) |
| Recent prescription medications c | ||||||
| Opioids | 48999 | 31749 | 9681 | 305 | 1.14 (1.10, 1.18) | 1.13 (1.09, 1.17) |
| Opioids within 30 days | 27064 | 17997.2 | 5637 | 313 | 1.15 (1.11, 1.19) | 1.12 (1.09, 1.17) |
| Benzodiazepines | 36952 | 23757 | 7803 | 328 | 1.27 (1.23, 1.31) | 1.25 (1.20, 1.29) |
| Antidepressants | 41926 | 27516 | 8510 | 309 | 1.17 (1.13, 1.21) | 1.15 (1.11, 1.20) |
| Antipsychotics | 19306 | 12727 | 4111 | 323 | 1.17 (1.13, 1.21) | 1.16 (1.12, 1.21) |
| Mood stabilizers | 22422 | 14728 | 4720 | 320 | 1.16 (1.12, 1.20) | 1.14 (1.10, 1.18) |
| Opioid overdose treatment setting | ||||||
| Outpatient | 23531 | 14624 | 5176 | 354 | 1.00 | 1.00 |
| Emergency department | 19758 | 12546 | 3726 | 297 | 0.83 (0.80, 0.87) | 0.83 (0.79, 0.86) |
| Inpatient | 28402 | 18672 | 4569 | 245 | 0.70 (0.67, 0.73) | 0.70 (0.67, 0.73) |
| Opioid overdose drug | ||||||
| Heroin | 14970 | 9389 | 3206 | 342 | 1.17 (1.13, 1.22) | 1.22 (1.16, 1.27) |
| Prescription opioids | 60586 | 38954 | 11057 | 284 | 1.00 | 1.00 |
| Near fatal event | ||||||
| Present | 5179 | 3370 | 632 | 188 | 0.62 (0.57, 0.67) | 0.61 (0.56, 0.66) |
| Absent | 70377 | 44974 | 13631 | 303 | 1.00 | 1.00 |
a
Includes fatal and nonfatal opioid overdoses.
b
Adjusted HRs are from models that control for age, sex, race/ethnicity, and geographic region.
c
Includes American Indian/Alaskan Native, Asian, Native Hawaiian/Other Pacific Islander, and more than one race.
d
During 180 days before the index opioid overdose event. MAT denotes medication assisted treatment.