Table 4.
Cox proportional hazards regression models of fatal opioid overdose during year following opioid overdose events for adult Medicaid patients with and without recent opioid prescriptions.
| Characteristic | Total Adjusted HR (95% CI) | With Opioid Prescriptions Adjusted HR (95% CI) | Without Opioid Prescriptions Adjusted HR (95% CI) | Interaction P-value |
|---|---|---|---|---|
|
| ||||
| Age, years | ||||
| 18–34 | 1.00 | 1.00 | 1.00 | N/A |
| 35–44 | 1.63 (1.33, 1.99) | 1.56 (1.22, 1.99) | 1.67 (1.18, 2.38) | 0.20 |
| 45–64 | 1.64 (1.36, 1.99) | 1.48 (1.17, 1.87) | 1.93 (1.39, 2.67) | 0.86 |
| Sex | ||||
| Male | 1.43 (1.24, 1.65) | 1.62 (1.36, 1.93) | 1.11 (0.86, 1.45) | 0.007 |
| Female | 1.00 | 1.00 | 1.00 | N/A |
| Race/Ethnicity | ||||
| Hispanic | 0.58 (0.42, 0.82) | 0.55 (0.34, 0.88) | 0.68 (0.42, 1.09) | 0.98 |
| White, non-Hispanic | 1.00 | 1.00 | 1.00 | N/A |
| Black, non-Hispanic | 0.50 (0.40, 0.63) | 0.52 (0.39, 0.71) | 0.48 (0.33, 0.70) | 0.46 |
| Other, non-Hispanica | 0.57 (0.33, 0.97) | 0.75 (0.43, 1.31) | 0.15 (0.02, 1.08) | 0.06 |
| Recent chronic pain condition b | ||||
| Present | 1.26 (1.08, 1.48) | 1.24 (1.004, 1.53) | 1.20 (0.91, 1.57) | 0.77 |
| Absent | 1.00 | 1.00 | 1.00 | N/A |
| Any recent outpatient visit b | 0.96 (0.73, 1.27) | 0.67 (0.43, 1.04) | 1.03 (0.72, 1.48) | 0.26 |
| Recent clinical diagnoses b | ||||
| Mental healthb | 1.22 (1.06, 1.41) | 1.20 (1.003, 1.43) | 1.24 (0.95, 1.61) | 0.54 |
| Substance use | 1.30 (1.12, 1.50) | 1.38 (1.16, 1.64) | 1.11 (0.84, 1.46) | 0.02 |
| Drug use | 1.24 (1.06, 1.44) | 1.32 (1.10, 1.57) | 1.05 (0.79, 1.39) | 0.02 |
| Opioid use | 1.24 (1.01, 1.51) | 1.37 (1.08, 1.74) | 1.02 (0.72, 1.44) | 0.03 |
| Alcohol use | 1.35 (1.11, 1.65) | 1.52 (1.20, 1.91) | 1.01 (0.68, 1.49) | 0.01 |
| Recent MAT c | 0.79 (0.47, 1.35) | 0.64 (0.29, 1.45) | 0.98 (0.48, 2.00) | 0.64 |
| Recent prescription medications b | ||||
| Benzodiazepines | 1.71 (1.46, 1.99) | 1.69 (1.38, 2.06) | 1.75 (1.34, 2.29) | 0.54 |
| Antidepressants | 1.23 (1.06, 1.43) | 1.32 (1.08, 1.61) | 1.05 (0.80, 1.38) | 0.19 |
| Antipsychotics | 1.32 (1.13, 1.54) | 1.37 (1.14, 1.64) | 1.15 (0.84, 1.58) | 0.14 |
| Mood stabilizers | 1.30 (1.11, 1.51) | 1.27 (1.06, 1.51) | 1.34 (0.98, 1.84) | 0.93 |
| Opioid poisoning treatment setting | ||||
| Outpatient | 1.00 | 1.00 | 1.00 | N/A |
| Emergency department | 0.99 (0.81, 1.20) | 0.97 (0.76, 1.23) | 1.04 (0.73, 1.48) | 0.49 |
| Inpatient | 1.05 (0.88, 1.25) | 1.06 (0.86, 1.30) | 1.03 (0.75, 1.41) | 0.63 |
| Opioid overdose drug | ||||
| Heroin | 1.57 (1.30, 1.89) | 1.83 (1.44, 2.33) | 1.47 (1.09, 1.99) | 0.002 |
| Prescription opioids | 1.00 | 1.00 | 1.00 | N/A |
| Near fatal event | ||||
| Present | 1.86 (1.50, 2.31) | 1.59 (1.21, 2.08) | 2.60 (1.81, 3.73) | 0.09 |
| Absent | 1.00 | 1.00 | 1.00 | N/A |
Adjusted HRs are from models that control for age, sex, race/ethnicity, and geographic region.
a
Includes American Indian/Alaskan Native, Asian, Native Hawaiian/Other Pacific Islander, and more than one race.
b
During 180 days before the index overdose event.
c
MAT denotes medication assisted treatment.