Table 1.
All prescriptions (i.e. opioids, mental health treatment, other potenially sedating medications) refer to presence of a prescription order in the electronic medical record in the 3 months prior to initial opioid overdose. MME/d refers only to the maximum exposure when a opioid was prescribed. Abbreviations: ED=emergency department; iOD=initial opioid overdose; OST=opioid substitution therapy (i.e. methadone, buprenorphine); MME/d=morphine milligram equivalents per day.
| Total opioid overdoses % (n) (N=4,155) | No repeat opioid overdose % (n) (N=3,534) | Repeat opioid overdose % (n) (N=621) | Unadjusted Hazard Ratio (95% CI) | Adjusted Hazard Ratio (95% CI) | |
|---|---|---|---|---|---|
| Age, years | |||||
| 18–34 | 47.48 (1973) | 47.45 (1677) | 47.67(296) | 1.00 | 1.00 |
| 35–44 | 25.68(1067) | 25.55 (903) | 26.41 (164) | 1.01 (0.83, 1.22) | 1.02 (0.81, 1.18) |
| 45–64 | 26.84 (1115) | 26.99 (954) | 25.93 (161) | 0.97 (0.79, 1.16) | 0.98 (0.81, 1.18) |
| Sex | |||||
| Male | 35.21 (1463) | 35.82 (1266) | 31.72 (197) | 1.19 (1.01, 1.41) | 1.19 (1.01, 1.41) |
| Female | 64.79 (2692) | 64.18 (2268) | 68.28 (424) | 1.00 | 1.00 |
| Race | |||||
| White | 85.29 (3544) | 85.09 (3007) | 86.47 (537) | 1.00 | 1.00 |
| Black | 11.82 (491) | 11.88 (420) | 11.43 (71) | 0.95 (0.74, 1.23) | 0.95 (0.74, 1.23) |
| Asian | 0.26 (11) | 0.23 (8) | 0.48 (3) | 1.97 (0.63, 6.13) | 1.99 (0.63, 6.20) |
| Other | 2.62 (109) | 2.8 (99) | 1.61 (10) | 0.59 (0.31, 1.02) | 0.57 (0.31, 1.07) |
| Any ED visit in prior 12 mo. | 6.40 (266) | 6.59 (233) | 5.31 (33) | 0.78 (0.56, 1.12) | 0.79 (0.56, 1.12) |
| Hospital admission for iOD | 6.30 (238) | 6.73 (238) | 3.70 (23) | 0.55 (0.36, 0.83) | 0.56 (0.37, 0.86) |
| Mental health diagnoses | |||||
| Depression disorder | 11.17 (464) | 10.64 (376) | 14.17 (88) | 1.35 (1.08, 1.69) | 1.38 (1.02, 1.73) |
| Anxiety disorder | 11.46 (476) | 10.89 (385) | 14.65 (91) | 1.38 (1.11, 1.73) | 1.41 (1.13, 1.77) |
| Bipolar disorder | 5.29 (220) | 5.07(179) | 6.60 (41) | 1.28 (0.94, 1.76) | 1.32 (0.96, 1.82) |
| Stress disorder | 2.00 (83) | 1.90 (67) | 2.58 (16) | 1.33 (0.81, 2.19) | 1.38 (0.84, 2.27) |
| Schizophrenia | 1.18 (49) | 1.16 (41) | 1.29 (8) | 1.10 (0.55, 2.21) | 1.14 (0.57, 2.29) |
| Any mental health disorder | 16.44 (683) | 15.85 (560) | 19.81 (123) | 1.30 (1.07, 1.58) | 1.32 (1.08, 1.61) |
| No mental health disorder | 83.56 (3472) | 84.15 (2983) | 80.19 (498) | 0.77 (0.63, 0.94) | 0.76 (0.62, 0.92) |
| Drug and alcohol diagnoses | |||||
| Substance use disorder | 22.19 (922) | 21.45 (758) | 26.41 (164) | 1.31 (1.09, 1.56) | 1.30 (1.09, 1.56) |
| Alcohol use disorder | 2.94 (122) | 2.72 (96) | 4.19 (26) | 1.53 (1.04, 2.67) | 1.52 (1.02, 2.25) |
| Opioid prescriptions | |||||
| Any prescribed opioid | 4.45 (185) | 4.84 (165) | 2.68 (20) | 0.58 (0.36, 0.94) | 0.59 (0.37, 0.97) |
| Any OST | 0.82 (34) | 0.76 (27) | 1.13 (7) | 1.43 (0.68, 3.01) | 1.45 (0.69, 3.05) |
| MME/d | |||||
| 1 to 50 | 30.28 (33) | 30.21 (29) | 30.77 (4) | 1.00 | 1.00 |
| 50 to <100 | 31.19 (34) | 29.17 (28) | 46.15 (6) | 1.47 (0.42, 5.21) | 1.65 (0.46, 5.88) |
| >=100 | 38.53 (42) | 40.62 (39) | 23.08 (3) | 0.58 (0.13, 2.60) | 0.62 (0.14, 2.79) |
| Mental health prescriptions | |||||
| Any antidepressant | 5.78 (240) | 5.75 (196) | 5.89 (44) | 0.97 (0.69, 1.36) | 0.99 (0.70, 1.39) |
| Any antipsychotic | 1.54 (64) | 1.53 (52) | 1.61 (12) | 0.95 (0.49, 1.83) | 0.98 (0.51, 1.89) |
| Any mood stabilizer | 1.18 (49) | 1.17 (40) | 1.20 (9) | 0.64 (0.27, 1.54) | 0.66 (0.27, 1.60) |
| Other potentially sedating prescriptions | |||||
| Any benzodiazepine | 3.03 (126) | 2.97 (105) | 3.38 (21) | 1.11 (0.72, 1.71) | 1.13 (0.73, 1.75) |
| Any gabapentinoid | 5.17 (215) | 5.11 (174) | 5.49 (41) | 1.06 (0.75, 1.50) | 1.08 (0.76, 1.52) |
| Any muscle relaxer | 1.44 (60) | 1.50 (51) | 1.20 (9) | 0.77 (0.37, 1.63) | 0.79 (0.37, 1.66) |