How Often Do You Go to the ER?

If you’ve made more than one trip to the emergency room in the previous 12 months, you may be at an increased risk of dying from a prescription drug overdose, say researchers at Columbia University’s Mailman School of Public Health. According to the study, recently published in the Annals of Epidemiology, the risk of dying from prescription drug overdose was five times greater for patients with two ER visits in the past year than for patients with one or fewer ER visits in the past year.

The risk of dying jumped to 17 times greater for those with three visits and was a whopping 48 times greater for patients with four or more visits. While the study didn’t identify the specific drugs the ER patients took, the researchers say that the deaths were linked to overdoses of both prescribed and not-prescribed drugs that can be addicting, such as narcotic painkillers like hydrocodone and oxycodone that slow body functions (especially breathing) if taken in amounts beyond what a health care provider recommends and/or in combination with other drugs or alcohol.

Over one million ER visits in the U.S. every year are due to the misuse of prescription drugs, meaning using someone else’s drugs; combining drugs or using the drug with alcohol; and/or taking too much, says Joanne Brady, PhD, lead researcher on the study and an adjunct assistant professor of epidemiology at Mailman.

The researchers analyzed New York State emergency room data from 2006 to 2010, comparing 2,732 patients who died of a prescription drug overdose with 2,732 patients who didn’t. The result: In addition to an increased risk of dying with every additional ER visit, the Mailman researchers found that men and people 35 to 54 were at even higher risk, as were patients with a substance use disorder (SUD), a history of a SUD or another other psychiatric disorder.

Moreover, patients who died of a prescription drug overdose after an ER visit were more likely to have been discharged from the hospital against the advice of a doctor. This means that physicians have a chance to intervene when someone who’s overdosing or experiencing a near-overdose comes through a hospital’s doors: “Emergency department visits may serve as an important window of opportunity [for doctors] for identifying patients at heightened risk of prescription drug overdose, and for implementing evidence-based intervention programs, such as providing patients and their families with take-home naloxone [the drug Narcan] [to reverse an overdose] and drug treatment referrals,” said Guohua Li, MD, PhD, a professor of epidemiology at Mailman and senior author on the study, in a press release.

Help is Closer Than You Think

How Often Do You Go to the ER?Dr. Brady hopes the study will be shared widely, alerting more people who misuse prescription drugs that if they’re taking a prescription drug(s) and going to the ER multiple times a year that they are at a much greater risk of dying. But she also wants the public to know that help is available right at the hospital if they do wind up in the ER. The enormity of the problem — 60% of all drug overdoses are from prescription drug misuse, not illicit drugs, according to Mailman researchers — have led many hospitals to add on-site programs and training for social workers to help connect those abusing prescription drugs with addiction treatment services and referrals to health care providers and mental health professionals. Family members and friends also need to know about these emergency room resources: The drug user “is only thinking about day-to-day and needs help thinking about the long-term,” adds Brady.

If you’re concerned that you or your loved one is addicted to prescription or illicit drugs, visit the Drug Addiction section, and if you think someone is experiencing an overdose, call 911 and seek immediate medical attention.

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