“We need systems that can address comprehensive needs of people with substance use disorder and serious medical illness,” said senior author Honora Englander, M.D., associate professor of medicine (hospital medicine) in the OHSU School of Medicine.
Researchers went into the study knowing that people with opioid use disorder are more likely to be hospitalized than the general population, but the new study is the first to characterize the rate at which these patients died a year after they leave the hospital.
Researchers reviewed data from a total of 6,654 Medicaid patients treated in 62 Oregon hospitals between April of 2015 and December of 2017.
Drug-related deaths, including overdoses, accounted for 58% of the 522 people who died within a year of being discharged from the hospital. The other deaths were attributed to causes other than drug-related, including diseases of the circulatory, respiratory and endocrine systems.
Researchers found that overdose deaths are just the tip of the iceberg for these patients, representing 13% of deaths in the year after discharge. A one-year death rate of 8% in patients with opioid use disorder is similar to conditions like acute myocardial infarction, or heart attack.
For heart attacks, hospital systems across the U.S. have universally accepted standards, metrics, and quality reporting that drives performance. The same should be available for opioid use disorder, where death rates are similar.
Health systems need to integrate and destigmatize medical care for these patients with easy access to addiction medications such as methadone and buprenorphine and also to life-saving treatments.