The Opiold Crisis: How to Lessen the Burden on Emergency Departments by At-risk Populations

Patel, Sapan; Sheikh, Asad; Nazir, Natasha; Monro, Shannon; Anwar, Ammaar

Background The opioid crisis in the United States of America has been worsening due to previous sharp increases in opioid prescriptions and a lack of resources available to those affected. Emergency departments (ED) across the nation have been exhausted with a constant influx of patients related to opioid-related issues. Because of limited resources, it is crucial to efficiently distribute rehabilitation and mental wellness efforts amongst those most susceptible to opioid abuse. By identifying common environments and characteristics of the population presenting to ED´s for opioid-related issues, we can (1) lessen the economic burden on the healthcare system while (2) increasing the rate of successful treatment for those affected by opioid addiction. Methods Data was obtained regarding ED visits for opioid-related issues at the level of all 50 states from the Healthcare Cost and Utilization Project´s (HCUP) State Emergency Department Databases (SEDD) and nationally from the Nationwide Emergency Department Sample (NEDS). Rates of ED admissions for opioid-related issues were statistically analyzed to identify characteristics of the population that are most at risk for presenting to the ED for opioid-related issues. Results Statistical analysis showed residents of Large Metropolitan areas (M=351.94, p=0.022, CI +/- 42.89), those earning incomes below the 25th percentile (M=359.14, p=0.008, CI +/- 61.39), and 25-14-year-old population (M=456.71, p=0.001, CI +/- 27.01) to be the most likely subset of the population to report to the ED for opioiduse issues. Conversely, those earning incomes above the 75th percentile were significantly less likely to utilize ED´s for opioid-related issues (M=143.10, p=0.026, CI +/- 0.026). Conclusion Results demonstrated that patients between the ages of 25 and 44 were more likely to develop opioid use disorders. This provides an opportunity to educate this population via opioid education centers. Additionally, residents of Large Metropolitan areas would benefit from naloxone distribution centers. Lastly, higher income levels appear to be related to a decrease in ED presentation for opioid abuse. This provides evidence for medication-assisted therapy (MAT) to be provided by low-income insurance plans.