Skip to main content

Abstract

Objectives:

Prescription opioid medications are the most commonly implicated substances in unintentional overdoses. Outpatient health care encounters represent a potential opportunity to intervene to reduce opioid overdose risk. This study assessed the timing and type of outpatient provider contacts prior to death from unintentional prescription opioid overdose.

Methods:

This study examined all adult patients nationally in the Veterans Health Administration (VHA) who died from unintentional prescription opioid overdose in fiscal years 2004–2007 and who used VHA services anytime within two years of their deaths (N=1,813). For those whose final treatment contact was in an outpatient setting (N=1,457), demographic, clinical, and treatment characteristics were compared among patients categorized by the location of their last contact.

Results:

Among individuals last seen in outpatient settings, 33% were seen within one week of their overdose and 62% within one month of their overdose. A substantial proportion of patients (30%) were last seen within one month of death in mental health or substance use disorder outpatient settings. The majority of patients (86%) did not fill an opioid prescription on their last outpatient visit prior to death from unintentional opioid overdose.

Conclusions:

Most patients who died by unintentional prescription opioid overdose were seen in outpatient settings within a month of their overdose. These settings may provide an opportunity to prevent patients from dying from prescription opioid overdoses. Interventions to reduce risk should not be limited to visits during which an opioid is prescribed.

Formats available

You can view the full content in the following formats:

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: Horse Drawn Cabs at Evening, New York, by Childe Hassam, circa 1890. Watercolor. Daniel J. Terra Collection, 199.66. Terra Foundation for American Art. Photo credit: Terra Foundation for American Art, Chicago/Art Resource, New York City.

Psychiatric Services
Pages: 1149 - 1154
PubMed: 26129993

History

Received: 5 May 2014
Revision received: 27 September 2014
Revision received: 9 January 2015
Accepted: 13 February 2015
Published online: 1 July 2015
Published in print: November 01, 2015

Authors

Details

Lewei (Allison) Lin, M.D.
The authors are affiliated with the Department of Psychiatry, University of Michigan, and with the Department of Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan (e-mail: [email protected]).
Amy S. B. Bohnert, Ph.D.
The authors are affiliated with the Department of Psychiatry, University of Michigan, and with the Department of Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan (e-mail: [email protected]).
Mark A. Ilgen, Ph.D.
The authors are affiliated with the Department of Psychiatry, University of Michigan, and with the Department of Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan (e-mail: [email protected]).
Paul N. Pfeiffer, M.D., M.S.
The authors are affiliated with the Department of Psychiatry, University of Michigan, and with the Department of Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan (e-mail: [email protected]).
Dara Ganoczy, M.P.H.
The authors are affiliated with the Department of Psychiatry, University of Michigan, and with the Department of Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan (e-mail: [email protected]).
Frederic C. Blow, Ph.D.
The authors are affiliated with the Department of Psychiatry, University of Michigan, and with the Department of Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan (e-mail: [email protected]).

Funding Information

National Institute of Health: R03 AG042899
HSR&D: CDA09-204
This research was supported by funding from Health Services Research and Development, U.S. Department of Veterans Affairs (grant CDA09-204); the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; and the National Institutes of Health (grant R03 AG042899). Data collection was supported by the Office of Mental Health Operations, Veterans Health Administration.The authors report no financial relationships with commercial interests.

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard

View Options

View options

PDF/EPUB

View PDF/EPUB

Full Text

View Full Text

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login
Purchase Options

Purchase this article to access the full text.

PPV Articles - Psychiatric Services

PPV Articles - Psychiatric Services

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share