Drug Overdose Sending More Americans to the ED

Megan Brooks

April 09, 2015

Drug overdoses send more than 1 million Americans to the emergency department (ED) each year, and the number is rising, according to a new data brief from the US Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

A substantial portion of drug-poisoning visits involve analgesics, antipyretics, and antirheumatics, as well as sedatives, hypnotics, tranquilizers, and other psychotropic agents.

"Poisoning is the leading cause of injury-related mortality in the United States, with more than 40,000 deaths annually. Drugs account for 90% of poisoning deaths, and the number of deaths from drug poisoning has increased substantially in recent years," Michael Albert, MD, MPH, and colleagues from the NCHS note in their article.

Their review of data from the National Hospital Ambulatory Medical Care Survey found that for the period 2008-2011, an annual average of 1.1 million ED visits were made for drug poisoning, corresponding to an overall visit rate of 35.4 per 10,000 persons, they report.

The highest visit rate was observed for persons aged 20 to 34 years. This age group showed a statistically significant increase from 36.3 per 10,000 in 2004-2007 to 53.9 per 10,000 in 2008- 2011.

The ED visit rate for drug poisoning was similar in men and women, with the exception of individuals aged 35 to 49 years, for whom women had higher rates than men (51.2 vs 31.9 per 10,000).

The ED visit rate was highest for unintentional drug poisoning (17.0 per 10,000), followed by self-inflicted drug poisoning (13.4 per 10,000) and drug poisoning of undetermined intent (5.0 per 10,000). Women had a higher ED visit rate for self-inflicted drug poisoning than men (16.4 vs 10.2 per 10,000).

For both unintentional and self-inflicted drug-poisoning ED visits, about one half of visits resulted from poisoning by drugs in the categories of analgesics, antipyretics, and antirheumatics; and sedatives, hypnotics, tranquilizers, and other psychotropic agents. Analgesics that were specifically opiates or opiate-related narcotics, including heroin and methadone, accounted for 14.0% of ED visits for unintentional drug poisoning.

Overall, nearly one quarter (24.5%) of trips to the ED for drug poisoning resulted in hospital admission, "which was higher compared with other ED visits (12.7%)," the researchers say.

"Although visits for drug poisoning made up a small percentage of overall ED visits, they tended to be more serious, resulting in more frequent hospitalization," Dr Albert and colleagues point out.

"Preventing increases in both poisoning deaths and nonfatal poisonings are Healthy People 2020 objectives. This report examining national data on ED visits for drug poisoning can help inform injury-prevention efforts to meet these objectives," they conclude.

NCHS Data Brief 198. Full text

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