Prescribing patterns before and after a non-fatal drug overdose using Tennessee's Controlled Substance Monitoring Database linked to hospital discharge data
Preventive Medicine Nov 14, 2019
Krishnaswami S, et al. - Researchers used Tennessee's Hospital Discharge Data System and the Controlled Substance Monitoring Database (CSMD) to analyze prescribing patterns of controlled substances (CS) prior to and following an overdose via this statewide assessment. They linked adults' first non-fatal overdose discharges either from the emergency department (ED) or inpatient stay occurring between 2013 and 2016 to prescriptions in the CSMD. They computed the difference in the proportion of patients filling a prescription prior to vs following an overdose. This analysis included 49,398 patients with an overdose and a prescription record. In majority of the cases (60.5%), treatment was received in the ED. Within a year of having an overdose, the percentage of patients who filled a CS prescription among any drug type overdose was as follows: opioid analgesics: 59.1%, benzodiazepines: 37.3%, stimulants: 5.0%, muscle relaxants: 3.4%, concurrent opioid-benzodiazepines: 24.0% with the percent variation from before to after similar in both settings. Hydrocodone and oxycodone were identified as the most common opioid analgesics. Overall, findings revealed a rise in the number of patients filling buprenorphine for treatment in the year following overdoses related to any drug or opioids but a reduction was seen in those who were managed for a heroin overdose.
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