Gender Differences in Emergency Department Visits and Detox Referrals for Illicit and Nonmedical Use of Opioids.

Hyeon-Ju Ryoo,Esther K Choo

doi:10.5811/westjem.2016.2.29425

Abstract

IntroductionVisits to the emergency department (ED) for use of illicit drugs and opioids have increased in the past decade. In the ED, little is known about how gender may play a role in drug-related visits and referrals to treatment. This study performs gender-based comparison analyses of drug-related ED visits nationwide.MethodsWe performed a cross-sectional analysis with data collected from 2004 to 2011 by the Drug Abuse Warning Network (DAWN). All data were coded to capture major drug categories and opioids. We used logistic regression models to find associations between gender and odds of referral to treatment programs. A second set of models were controlled for patient “seeking detox,” or patient explicitly requesting for detox referral.ResultsOf the 27.9 million ED visits related to drug use in the DAWN database, visits by men were 2.69 times more likely to involve illicit drugs than visits by women (95% CI [2.56, 2.80]). Men were more likely than women to be referred to detox programs for any illicit drugs (OR 1.12, 95% CI [1.02–1.22]), for each of the major illicit drugs (e.g., cocaine: OR 1.27, 95% CI [1.15–1.40]), and for prescription opioids (OR 1.30, 95% CI [1.17–1.43]). This significant association prevailed after controlling for “seeking detox.”ConclusionWomen are less likely to receive referrals to detox programs than men when presenting to the ED regardless of whether they are “seeking detox.” Future research may help determine the cause for this gender-based difference and its significance for healthcare costs and health outcomes.

Highlights

IntroductionVisits to the emergency department (ED) for use of illicit drug and misuse of opioid analgesic have increased disproportionately among certain sub-populations during the past decade.[1,2] The number of ED visits for nonmedical use of opioid analgesics increased by 111% between 2004 and 20083 in the setting of marked increase in opioid prescriptions from both primary care and ED.[4] Interestingly, a clear gender-specific pattern has emerged from the epidemiologic data on opioid overdoses: the rate of drug overdose deaths increased 500% in women over the past decade, compared to a 360% increase in men.[3] Drug use in the ED population is associated with high prevalence of comorbid conditions, injuries, high recidivism, morbidity, and mortality.[5] the ED is an important point of contact for providing standardized screening, brief interventions and referrals to treatment (SBIRT) for drug use.[6]
Visits to the emergency department (ED) for use of illicit drugs and opioids have increased in the past decade
Of the 27.9 million ED visits related to drug use in the Drug Abuse Warning Network (DAWN) database, visits by men were 2.69 times more likely to involve illicit drugs than visits by women

Summary

Introduction

Visits to the emergency department (ED) for use of illicit drug and misuse of opioid analgesic have increased disproportionately among certain sub-populations during the past decade.[1,2] The number of ED visits for nonmedical use of opioid analgesics increased by 111% between 2004 and 20083 in the setting of marked increase in opioid prescriptions from both primary care and ED.[4] Interestingly, a clear gender-specific pattern has emerged from the epidemiologic data on opioid overdoses: the rate of drug overdose deaths increased 500% in women over the past decade, compared to a 360% increase in men.[3] Drug use in the ED population is associated with high prevalence of comorbid conditions, injuries, high recidivism, morbidity, and mortality.[5] the ED is an important point of contact for providing standardized screening, brief interventions and referrals to treatment (SBIRT) for drug use.[6].

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