Escalation of Opioid Withdrawal Frequency and Subsequent AMA Rates in Hospitalized Patients From 2017 to 2020

Objective To measure trends for the emergence of opioid withdrawal (OW) and leaving against medical advice (AMA) among hospitalized patients. Method Retrospective time-series of hospitalized patients with OW, defined by a Clinical Opioid Withdrawal score>8, using electronic health record data at a tertiary health system and of patients with a discharge status of AMA from January 1, 2017 to December 31, 2020. Results The average number of monthly hospitalizations with OW showed a year-to-year increment of 15% in 2018, 21% in 2019, and 34% from 2019 to 2020, whereas the total monthly hospitalizations remained stable. The segmented regression analysis showed that the upward trend in hospitalizations with OW became significant after January 2019 (slope: 1.14, 95% confidence interval [CI]: 0.70, 1.57). After August 2019, Fentanyl was added to the hospital urine drug testing panel and was identified in most OW patients. The monthly proportion of patients who left AMA was significantly higher among the OW patients than among all other admitted patients. There was a significant increase of 0.39 (95% CI: 0.29–0.49, P
Source: Journal of Addiction Medicine - Category: Addiction Tags: Brief Reports Source Type: research