Prescribing patterns before and after a non-fatal drug overdose using Tennessee's controlled substance monitoring database linked to hospital discharge data

Publication date: Available online 6 November 2019Source: Preventive MedicineAuthor(s): Shanthi Krishnaswami, Sutapa Mukhopadhyay, Melissa McPheeters, Sarah J. NechutaAbstractWe performed a statewide evaluation of prescribing patterns of controlled substances (CS) before and after an overdose, using Tennessee's Hospital Discharge Data System and the Controlled Substance Monitoring Database (CSMD). Adults' first non-fatal overdose discharges either from the emergency department (ED) or inpatient (IP) stay occurring between 2013 and 2016 were linked to prescriptions in the CSMD. The difference in the proportion of patients filling a prescription before versus after an overdose was calculated. Included were 49,398 patients with an overdose and a prescription record; most (60.5%) were treated in the ED. Among any drug type overdose the percentage of patients who filled a CS prescription within a year of experiencing an 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 difference from before to after similar in both settings. Among patients treated for an opioid overdose, this represented a decrease in opioid analgesics filled by 9.7% (95%CI: −11.2, −8.3) among those treated in the ED, and by 7.1% (95% CI: −8.3, −5.9) among treated inpatients. Among patients treated for a heroin overdose, 12.2% (95%CI: −15.2, −9.3) fewer of those treated in the E...
Source: Preventive Medicine - Category: International Medicine & Public Health Source Type: research