Doctors need to recognize ‘alarmingly high’ death rate for patients with opioid addiction

Patients with opioid use disorder (OUD) who are treated in general healthcare settings have an “alarmingly high” death rate, a new study finds.

Those patients are 10 times more likely to die than people without opioid addictions, according to a study in the Journal of Addiction Medicine.

Researchers decided to look at the morbidity and mortality rates for patients with OUD being treated in primary healthcare systems. While patients with opioid addictions were traditionally treated in addiction clinics or programs, that has shifted due to efforts to integrate addiction services into primary healthcare.

Researchers analyzed electronic health records for more than 2,500 patients with OUD who were treated at a major university hospital system from 2006 to 2014 and found the high death rate that suggests many physicians do not fully appreciate the mortality risks to these patients.

Lead investigator Yih-Ing Hser, Ph.D., a professor of psychiatry and behavioral sciences at the David Geffen School of Medicine at the University of California, Los Angeles, said he did not expect to see such a high mortality rate because he expected general healthcare centers would be able to provide patients, who usually have health insurance, with more comprehensive health services. “But when I saw such a high mortality rate, I was shocked," Hser told Medscape Medical News (reg. req.).

Healthcare providers outside specialty addiction treatment settings have not traditionally been adequately equipped to identify and address patients’ drug addictions, researchers said.

Among the 2,500 patients, 465 died during the eight-year period. While drug overdose and disorder (19.8%) was the leading cause of death, other causes included cardiovascular diseases, cancer and infectious diseases. Hepatitis C virus and alcohol use disorder were two clinically important indicators of overall risk of death, the study found.

The high morbidity and mortality rates are proof that healthcare systems need to find innovative ways to identify and treat patients with substance use disorder, researchers said.

The study suggests doctors need to better screen patients for addictions so they can receive interventions early on. After identifying patients with addiction problems, clinicians also need resources to treat them.