Risk factors for mortality, hospitalisation and imprisonment in substance misuse patients

Colette Montgomery Sardar, Lauren Gibson, Richard Lowrie

Research output: Contribution to journalArticlepeer-review

Abstract

Opioid substitution therapy (OST) is currently the gold standard treatment for patients with illicit opioid addiction (most commonly to heroin). Its use is evidence based, with proven reductions in negative outcomes and increased positive outcomes for patients taking OST compared with those who do not. However, mortality rates and adverse outcomes, including hospitalisation and imprisonment, are still higher in illicit drug users and patients on OST compared with the general population.
Polydrug use, male gender, increased age and injection of drugs are associated with higher mortality. Time points associated with the greatest risk of mortality include the first 2 weeks of commencing or discontinuing OST; during hospitalisation; within the first 28 days of discharge from hospital; and within the first 2 weeks of discharge from prison.
Risk factors for hospitalisation include hepatitis C-positive status, HIV-positive status and co-morbid mental health disorders. The greatest risk factor for imprisonment and criminal recidivism is polydrug use. Continuity and consistency of OST are associated with lower risk of mortality, hospitalisation and re-incarceration.
This article summarises the risk factors of these adverse outcomes in order to raise awareness among pharmacists and other healthcare professionals working with OST patients, as it is their role to optimise patient safety and reduce adverse outcomes.
Original languageEnglish
Pages (from-to)219-224
Number of pages6
JournalClinical Pharmacist
DOIs
Publication statusPublished - 6 Jul 2018

Keywords / Materials (for Non-textual outputs)

  • addiction
  • mortality
  • hospitalisation
  • opioid
  • OST
  • opioid substitution therapy
  • prison

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