Naloxone prescriptions among patients with a substance use disorder and a positive fentanyl urine drug screen presenting to the emergency department

Ali, Shawkut Amaan; Shell, Jasmine; Harris, Raymond; Bedder, Marshall

doi:10.1186/s12954-023-00878-8

Harm Reduction Journal

Table 4 Odds of having a UDS presumptive positive for fentanyl at first ED Visit during the study time-period 2019–2021. Notable results

From: Naloxone prescriptions among patients with a substance use disorder and a positive fentanyl urine drug screen presenting to the emergency department

Variable	Data Subset	OR	95% OR CI	p Value	Covariate (s)	aOR^a	95% aOR CI	p Value
During COVID^b	All Patients	1.855	1.580–2.177	< 0.001*
Multiple SUDs	All Patients	1.597	1.384–1.842	< 0.001*	OUD dx	1.355	1.166–1.574	< 0.001*
Co-occurring Psych dx	All Patients	0.839	0.719–0.978	0.03*
Co-occurring medical dx	All Patients	0.771	0.667–0.891	< 0.001*	Age 65 and older; OUD dx	0.819	0.700–0.957	0.01*
< 18 years old	All Patients	0.165	0.072–0.377	< 0.001*	OUD diagnosis	0.187	0.081–0.431	< 0.001*
Age 65 and older	All Patients	0.683	0.532–0.878	0.003*	OUD dx; Co-occurring medical dx	0.742	0.567–0.971	0.03*
Uninsured	All Patients	1.323	1.146–1.526	< 0.001*	Patient race – White; OUD dx	1.251	1.075–1.456	0.004*
Medicaid	All Patients	0.792	0.663–0.945	0.01*	Patient race-Black	0.868	0.724–1.040	0.13
Medicare	All Patients	0.758	0.618–09.29	0.008*	Age 65 and older	0.861	0.678–1.093	0.22
Patient race-Black	All Patients	0.499	0.430–0.579	< 0.001*	Medicaid; OUD dx	0.600	0.513–0.701	< 0.001*
Patient race-White	All Patients	1.950	1.684–2.257	< 0.001*	Uninsured; OUD dx	1.638	1.405–1.909	< 0.001*
OUD dx	All Patients	6.539	5.251–8.142	< 0.001*	Patient race-White	5.789	4.633–7.234	< 0.001*
UDS amph POS	All Patients	4.406	3.767–5.153	< 0.001*	OUD dx; Multiple SUDs; UDS benzo, oxy, opiates POS	4.456	3.767–5.270	< 0.001*
UDS benzo POS	All Patients	3.594	3.027–4.268	< 0.001*	OUD dx; Multiple SUDs; UDS amph, oxy, opiates POS	3.540	2.933–4.273	< 0.001*
UDS cocaine POS	All Patients	0.867	0.726–1.036	0.12
UDS opiate POS	All Patients	3.608	3.040–4.282	< 0.001*	OUD dx; Multiple SUDs; UDS amph, benzo, oxy POS	2.973	2.410–3.668	< 0.001*
UDS oxy POS	All Patients	2.690	2.136–3.386	< 0.001*	OUD diagnosis; Multiple SUDs; UDS amph, benzo, opiates POS	1.181	0.884–1.578	0.26
UDS THC POS	All Patients	1.294	1.116–1.499	< 0.001*	OUD dx; Multiple SUDs; UDS amph POS	1.164	0.989–1.369	0.07

^aOdds ratio adjusted by covariates listed
^bDuring COVID was defined as years 2021 and 2020 and before COVID as year 2019
* statistically significant, p < 0.05
Reference groups for each variable
Multiple SUDs—only one SUD; During COVID—visits during 2019; UDS fentanyl POS—UDS fentanyl negative; < 18 years old—18yo and older; 65yo or older—less than 65 years old; OUD dx—no OUD dx; Co-occurring psych dx—no psych dx; Co-occurring chronic medical condition—no chronic medical condition; Uninsured—all other insurances; Medicaid—all other insurances; Medicare—all other insurances; Private insurance—all other insurances; Patient race-White—all other races; Patient race-Black—all other races; UDS amph POS—UDS amph negative; UDS benzo POS—UDS benzo negative; UDS cocaine POS—UDS cocaine negative; UDS opiate POS—UDS opiate negative; UDS THC POS—UDS THC negative; UDS oxy POS—UDS oxy negative
ED—emergency department; UDS—urine drug screen; AMCL—addiction medicine consult liaison service; Psych—psychiatric; OUD—opioid use disorder; POS—positive; dx—diagnosis; amph—amphetamine; benzo—benzodiazepine; oxy—oxycodone

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ISSN: 1477-7517

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