Abstract
Background: According to the CDC surveillance data, between 2016 and 2017 opioid use disorder (OUD)-related emergency department (ED) visits increased by 30%. No study has examined OUD-related ED visits among deaf or hard-of-hearing (DHH) non-elderly adults.
Research Objectives: To determine risk of OUD-related ED visits and associated mortalities among DHH non-elderly adults (18-64 years).
Study Design: We analyzed combined 2016-2017 National Emergency Department Sample (NEDS) to examine risk of OUD-related ED visits and associated mortalities. We used logistic regressions models to compare risk of OUD-related ED visits and associated mortalities between DHH and non-DHH non-elderly adults.
Principal Findings: DHH non-elderly adults had higher odds for OUD-related ED visits than controls (RR=1.81,95%CI:1.73-1.90,p<0.001), including for prescribed opioid overdose-related ED visits (RR=1.83,95%CI:1.54-2.17,p<0.001). Risks remained high even after adjustment for sociodemographic, hospital, and clinical characteristics (OR=1.52,95%CI:1.44-1.60,p<0.001 and OR=1.52,95%CI:1.27-1.81, p<0.001 respectively). DHH non-elderly adults also had 2.5 times higher odds (RR=2.53,95%CI:1.55-4.14,p<0.001) of mortality during OUD-related ED visits and 3.5 times higher odds (RR=3.57,95%CI:1.29-9.92,p<0.001) during prescribed opioid overdose-related ED visits. These risks were only somewhat attenuated after adjustment for sociodemographic, hospital, and clinical characteristics (OR=1.52,95%CI:1.44-1.60,p<0.001 and OR=1.52,95%CI:1.27-1.81,p<0.001 respectively). However, after adjusting for ER-based naloxone administration during these visits, differences in risks of mortality between DHH non-elderly adults and controls were fully explained.
Conclusions: DHH non-elderly adults compared to the general population are at a higher risk of OUD-related ED visitsand OUD associated mortality. The implied disparities in ER-based naloxone administration to non-elderly DHH adults should be further examined.