Periods of altered risk for non-fatal drug overdose: a self-controlled case series
نویسندگان
چکیده
BackgroundBeing recently released from prison or discharged hospital, being dispensed opioids, benzodiazepines, antipsychotics have been associated with an increased risk of fatal drug overdose. This study aimed to examine the association between these periods and non-fatal overdose using a within-person design.MethodsIn this self-controlled case series, we used data provincial health insurance client roster identify 20% random sample residents (aged ?10 years) in British Columbia, Canada Jan 1, 2015, Dec 31, 2017 (n=921 346). Individuals aged younger than 10 years as who did not their sex recorded were excluded. We linked correctional records cohort individuals had resulting medical care during time period, key exposures, including incarceration, admission emergency department care, supply medications for opioid use disorder (MOUD), opioids pain (unrelated MOUD), antipsychotics. Using examined after each exposures incidence case-only, conditional Poisson regression analysis. Sensitivity analyses included recurrent overdoses pre-exposure periods.FindingsWe identified 4149 2015–17. Compared unexposed (ie, all follow-up that was part designated period exposure), higher on day (adjusted rate ratio [aIRR] 2·76 [95% CI 1·51–5·04]), at 1–2 weeks (2·92 [2·37–3·61]), 3–4 (1·34 [1·01–1·78]) release prison, discharge hospital (1·35 [1·11–1·63]), when (after ?4 weeks) benzodiazepines (entire period), 3 discontinuing The reduced MOUD (aIRRs ranging 0·33 [0·26–0·42] 0·41 [0·25–0·67]) (0·12 [0·08–0·19]).InterpretationExpanding access increasing support stable long-term medication management disorder, improving continuity transitioning service systems, ensuring safe prescribing monitoring processes reduce respiratory function (eg, benzodiazepines) could decrease overdose.FundingMurdoch Children's Research Institute National Health Medical Council. Being design. In periods. [0·08–0·19]). Expanding
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ژورنال
عنوان ژورنال: The Lancet. Public health
سال: 2021
ISSN: ['2468-2667']
DOI: https://doi.org/10.1016/s2468-2667(21)00007-4