Epidemiologic trends in substance and opioid misuse-related emergency department visits in Alberta a cross-sectional time-series analysis

• Published in: Canadian journal of public health Vol. 109; no. 2; pp. 164 - 173
• Main Authors: Moe, Jessica, Camargo, Carlos A., Jelinski, Susan, Erdelyi, Shannon, Brubacher, Jeff, Rowe, Brian H.
• Format: Journal Article
• Language: English
• Published: Cham Springer Science + Business Media 01-04-2018; Springer International Publishing; Springer Nature B.V
• Subjects: Acuity; Adolescent; Adult; Alberta - epidemiology; Ambulatory care; Cross-Sectional Studies; Diagnostic systems; Emergency medical care; Emergency medical services; Emergency Service, Hospital - statistics & numerical data; Epidemiology; Female; Females; Growth rate; Humans; Male; Males; Medicine; Medicine & Public Health; Middle Aged; Narcotics; Opioid-Related Disorders - epidemiology; Opioids; Patients; Public Health; Regression analysis; Seasonal variations; Sex differences; SPECIAL SECTION ON SUBSTANCE USE: QUANTITATIVE RESEARCH; Subgroups; Substance-Related Disorders - epidemiology; Time series; Trends; Young Adult; Alberta; Alberta Canada; Canada; Troubles liés à une substance; Substance-related disorders; Opioid-related disorders; Santé publique; Drug misuse; Troubles liés aux opiacés; Dose excessive; Épidémiologie; Epidemiology; Public health
• ISSN: 0008-4263; 1920-7476
• DOI: 10.17269/s41997-018-0053-6

Objectives
Substance and opioid misuse are growing public health concerns. This study’s objectives were to evaluate trends in substance and opioid misuse-related emergency department (ED) visits in Alberta, Canada.
Methods
This is a cross-sectional time-series analysis utilizing National Ambulatory Care Reporting System ED data from Alberta, Canada. All substance and opioid misuse-related visits made by adults (≥ 18 years) from 2010/11 to 2014/15 were analyzed. Acuity was measured by the Canadian Triage and Acuity Scale (CTAS). Relevant visits were identified by ICD-10 diagnostic coding. Substance and opioid visits over 60 months were compared to all ED visits per 100,000 adult population using regression analysis, while controlling for temporal and seasonal variation. Trends among age and sex subgroups were also evaluated.
Results
From 2010/11 to 2014/15, substance and opioid misuse-related visits increased by 38.0% and 57.3% to 1119 and 118 visits per 100,000 population, respectively. Annual growth rates for substance and opioid visits were 4.4% higher (95% CI: 2.2, 6.7) and 10.6% higher (95% CI: 6.8, 14.6) than all ED visits. The 18–29 year-old category experienced the highest annual growth rate of all age groups, and the annual opioid visit growth rate was 5.6% higher among males than females. Compared to all visits, substance misuse-related visits arrived more frequently by ambulance, were higher acuity, and were hospitalized more often.
Conclusion
Substance and opioid misuse-related ED visits increased significantly from 2010 to 2015, especially among younger patients. Future research should elaborate causes and evaluate interventions to curb the growth of this issue.