• Christopher Griggs, Stephen Wyatt, Meghan K Wally, Michael Runyon, Joseph R Hsu, Rachel B Seymour, Michael Beuhler, Michael J Bosse, Ryan Fogg, Michael Gibbs, Eric Haas, Steven Jarrett, Daniel Leas, Animita Saha, Sharon Schiro, Bradley Watling, and PRIMUM Group.
• Atrium Health Musculoskeletal Institute, Department of Orthopaedic Surgery, Carolinas Trauma Network Research Center of Excellence, Atrium Health, Charlotte, NC (MKW, JRH, RBS, MJB, RF, EH, DL, SS); Poison Information Center, Atrium Health, Charlotte, NC (MB); Department of Emergency Medicine, Carolinas Trauma Network Research Center of Excellence, Atrium Health, Charlotte, NC (CG, MR, MG); Patient Safety, Atrium Health, Charlotte, NC, USA (SJ); Department of Internal Medicine, Atrium Health, Charlotte, NC (AS); US Acute Care Solutions, Atrium Health, Pineville, NC (BW); Adult Psychiatry, Atrium Health, Charlotte, NC (SW).
• J Addict Med. 2019 Sep 1; 13 (5): 396-402.

ObjectivesAddiction and overdose related to prescription drugs continues to be a leading cause of morbidity and mortality in the United States. We aimed to characterize the prescribing of opioids and benzodiazepines to patients who had previously presented with an opioid or benzodiazepine overdose.MethodsThis was a retrospective chart review of patients who were prescribed an opioid or benzodiazepine in a 1-month time-period in 2015 (May) and had a previous presentation for opioid or benzodiazepine overdose at a large healthcare system.ResultsWe identified 60,129 prescribing encounters for opioids and/or benzodiazepines, 543 of which involved a patient with a previous opioid or benzodiazepine overdose. There were 404 unique patients in this cohort, with 97 having more than 1 visit including a prescription opioid and/or benzodiazepine. A majority of prescriptions (54.1%) were to patients with an overdose within the 2 years of the documented prescribing encounter. Prescribing in the outpatient clinical setting represented half (49.9%) of encounters, whereas emergency department prescribing was responsible for nearly a third (31.5%).ConclusionsIn conclusion, prescribing of opioids and benzodiazepines occurs across multiple locations in a large health care system to patients with a previous overdose. Risk factors, such as previous overdose should be highlighted through clinical decision support tools in the medical record to help prescribers identify patients at higher risk and to mobilize resources for this patient population. Prescribers need further education on factors that place their patients at risk for opioid use disorder and on alternative therapies to opioids and benzodiazepines.

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