Patient characteristics associated with being offered take home naloxone in a busy, urban emergency department: a retrospective chart review

People who visit the emergency department (ED) for opioid overdose are at high risk for future overdose death. Offering these patients take-home naloxone (THN) can help prevent future mortality. We examined medical records to determine the percentage of patients seen for opioid overdose that were offered THN in the Royal Alexandra Hospital ED. We also looked at factors that influenced whether or not a patient was offered THN.

We found that in half of the ED visits for overdose, patients were offered THN. Patients were more likely to be offered THN if they had used an illegal opioid, or if they were unconscious when they were found by EMS. Patients were less likely to be offered THN if they had a current prescription for opioids, if they were admitted to the hospital after their ED visit, or if they left the ED before they were formally discharged.

Based on our findings, we have recommended that hospital staff should offer THN at the beginning of an ED visit to ensure patients who leave unexpectedly are not missed. It is important to recognize that there is a risk of future overdose among people who use prescription as well as illegal opioids, and THN should be offered accordingly.

Resources

Study Lead: Elaine Hyshka (principal investigator) and Daniel O’Brien (research assistant and former MSc. student)

Funding Support: Alberta Innovates Health Solutions (AIHS), The Alberta Health Services Emergency Strategic Clinical Network (ESCN), The Edmonton Emergency Physicians Association (EEPA), and Canadian Research Initiative on Substance Misuse (CRISM) – Prairie Node

Status: Complete