Predictors of receiving an emergency department naloxone prescription following an opioid overdose

[...]naloxone distribution programs have been increasingly integrated into the emergency department (ED) in an effort to better reach high-risk patients. [...]future ED naloxone programs should focus on directly dispensing naloxone at the point of care and overcoming administrative barriers to ensure patient access.Funding source This project was supported by a grant from the National Institute on Drug Abuse K23DA039974. Variable Cohorta Total No prescription Prescription N = 438 N = 343 N = 95 Age in years (SD) 37.4 (12.0) 38.0 (12.1) 35.1 (11.7) Female 107 (24.4) 86 (25.1) 21 (22.1) Insurance CAID 299 (68.3) 242 (70.6) 57 (60) Other 88 (20.1) 66 (19.2) 22 (23.2) Self 51 (11.6) 35 (10.2) 16 (16.8) Race Black/African American 62 (14.2) 53 (15.5) 9 (9.5) White/Caucasian 331 (75.6) 255 (74.3) 76 (80) Other 45 (10.3) 35 (10.2) 10 (10.5) Medical history Opioid poisoning 143 (32.6) 126 (36.7) 17 (17.9) Opioid use 174 (39.7 156 (45.5) 18 (18.9) Other substance use# 127 (29) 107 (31.2) 20 (21.1) Mental Illness% 121 (27.6) 104 (30.3) 17 (17.9) Prior naloxone prescription 3 (0.7) 2 (0.6) 1 (1.1) Chief complaint Opioid overdose 414 (94.5) 321 (93.6) 93 (97.9) Heroin overdose 337 (76.9) 255 (74.3) 82 (86.3) Heroin use 21 (4.8) 20 (5.8) 1 (1.1) Polysubstance use 3 (0.7) 2 (0.6) 1 (1.1) Social work evaluation 89 (20.3) 65 (19) 24 (25.3) Psychiatric evaluation 10 (2.3) 10 (2.9) 0 (0) ED Naloxone administered 129 (29.5) 104 (30.3) 25 (26.3) Table 1 Comparison of demographics and visit characteristics between no prescription and prescription cohorts Variable aOR (95% CI) Age 0.98 (0.96–1.00) Female 0.79 (0.44–1.42) Insurance vs CAID Other 1.15 (0.63–2.09) Self 1.24 (0.61–2.54) Social work evaluation 1.29 (0.73–2.29) Chief complaint Opioid overdose 7.46 (0.96–58.01) Polysubstance use 14.87 (0.54–407.96) Any opioid use in 5 Years prior 0.31 (0.17–0.56) Table 2 Multivariate Logistic Regression Model for Receiving Naloxone Prescription