Investigating the Opioid Epidemic in Illinois: An Analysis of Emergency Room Utilization

Abstract

Introduction: Between July 2016 and September 2017, emergency department (ED) visits for opioid overdose increased by 30% in the United States and by 66% in Illinois. The objective of this study was to monitor the progression of the opioid epidemic in Illinois through an analysis of ED visits for opioid use, abuse, dependence, and overdose between January 2016 and June 2018. We analyze the relative incidence of inpatient hospitalization and death among patient demographics. Methods: Administrative data from 194 non-federal Illinois hospital EDs were obtained from the Illinois Hospital Association Comparative Health Care and Hospital Data Reporting Services database. We isolated ED visits with ICD-10 codes for opioids and looked at patient characteristics. We estimated Poisson regression models to calculate incidence rate ratios (IRRs) for death or hospitalization.Results: We found 130,785 ED visits for opioid use, abuse, dependence, or overdose during the 30-month study period. Comparing the first six months of each year, the average number of opioid-related ED visits increased from 3,935 visits per month in 2016 to 4,462 visits per month in 2018 (13% increase). Of those coded as opioid overdose (n=31,129), 65.6% were male, 52.5% were non-Hispanic white, 55.5% were between 35-64 years old, and 47.1% were Medicaid enrollees. Non-Hispanic blacks were less likely to have opioid-related death compared to non-Hispanic whites (IRR = 0.76, 95% CI = 0.60-0.95). Compared to visits for opioid use, visits coded as opioid overdose resulted in death more frequently (IRR = 2.04, 95% CI = 1.60-2.61) and hospitalization less frequently (IRR = 0.65, 95% CI = 0.56-0.76). Visits coded as opioid dependence resulted in death less frequently (IRR = 0.65, 95% CI = 0.50-0.85) compared to opioid use. There were no statistically significant differences in hospitalization rates between opioid abuse or dependence and opioid use. Overdose with synthetic opioids had a lower likelihood of death compared to non-synthetic opioid use (IRR = 0.54, 95% CI = 0.32-0.93).Conclusions: Over 30 months, ED visits for opioid overdoses have increased whereas the number for opioid use, abuse, and dependence have remained unchanged. The number of deaths and hospitalizations by overdose primarily reflects trends in heroin use. Publicly available hospital administrative data has a wealth of valuable information for public health officials working to control the opioid epidemic.

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