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Outcomes and resource utilisation of patients presented to the emergency department with opioid and benzodiazepine poisoning
  1. Christine Ramdin1,
  2. Michael Makutonin2,
  3. Lewis S Nelson1,
  4. Andrew C Meltzer2,
  5. Maryann Mazer-Amirshahi3
  1. 1 Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
  2. 2 Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
  3. 3 Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, USA
  1. Correspondence to Dr Christine Ramdin, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; cramdin{at}

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Many overdose deaths are associated with patient co-use of opioids and other substances, such as benzodiazepines.1–3 However, the literature is sparse surrounding the characteristics, treatment, outcomes, costs, disposition and resource utilisation of people who co-use compared with those who use opioids alone.

This is an Institutional Review Board-exempt retrospective review of de-identified ED data available for the state of Maryland through the Healthcare Cost and Utilization Project (HCUP) database from 2016 to 2018. We included patients who presented to the ED with opioid exposures either alone or with benzodiazepine, using ICD-10 (International Statistical Classification of Diseases, 10TH Revision) codes (online supplemental file A). We censored the first 6 months of the dataset to remove patients with opioid only visits, to ensure that we captured only initial visits for co-use. Therefore, the observation window for this study was 1.5 years, where patients were followed for a year. We excluded cases that had missing demographic data in the initial visit when we conducted regression analyses. However, these cases were included in the univariate and outcome calculations. Sample size was based on available data. We used Welch’s t-test to compare patients who co-used …

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  • Handling editor Gene Yong-Kwang Ong

  • Twitter @acmeltzer

  • Presented at This manuscript was presented as an abstract at ACEP research forum in October 2022.

  • Contributors CR—conceptualisation, investigation, methodology, project administration, supervision, visualisation, writing (original draft preparation), writing (review and editing). MM—conceptualisation, data curation, formal analysis, investigation, methodology, writing (review and editing). LSN—conceptualisation, project administration, supervision, validation, writing (review and editing). ACM—investigation, methodology, writing (review and editing). MM-A—conceptualisation, investigation, methodology, supervision, writing (review and editing).

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.