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Psychiatric comorbidities, polysubstance use, recent opioid use, and injection drug use drive higher readmission and mortality in opioid use disorder, while treatment adherence reduces readmission but not mortality.
A large retrospective study highlights major risk factors for treatment readmission and mortality in opioid use disorder (OUD), underscoring the impact of psychiatric comorbidities, polysubstance use, and human immunodeficiency virus (HIV) infection on patient outcomes.
The analysis included 16,343 people treated at 124 public outpatient substance use disorder centers. Using recurrent-event survival analysis with terminal events (re-Reg model), researchers simultaneously assessed repeated treatment readmissions and mortality risk, offering a comprehensive real-world evaluation.
Patients were more likely to experience treatment readmission if they had recent opioid use (within 30 days), parental responsibilities (having a child), polysubstance use disorders (cannabis, cocaine, alcohol), and psychiatric comorbidities like cluster B personality, psychotic, and anxiety disorders.
In contrast, mortality risk was strongly linked with injection drug use, human immunodeficiency virus (HIV)-positive status, alcohol use disorder, and cluster B personality disorders, highlighting a distinct high-risk clinical profile.
Importantly, treatment adherence substantially minimized the risk of readmission, but did not lower mortality risk, suggesting that different mechanisms drive recurrent treatment episodes and death in OUD. These findings emphasize the requisition for personalized addiction treatment, integrating mental health care, harm reduction strategies, and management of polysubstance use. The use of re-Reg survival analysis facilitates better identification of high-risk patients who may benefit from intensive monitoring and targeted interventions.
International Journal of Mental Health and Addiction
Mortality and Readmission in Opioid Patients: Associations with Comorbid Disorders and Treatment Adherence
Marta Narváez-Camargo et al.
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