Medications for Opioid Use Disorder and Mortality and Hospitalization among People with Opioid Use-Related Infections

Citation

Figgatt, Mary C.; Hincapie-Castillo, Juan M.; Schranz, Asher J.; Dasgupta, Nabarun; Edwards, Jessie K.; Jackson, Bradford E.; Marshall, Stephen W.; & Golightly, Yvonne M. (2024). Medications for Opioid Use Disorder and Mortality and Hospitalization among People with Opioid Use-Related Infections. Epidemiology, 35(1), 7-15.

Abstract

BACKGROUND: Severe skin and soft tissue infections related to injection drug use have increased in concordance with a shift to heroin and illicitly manufactured fentanyl. Opioid agonist therapy medications (methadone and buprenorphine) may improve long-term outcomes by reducing injection drug use. We aimed to examine the association of medication use with mortality among people with an opioid use-related skin or soft tissue infections.
METHODS: An observational cohort study of Medicaid enrollees aged 18 years or older following their first documented medical encounters for opioid use-related skin or soft tissue infections during 2007-2018 in North Carolina. The exposure was documented medication use (methadone or buprenorphine claim) in the first 30 days following initial infection compared to no medication claim. Using Kaplan-Meier estimators, we examined the difference in 3-year incidence of mortality by medication use, weighted for year, age, comorbidities, and length of hospital stay.
RESULTS: In this sample, there were 13,286 people with opioid use-related skin or soft tissue infections. The median age was 37 years, 68% were women, and 78% were white. In Kaplan-Meier curves for the total study population, 12 of every 100 patients died during the first 3 years. In weighted models, for every 100 people who used medications, there were 4 fewer deaths over 3 years (95% confidence interval:2 to 6).
CONCLUSIONS: In this study, people with opioid use-related skin and soft tissue infections had high risk of mortality following their initial healthcare visit for infections. Methadone or buprenorphine use was associated with reductions in mortality.

URL

http://dx.doi.org/10.1097/EDE.0000000000001681

Reference Type

Journal Article

Year Published

2024

Journal Title

Epidemiology

Author(s)

Figgatt, Mary C.
Hincapie-Castillo, Juan M.
Schranz, Asher J.
Dasgupta, Nabarun
Edwards, Jessie K.
Jackson, Bradford E.
Marshall, Stephen W.
Golightly, Yvonne M.

Article Type

Regular

Continent/Country

United States

State

North Carolina

Race/Ethnicity

White
Hispanic
Black

ORCiD

Edwards, J -0000-0002-1741-335X