Recovery Capital and Subsequent Overdose Risk and Addiction Treatment Engagement Among Emergency Department Patients at High Risk of Opioid Overdose

Bibliographic Data

ID21646121
AuthorsLaura C Chambers (0000-0003-1802-6578, Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, corresponding author), Ralph Welwean (0000-0003-3019-0549, Brown University), Ralph A Welwean (Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island), Daniel K Cho (0000-0002-9272-3497, Alpert Medical School of Brown University, Providence, Rhode Island), Kirsten J Langdon (0000-0001-8404-397X, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island), Yu Li (0000-0002-0964-6399, Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island), Benjamin D Hallowell (0000-0002-6943-9615, Substance Use Epidemiology Program, Rhode Island Department of Health, Providence, Rhode Island), Mackenzie Daly (0009-0006-8271-5094, Providence College), Mackenzie M Daly (Research, Data Evaluation, and Compliance Unit; Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals; Providence, Rhode Island), Brandon D L Marshall (0000-0002-0134-7052, Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island), Francesca L Beaudoin (0000-0002-0462-019X, Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island)
Year2025
Volume60
Issue3
Pages381-392
Publication date2025-02-23
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueSubstance Use & Misuse (JOURNAL)
Journal identifiersISSN: 1082-6084 • E-ISSN: 1532-2491
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/10826084.2024.2434003
PMID39618048
OpenAlexW4404900494
LanguageEN
References cited36

BACKGROUND: Emergency department (ED) visits are an opportunity to provide prevention services to people at high risk of overdose. Considering patients' resources to initiate and sustain recovery ("recovery capital") may be useful for tailoring ED services, although its relevance in this population is unknown. METHODS: This secondary analysis used data from ED patients at high risk of opioid overdose enrolled in a randomized controlled trial in Rhode Island (2018-2021). We assessed baseline recovery capital using the Brief Assessment of Recovery Capital (BARC-10), dichotomized as a total score <47 versus ≥47. Post-discharge addiction treatment engagement within 30 days and non-fatal opioid overdose and fatal overdose within 18 months were assessed using statewide administrative data. We used modified Poisson regression and Cox proportional hazards models to estimate the association between recovery capital and (1) treatment engagement and (2) overdose risk, respectively, adjusting for potential confounders. RESULTS: Among 543 participants, 32.2% had a baseline BARC-10 total score of ≥47, 32.6% engaged in treatment within 30 days, and 25.6% had a non-fatal opioid overdose and 4.2% had a fatal overdose within 18 months. BARC-10 total score was not associated with treatment engagement within 30 days (adjusted relative risk = 0.79, 95% confidence interval [CI] = 0.60-1.05) or non-fatal opioid overdose (adjusted hazard ratio [aHR] = 0.83, 95%CI = 0.57-1.20) or fatal overdose (aHR = 0.45, 95%CI = 0.14-1.40) within 18 months. CONCLUSION: The majority of ED patients at high risk of opioid overdose had a BARC-10 total score of <47, suggesting low recovery capital. BARC-10 total score was not associated with post-discharge treatment engagement or overdose risk

Addiction · Emergency department · Environmental health · Medical emergency · Opioid · Opioid overdose · Population · Psychiatry · Emergency and Acute Care Studies · Medicine · Mental Health and Patient Involvement · Opioid Use Disorder Treatment · Emergency Medicine