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People with an opioid addiction are more likely to leave the hospital early and against medical advice, before treatment for an injury or infection is complete, according to a new study.
It’s happening as often as one in every six hospital admissions — a number that researchers at the University of Pennsylvania call scary, and a “dramatic rise” from previous years.
The increase in early discharge rates is co-occurring with the rapid spread of fentanyl in street drug supplies in Philadelphia and across the country, said study author Dr. Ashish Thakrar, an addiction medicine specialist and UPenn assistant professor of medicine.
“There is an expectation a lot of them have that they will have untreated withdrawal, that they’ll have undertreated pain,” he said. “Many of them have had, frankly, stigmatizing experiences from health care providers who might be well intentioned, but who ultimately make a lot of these individuals feel like they don’t belong there.”
Fentanyl is a synthetic opioid up to 50 times more potent than heroin. Experts say it can cause severe withdrawal symptoms when there’s a delay between injections or doses.
Since the highly potent drug began showing up in street drugs a few years ago, Thakrar said he and his colleagues began noticing that more patients with opioid addiction were not staying in the hospital.
Researchers looked at hospital admissions and discharge records from 30 states for their study, published Dec. 4 in the Journal of the American Medical Association.
Data confirmed that patients living with addiction were leaving early about 10% to 17% of the time in 2020, compared to 5% to 10% of the time in 2016. The increase was most pronounced among patients with both an opioid use disorder and an infection related to injection drug use.
By contrast, less than 2% of patients in the general population are discharged against medical advice.