Problem: Drug Overdoses and Hospital Readmissions

A drug overdose means:

*having too much of a drug in one’s body
*Drug users’ tolerance for a drug can drop quickly if they haven’t used in a while and they ingest the amount used previous to hospital admission
*This new round of drug ingestion can cause an overdose and re-admission to the hospital
*Signs of an overdose:
1. shallow breathing
2. blue lips
3. floppy arms
4. no response to stimuli
5. disorientation

The sad part is that drug overdose, or at least substance abuse requiring hospital treatment, happens too often. A recent article evidences that drug overdoses occur all to frequently, especially during certain community events:

http://loyolamedicine.org/newswire/news/chicago-hospitals-brace-surge-drug-cases-during-lollapalooza

In my experience, here’s a typical Saturday night in a behavioral healthcare hospital’s admission’s department:

11:00 p.m., and there are (twenty-three) 23 patients in the admissions department of Beach Hospital (fictitious name) , a behavioral health acute care facility treating people with drug and alcohol and acute psychiatric problems. Almost all of these patients have just self-administered at least five (5) bags of heroin prior to their arrival. Some patients are seriously impaired with alcohol while others are under the influence of oxycodone and another drug of choice. Blood, urine, moans from withdrawal pains, cries for help, and other physical responses are commonplace in this admissions department. Patients writhe on the floor, others are slumped in their chairs with vomit. The admissions department is pulsing with activity: ancillary staff are taking histories, nurses are taking physicals, physicians are busy entering admission and medication orders in the electronic medical record while attending to the medical needs of the patient. While these events may appear chaotic and unseemly to the average person, Beach Hospital staff are used to situations like this. What is unusual about tonight, however, is that most of these patients have been previously admitted to Beach Hospital. In fact, staff recognize some of these readmitted patients and even know them by their first name.

Also, look at this graph- shocking that we see so much hospital admissions for drug abuse.

Rates of Drug-Related ED visits per 100,000 population by age group, 2011

Readmission rates are a critical indicator for Medicare; the higher the rates, the lower the Medicare payment. Perhaps Beach Hospital could stem readmissions if their discharge planning were better. So, go to the SOLUTIONS link to see what Hospitals can do to reduce drug users’ readmissions.