Opioid-Related Visits to Rural Emergency Departments


Increased rates of acute opioid poisoning and related emergency department (ED) visits in the U.S. have occurred at the same time as rural EDs face a number of resource constraints. The purpose of this study was to examine rural and urban ED visits for acute opioid poisoning using the Nationwide Emergency Department Sample from the Agency for Healthcare Research and Quality.

The study compared rural and urban opioid-related visits (ORVs) to EDs, including rate change over time, and the outcomes of these visits (treatment and release, inpatient admission, transfer, and death). The study found that between 2006 and 2013, ORVs as a proportion of total visits increased in rural and urban EDs. Rural ORV rates were lower than urban rates in both time periods, but this difference narrowed because of somewhat higher rural increases. Rural ORVs were more likely than those in urban areas to be by patients 65 and older and to involve concurrent use of benzodiazepines. One fifth of ORVs by rural residents occurred in urban EDs, and rural EDs were more likely to transfer patients to another hospital.

More research is needed to understand the impact of rural residents' treatment in urban EDs or other facilities on short- and long-term outcomes for patients who experience an ORV.

Maine Rural Health Research Center
Erika Ziller, Jean Talbot, Deborah Thayer, Carly Milkowski