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High Stakes in Opioid Relapse: How Traumatic Injury Mechanism Affects Recovery
Samantha Watts
1, Hannah Bard
1, Gurkeerat Singh
1, Robert E Koegel
1, Sophia M Smith
2, Anne K Buck
3, Lisa Allee
1,
2
1Boston University Chobanian and Avedisian School of Medicine, 2Department of Surgery, Boston Medical Center, 3Boston University School of Public Health
Background: Hospitalized patients with opioid use disorder (OUD) often relapse following discharge, but the impact of injury mechanism on relapse rates is unclear. This study examines relapse rates one-year post-discharge in patients with OUD following a traumatic injury to identify injury mechanisms linked to higher relapse rates and guide interventions.
Methods: Injury mechanisms (gunshot wounds, pedestrian, motor vehicle collision (MVC/MCC), assault, stab wound, fall, and other) were analyzed for 209 trauma patients with pre-existing OUD admitted to Boston Medical Center (January 2017–December 2022). Chi-square analysis assessed the link between injury mechanism and one-year post-discharge relapse.
Results: Relapse rates varied significantly by injury mechanism (?˛=15.92, p=0.014). Stab wound and assault patients had 82% and 69% relapse rates, respectively. Together, these are 1.65 times higher than the relapse rates for MVC/MCC and fall patients combined, which both had a 46% relapse rate. Falls, the largest injury group (28%), had the lowest relapse rate at 46%.
Conclusion: The high relapse rates in stab wound and assault patients underscore the need for specialized post-discharge care for high-risk injury groups compared to lower-risk groups like MVC/MCC and fall patients. This suggests that injury mechanism can be used as a proxy to stratify one-year post-discharge relapse risk to provide more tailored interventions, including individualized counseling, targeted support, and enhanced monitoring, to improve outcomes and address the needs of this vulnerable population.
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