Opioid use disorder-related emergency department visits among deaf or hard of hearing adults in the United States.

BACKGROUND

Despite the devastating consequences of the opioid epidemic, little is known about its impact on the deaf and hard of hearing (DHH) community.

OBJECTIVE

To determine risk of OUD-related ED visits, ED visits involving a prescription or non-prescription opioid overdose, and mortality during OUD-related ED visits among DHH adults, compared to non-DHH adults.

METHODS

We analyzed the combined 2016-2017 National Emergency Department Sample (NEDS). We identified DHH adults using ICD-10-CM codes, extracting 63,865 case records of ED visits among DHH adults ages 18-64. The control group of non-DHH adult ED visits was age-, sex-, and admission year-matched in a 1:3 case-control ratio. We conducted multi-level logistic regression models for the binary dependent variables. Covariates included sociodemographic, hospital, and clinical characteristics.

RESULTS

In our unadjusted models, compared to non-DHH adults, DHH adults had significantly higher risk for OUD-related ED visits (OR = 1.69, 95%CI: 1.59-1.80, p < 0.001), ED visits involving prescription (OR = 1.80, 95%CI: 1.47-2.20, p < 0.001) and non-prescription opioid overdose (OR = 1.31, 95%CI: 1.05-1.63, p < 0.05), and mortality during OUD-related ED visits (OR = 2.22, 95%CI: 1.21-4.08, p < 0.05). However, after adjustment for confounding variables, including comorbid chronic pain and psychiatric conditions, except OUD-related ED visits, the risk for ED visits involving prescription and non-prescription opioid overdose, and OUD-related mortality became non-significant.

CONCLUSIONS

Compared to adults without hearing loss, DHH non-elderly adults are at a higher risk of OUD-related ED visits. Future research is needed to understand the interplay between chronic pain, psychiatric conditions, and OUD among DHH adults.