Discharge Before Medically Advised Associated With Subsequent Overdose

Background: Risk of drug overdose may rise after hospital discharge. It is unclear if discharge before medically advised conveys additional risk. Objective: To assess the association between hospital discharge before medically advised and drug overdose. Design: Self-matched case-crossover study. Participants: Patients experiencing drug overdose in British Columbia between 2016 and 2019. Methods: The outcome of interest was hospital discharge, either patient directed or physician initiated, within the 28-day period prior to an overdose. Two 28-day lookback periods 6 and 12 months before the overdose served as the control. The authors compared hospital discharges during case and control periods for each patient. Results: 27,584 overdoses occurred among 26,589 individuals. Patient-initiated discharge was associated with double the risk of overdose compared with control periods (odds ratio [OR], 2.08). Physician-initiated discharge was also associated with overdose (OR, 1.39). Homelessne more...