Study Suggests Rates of Accidental Poisoning among VA Patients Higher than General Population
BACKGROUND:
Unintentional poisoning is the second most common cause of accidental death among adults in the U.S and 95% of poisoning deaths are due to medications, alcohol, and illegal drugs. Since healthcare systems both distribute potentially poisoning medications and treat substance use disorders, accidental poisoning mortality is an increasingly important concern. This study describes the rate of accidental poisoning mortality among Veterans who used VA healthcare services, compares this rate to the general U.S. population, and describes the drugs/medications involved. The study cohort included more than five million Veterans who used VA healthcare services during FY04 or FY05 – and who were alive at the beginning of FY05. Investigators used VA data in addition to data from the National Death Index and the CDC to determine mortality and cause of death.
FINDINGS:
- For FY05, VA patients had nearly twice the rate of fatal accidental poisoning compared to adults in the general population. The crude accidental poisoning mortality rate was 20 per 100,000 person years for VA healthcare users compared to a crude rate of 10 for the U.S. population as a whole.
- Among VA patients who died from accidental poisoning, opioid medications (including methadone) made up 32% of the reported deaths; cocaine also was common at 23%.
- In both the VA and U.S. general populations, the rate of accidental poisoning mortality was higher for men than women, and higher for individuals ages 30 to 64 as compared to those ages 18 to 29, or ages 65 and older.
- Although VA patients have a greater risk of suicide than death by accidental poisoning, their risk for accidental poisoning death relative to the general population is larger than that of suicide.
LIMITATIONS:
- Cause of death was based on medical examiners’ records, and differentiating between suicidal and accidental poisonings is difficult. Moreover, interviews with non-fatal poisoning victims indicate that intention does not always clearly fit into categories of suicidal and accidental.
AUTHOR/FUNDING INFORMATION:
This study was funded through VA’s Office of Mental Health Services and the Office of Academic Affiliations. Dr. Bohnert was supported by an HSR&D Career Development Award. Drs. Bohnert, Ilgen, McCarthy, and Blow are part of HSR&D’s Center for Clinical Management Research in Ann Arbor, MI.
Bohnert A, Ilgen M, Galea S, McCarthy J, and Blow F. Accidental Poisoning Mortality among Patients in the Department of Veterans Affairs Health System. Medical Care April 2011;49(4):393-96.
