MedicalResearch.com Interview with: Mayesha Khan, M.A. Research Coordinator Staples Lab | Road Safety & Public Health Research Dr. John A. Staples MD, FRCPC, MPH Clinical Associate Professor Department of Medicine The University of British Columbia | VCH Research Institute MedicalResearch.com: What is the background for this study? Response: About one in thirty patients leave hospital before their inpatient medical treatment is complete. Before medically advised (BMA) discharge from hospital (also known as patient-initiated discharge) is associated with a several-fold increase in mortality in the following year compared to routine physician-advised discharge. The study’s senior author is a physician who works in the hospital (JS), and it’s the patients who initiate a BMA discharge that he often worries about the most. We knew from past research that the rate of BMA discharge is much higher among people who use drugs. We suspected that the risk of drug overdose after BMA discharge was much higher than the risk of overdose after routine physician-advised discharge. We also suspected that BMA discharge itself might create conditions that encourage drug use and increase the risk of overdose. A hospital stay can result in drug abstinence and reduced drug tolerance, and it can disrupt social routines and interfere with access to familiar/safer sources of drugs. BMA discharges sometimes occur suddenly, leaving little time to prescribe medications for opioid use disorder like methadone and Suboxone. Lingering illness or persistent pain after leaving hospital might prompt people to engage in heavier-than-usual drug use. All of these factors might increase the risk of overdose after BMA discharge. (more…)