{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:38:09Z","timestamp":1791945489206,"version":"4.3.4"},"reference-count":47,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T00:00:00Z","timestamp":1701648000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["DRF\u20102018\u201011\u2010ST2\u2010016"],"award-info":[{"award-number":["DRF\u20102018\u201011\u2010ST2\u2010016"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>People who use illicit opioids have higher mortality and morbidity than the general population. Limited quantitative research has investigated how this population engages with health\u2010care, particularly regarding planned and primary care. We aimed to measure health\u2010care use among patients with a history of illicit opioid use in England across five settings: general practice (GP), hospital outpatient care, emergency departments, emergency hospital admissions and elective hospital admissions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This was a matched cohort study using Clinical Practice Research Datalink and Hospital Episode Statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Primary and secondary care practices in England took part in the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>A total of 57\u2009421 patients with a history of illicit opioid use were identified by GPs between 2010 and 2020, and 172\u2009263 patients with no recorded history of illicit opioid use matched by age, sex and practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>We estimated the rate (events per unit of time) of attendance and used quasi\u2010Poisson regression (unadjusted and adjusted) to estimate rate ratios between groups. We also compared rates of planned and unplanned hospital admissions for diagnoses and calculated excess admissions and rate ratios between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>A history of using illicit opioids was associated with higher rates of health\u2010care use in all settings. Rate ratios for those with a history of using illicit opioids relative to those without were 2.38 [95% confidence interval (CI)\u2009=\u20092.36\u20132.41] for GP; 1.99 (95% CI\u2009=\u20091.94\u20132.03) for hospital outpatient visits; 2.80 (95% CI\u2009=\u20092.73\u20132.87) for emergency department visits; 4.98 (95% CI\u2009=\u20094.82\u20135.14) for emergency hospital admissions; and 1.76 (95% CI\u2009=\u20091.60\u20131.94) for elective hospital admissions. For emergency hospital admissions, diagnoses with the most excess admissions were drug\u2010related and respiratory conditions, and those with the highest rate ratios were personality and behaviour (25.5, 95% CI\u2009=\u200923.5\u201327.6), drug\u2010related (21.2, 95% CI\u2009=\u200920.1\u201321.6) and chronic obstructive pulmonary disease (19.4, 95% CI\u2009=\u200918.7\u201320.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients who use illicit opioids in England appear to access health services more often than people of the same age and sex who do not use illicit opioids among a wide range of health\u2010care settings. The difference is especially large for emergency care, which probably reflects both episodic illness and decompensation of long\u2010term conditions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16401","type":"journal-article","created":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T03:50:22Z","timestamp":1701748222000},"page":"730-740","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Health\u2010care resource use among patients who use illicit opioids in England, 2010\u201320: A descriptive matched cohort study"],"prefix":"10.1111","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2282-8584","authenticated-orcid":false,"given":"Naomi","family":"van Hest","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Public Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5570-5556","authenticated-orcid":false,"given":"Thomas D.","family":"Brothers","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health University College London  London UK"},{"name":"Department of Medicine Dalhousie University  Halifax Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Williamson","sequence":"additional","affiliation":[{"name":"School of Health and Wellbeing, MVLS University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3698-7196","authenticated-orcid":false,"given":"Dan","family":"Lewer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health University College London  London UK"},{"name":"Bradford Institute for Health Research Bradford Teaching Hospitals NHS Foundation Trust  Bradford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,4]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"4","article-title":"Introduction: landscape of opioid dependence","volume":"16","author":"Jan SA","year":"2010","journal-title":"J Manag Care Pharm"},{"key":"e_1_2_10_3_1","volume-title":"Estimates of the prevalence of opiate use and\/or crack cocaine use, 2016\/17: Sweep 13 report","author":"Hay G","year":"2019"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.4170"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31869-X"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12337"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2010.03140.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.06.027"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-bioeng-060418-052155"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp10X483175"},{"key":"e_1_2_10_11_1","volume-title":"Type 2 diabetes in adults: management (NG28)","author":"National Institute for Health and Care Excellence (NICE)","year":"2020"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2524.2007.00739.x"},{"key":"e_1_2_10_13_1","first-page":"489","article-title":"Stigma among health professionals towards patients with substance use disorders and its consequences for health\u2010care delivery: systematic review","volume":"57","author":"Boekel L","year":"2015","journal-title":"Tijdschr Psychiatr"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.06.010"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14892"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv098"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz034"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5135"},{"key":"e_1_2_10_19_1","unstructured":"NHS Digital.SNOMED CT2023. 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