Opioid Use Disorder and Pharmacological Treatment in Southwestern North Carolina: NC SID Database 2000-2020

The objectives of the study were to provide a descriptive assessment of patient and hospital characteristics among individuals with an opioid use disorder (OUD) diagnosis in North Carolina and the seven western North Carolina counties and to identify rates of selected psychiatric/physical health outcomes associated with OUD and treatment gaps in medications for opioid use disorder (MOUD).

Using the State Inpatient Database (SID), analyses were conducted to identify OUD and MOUD-related discharges between 2000 and 2020. Descriptive statistics and rates of OUD per 1000 discharges were calculated. Statistical significance for rates of OUD and non-OUD cases was determined using 95% confidence intervals. Variables indicating OUD diagnosis, MOUD participation, and comorbidities were identified.

The seven selected counties in North Carolina had a total of 396,183 hospitalizations between 2000 and 2020. Apart from Macon County, the overall county-level prevalence rates of OUD were consistently higher than that of the state. Compared with North Carolina, the median hospital length of stay and hospital charges for OUD patients in the seven counties were consistently higher than those for non-OUD discharges. Significant MOUD treatment gaps were observed in the seven counties.

The impact of the opioid epidemic is still pervasive in North Carolina, particularly in the seven western countries. The high rates of OUD and comorbid conditions in tandem with treatment shortages pose serious public health threats in these rural communities. Policies, funding, and programmatic efforts should prioritize the expansion of MOUD and other treatment efforts, including crisis services, harm reduction services, and recovery programs. Public health needs assessment that involves both patients and stakeholders should be carried out to deliver targeted health services and deploy necessary resources in this medically underserved region.