Against medical advice (AMA) discharges among patients admitted for treatment of alcohol withdrawal occurred in 1 of every 7 admissions, a recent study found. Furthermore, being admitted from the emergency department (ED) and younger age were associated with AMA discharge. Data from admissions to a dedicated unit for treatment of substance withdrawal were collected over a 6-month period. Patients with AMA and planned discharge were compared with regard to demographics, clinical data, and substance use disorder disease characteristics. A stepwise logistic regression was used to find the best model. The study population included 655 patient encounters. Researchers found:

• A total of 93 (14%) discharges were AMA.
• Bivariate analysis showed patients with AMA discharge were younger (mean age 43 vs 46 years), more likely to leave on a Tuesday to Thursday, and to have an initial withdrawal score at or above the median (AMA 69% vs planned 56%).
• ED admissions had an AMA discharge rate of 21% compared with 10% of community admissions.
• There was no significant difference in discharge disposition among patients with concurrent opioid use disorder who were on opioid agonist therapy.