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Heroin Overdose-Related Child and Adolescent Hospitalizations: Insight on Comorbid Psychiatric and Substance Use Disorders

Published on Jul 13, 2019in Systems Research and Behavioral Science 1.05
· DOI :10.3390/bs9070077
Objective: To evaluate the association between psychiatric comorbidities, substance use disorders and heroin overdose-related hospitalizations (HOD). Next, to understand the demographic trend of HOD hospitalizations and comorbidities. Methods: Using the Nationwide Inpatient Sample (NIS), we included 27,442,808 child and adolescent hospitalizations, and 1432 inpatients (0.005%) were managed primarily for HOD. The odds ratio (OR) of the association of variables in HOD inpatients were measured using a logistic regression model. Results: Adolescents had 56 times higher odds (95% CI 43.36–73.30) for HOD-related hospitalizations compared to 4.6% children under 11 years. About three-fifth of the HOD inpatients were male, and they had 1.5-fold higher odds (95% CI 1.30–1.64) compared to 43% females in the study population. Whites were considerably higher in proportion (81%) than other race/ethnicities. A greater portion of HOD inpatients (40%) were from high-income families. Most common comorbid psychiatric disorders were mood (43.8%) and anxiety (20.4%). The prevalent comorbid substance use disorders were opioid (62.4%), tobacco (36.8%) and cannabis (28.5%) use disorders. Conclusion: HOD-related hospitalizations were predominant in males, White and older adolescents (12–18 years). Prescription opioids are the bridge to heroin abuse, thereby increasing the vulnerability to other substance abuse. This requires more surveillance and should be explored to help reduce the heroin epidemic in children.
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Published on Jan 1, 2019in Drug and Alcohol Dependence 3.47
Heather Clinton1
Estimated H-index: 1
Amy A. Hunter1
Estimated H-index: 1
+ 1 AuthorsGarry Lapidus17
Estimated H-index: 17
Abstract Background Unintentional opioid overdose death rates have increased nearly 500% in Connecticut from 1999 to 2016, resulting in a major public health crisis. Two primary types of opioids have been implicated in these fatalities – illicit and pharmaceutical. The objective of this study is to describe the epidemiology of fatal unintentional opioid overdoses by type. Methods Using the National Violent Death Reporting System, rates of unintentional opioid-related overdose death in Connecticu...
Published on Dec 28, 2018
Julie R. Gaither11
Estimated H-index: 11
(Yale University),
Veronika Shabanova9
Estimated H-index: 9
(Yale University),
John M. Leventhal44
Estimated H-index: 44
(Yale University)
Importance It is not yet known how many children and adolescents die each year from opioid poisonings and how mortality rates have changed over time. Objective To examine national trends in pediatric deaths from prescription and illicit opioids. Design, Setting, and Participants Cross-sectional in which serial mortality data from the Centers for Disease Control and Prevention were analyzed. The population included 8986 children and adolescents (age, Exposures All opioids. Main Outcomes and Measu...
Published on Jun 1, 2018in Current Pediatrics Reports
Amy Yule5
Estimated H-index: 5
(Harvard University),
Rachael M. Lyons (Harvard University), Timothy E. Wilens90
Estimated H-index: 90
(Harvard University)
Purpose of Review To review information specific to adolescents regarding trends in opioid use, risk factors for opioid misuse, medical co-morbidity, and treatment updates.
Published on Apr 1, 2018in Pediatrics 5.40
Jason M. Kane9
Estimated H-index: 9
(U of C: University of Chicago),
Jeffrey D. Colvin9
Estimated H-index: 9
(Children's Mercy Hospital)
+ 1 AuthorsMatt Hall56
Estimated H-index: 56
(Boston Children's Hospital)
BACKGROUND AND OBJECTIVES: There has been a rapid increase in the rate of pediatric opioid-related hospitalizations. It is unknown how this increase has impacted the use of pediatric critical care. Our objective in this study was to assess the trends in pediatric hospitalization for opioid ingestions in a cohort of US children’s hospitals and, specifically, to evaluate the impact on pediatric critical care resource use. METHODS: A retrospective cohort study of the Pediatric Health Information Sy...
Published on Apr 1, 2018in Drug and Alcohol Dependence 3.47
Tabitha E.H. Moses2
Estimated H-index: 2
(WSU: Wayne State University),
Leslie H. Lundahl16
Estimated H-index: 16
(WSU: Wayne State University),
Mark K. Greenwald30
Estimated H-index: 30
(Eugene Applebaum College of Pharmacy and Health Sciences)
Abstract Background Rates of both opioid and sedative use and misuse are rising. Comorbid opioid and sedative use is associated with especially severe consequences ( e.g. , overdose and poor health outcomes). Heroin users report multiple motivations for sedative use, including self-medication. We aimed to understand differences in lifetime substance use characteristics between heroin users with different sedative use histories. Methods Substance use data were collected from 385 non-treatment see...
Published on Jan 1, 2018in American Journal of Public Health 5.38
Xiwen Huang1
Estimated H-index: 1
Katherine M. Keyes51
Estimated H-index: 51
Guohua Li46
Estimated H-index: 46
Objectives. To assess cohort effects in prescription opioid and heroin overdose mortality in the United States.Methods. Using the National Center for Health Statistics’ multiple-cause-of-death file for 1999 to 2014, we performed an age–period–cohort analysis of drug overdose mortality in the United States.Results. Compared with those born in 1977 and 1978, individuals born between 1947 and 1964 experienced excess risks of prescription opioid overdose death (e.g., for the 1955–1956 birth cohort, ...
Published on Dec 1, 2017in SSM-Population Health
Christopher J. Ruhm46
Estimated H-index: 46
(UVA: University of Virginia)
Abstract Death certificate data from the Multiple Cause of Death (MCOD) files were analyzed to better understand the drug categories most responsible for the increase in fatal overdoses occurring between 1999 and 2014. Statistical adjustment methods were used to account for the understatement in reported drug involvement occurring because death certificates frequently do not specify which drugs were involved in the deaths. The frequency of combination drug use introduced additional uncertainty a...
Published on Feb 1, 2017in Addictive Behaviors 2.96
Sean Esteban McCabe53
Estimated H-index: 53
(UM: University of Michigan),
Philip Veliz14
Estimated H-index: 14
(UM: University of Michigan)
+ 1 AuthorsJohn E. Schulenberg66
Estimated H-index: 66
(UM: University of Michigan)
Abstract Objectives This study assessed the longitudinal associations between medical and nonmedical use of prescription sedatives/anxiolytics (NMPSA) during adolescence (age 18) and substance use disorder (SUD) symptoms during adulthood (age 35). Methods Multiple cohorts of nationally representative samples of U.S. high school seniors (n = 8373) were surveyed via self-administered questionnaires and followed longitudinally from adolescence (age 18, 1976–1996) to adulthood (age 35, 1993–2013). R...
Anne Case50
Estimated H-index: 50
(Princeton University),
A-S Deaton87
Estimated H-index: 87
(Princeton University)
This paper documents a marked increase in the all-cause mortality of middle-aged white non-Hispanic men and women in the United States between 1999 and 2013. This change reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround. The midlife mortality reversal was confined to white non-Hispanics; black non-Hispanics and Hispanics at midlife, and those aged 65 and above in every racial and ethnic group, continued to see mortality ...
Published on Jan 1, 2015
Tatjana Dragisic1
Estimated H-index: 1
Aleksandra Dickov5
Estimated H-index: 5
+ 1 AuthorsVesna Mijatović5
Estimated H-index: 5
INTRODUCTION: Suicide is closely linked to the substances use. Therefore it is very important to confirm the factors that affect the possibility of suicidal behavior. METHODOLOGY: The survey included 200 respondents; 100 heroin addicts on the substitution program that attempted suicide and 100 opiate addicts who have not attempted suicide. The evaluation included a questionnaire with socio-demographic, hereditary and addiction data, legal problems and then the Minnesota Multiphasic Personality I...
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