Non-fatal opioid-related overdoses among adolescents in Massachusetts 2012-2014.


Journal

Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587

Informations de publication

Date de publication:
01 01 2019
Historique:
received: 14 07 2018
revised: 21 09 2018
accepted: 29 09 2018
pubmed: 6 11 2018
medline: 17 4 2019
entrez: 5 11 2018
Statut: ppublish

Résumé

Opioid-related overdoses and deaths among adolescents in the United States continue to increase, but little is known about adolescents who experience opioid-related non-fatal overdose (NFOD). Our objective was to describe (1) the characteristics of adolescents aged 11-17 who experienced NFOD and (2) their receipt of medications for opioid use disorder (MOUD) in the 12 months following NFOD, compared with adults. We created a retrospective cohort using six Massachusetts state agency datasets linked at the individual level, with information on 98% of state residents. Individuals entered the cohort if they experienced NFOD between January 1, 2012 and December 31, 2014. We compared adolescents to adults experiencing NFOD, examining individual characteristics and receipt of medications for opioid use disorder (MOUD)-methadone, buprenorphine, or naltrexone. Among 22,506 individuals who experienced NFOD during the study period, 195 (0.9%) were aged 11-17. Fifty-two percent (102/195) of adolescents were female, whereas only 38% of adults were female (P < 0.001). In the year prior to NFOD, 11% (21/195) of adolescents received a prescription opioid, compared to 43% of adults (P < 0.001), and <5% (<10/195) received any MOUD compared to 23% of adults (P < 0.001). In the 12 months after NFOD, only 8% (15/195) of adolescents received MOUD, compared to 29% of adults. Among individuals experiencing NFOD, adolescents were more likely to be female and less likely to have been prescribed opioids in the year prior. Few adolescents received MOUD before or after NFOD. Non-fatal overdose is a missed opportunity for starting evidence-based treatment in adolescents.

Sections du résumé

BACKGROUND
Opioid-related overdoses and deaths among adolescents in the United States continue to increase, but little is known about adolescents who experience opioid-related non-fatal overdose (NFOD). Our objective was to describe (1) the characteristics of adolescents aged 11-17 who experienced NFOD and (2) their receipt of medications for opioid use disorder (MOUD) in the 12 months following NFOD, compared with adults.
METHODS
We created a retrospective cohort using six Massachusetts state agency datasets linked at the individual level, with information on 98% of state residents. Individuals entered the cohort if they experienced NFOD between January 1, 2012 and December 31, 2014. We compared adolescents to adults experiencing NFOD, examining individual characteristics and receipt of medications for opioid use disorder (MOUD)-methadone, buprenorphine, or naltrexone.
RESULTS
Among 22,506 individuals who experienced NFOD during the study period, 195 (0.9%) were aged 11-17. Fifty-two percent (102/195) of adolescents were female, whereas only 38% of adults were female (P < 0.001). In the year prior to NFOD, 11% (21/195) of adolescents received a prescription opioid, compared to 43% of adults (P < 0.001), and <5% (<10/195) received any MOUD compared to 23% of adults (P < 0.001). In the 12 months after NFOD, only 8% (15/195) of adolescents received MOUD, compared to 29% of adults.
CONCLUSION
Among individuals experiencing NFOD, adolescents were more likely to be female and less likely to have been prescribed opioids in the year prior. Few adolescents received MOUD before or after NFOD. Non-fatal overdose is a missed opportunity for starting evidence-based treatment in adolescents.

Identifiants

pubmed: 30391835
pii: S0376-8716(18)30760-9
doi: 10.1016/j.drugalcdep.2018.09.020
pmc: PMC6312455
mid: NIHMS1510748
pii:
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

28-31

Subventions

Organisme : NIDA NIH HHS
ID : K23 DA044324
Pays : United States
Organisme : NIDA NIH HHS
ID : L40 DA042434
Pays : United States
Organisme : NIDA NIH HHS
ID : L30 DA044647
Pays : United States
Organisme : NCIPC CDC HHS
ID : U01 CE002780
Pays : United States
Organisme : NIDA NIH HHS
ID : K23 DA045085
Pays : United States
Organisme : NIDA NIH HHS
ID : K23 DA042168
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001430
Pays : United States

Informations de copyright

Copyright © 2018 Elsevier B.V. All rights reserved.

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Auteurs

Avik Chatterjee (A)

Boston Health Care for the Homeless Program, Boston, MA, United States; Division of Global Health Equity, Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA, United States. Electronic address: avc031@mail.harvard.edu.

Marc R Larochelle (MR)

Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States; Grayken Center for Addiction, Boston Medical Center, Boston, MA, United States.

Ziming Xuan (Z)

Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States.

Na Wang (N)

Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, United States.

Dana Bernson (D)

University of Massachusetts School of Medicine, Worcester, MA, United States.

Michael Silverstein (M)

Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States.

Scott E Hadland (SE)

Grayken Center for Addiction, Boston Medical Center, Boston, MA, United States; Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States.

Thomas Land (T)

University of Massachusetts School of Medicine, Worcester, MA, United States.

Jeffrey H Samet (JH)

Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States; Grayken Center for Addiction, Boston Medical Center, Boston, MA, United States; Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States.

Alexander Y Walley (AY)

Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States; Grayken Center for Addiction, Boston Medical Center, Boston, MA, United States; University of Massachusetts School of Medicine, Worcester, MA, United States.

Sarah M Bagley (SM)

Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States; Grayken Center for Addiction, Boston Medical Center, Boston, MA, United States; Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States.

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Classifications MeSH