Risk Factors for Overdose in Young People Who Received Substance Use Disorder Treatment

Background and objectives: To identify substance and psychiatric predictors of overdose (OD) in young people with substance use disorders (SUDs) who received treatment.

Methods: We conducted a retrospective review of consecutive medical records of young people who were evaluated in a SUD program between 2012 and 2013 and received treatment. An independent group of patients from the same program who received treatment and had a fatal OD were also included in the sample. OD was defined as substance use associated with a significant impairment in level of consciousness without intention of self-harm, or an ingestion of a substance that was reported as a suicide attempt. t Tests, Pearson's χ² , and Fisher's exact tests were performed to identify predictors of OD after receiving treatment.

Results: After initial evaluation, 127 out of 200 patients followed up for treatment and were included in the sample. Ten (8%) of these patients had a nonfatal OD. Nine patients who received treatment and had a fatal OD were also identified. The sample's mean age was 20.2 ± 2.8 years. Compared with those without OD, those with OD were more likely to have a history of intravenous drug use (odds ratio [OR]: 36.5, P < .001) and mood disorder not otherwise specified (OR: 4.51, P = .01).

Discussion and conclusions: Intravenous drug use and mood dysregulation increased risk for OD in young people who received SUD treatment.

Scientific significance: It is important to identify clinically relevant risk factors for OD specific to young people in SUD treatment due to the risk for death associated with OD. (Am J Addict 2019;28:382-389).