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J Clin Psychiatry. 2018 May/Jun;79(3). pii: 17m11678. doi: 10.4088/JCP.17m11678.

Risk Factors for Overdose in Treatment-Seeking Youth With Substance Use Disorders.

Author information

1
Addiction Recovery Management Services (ARMS), Massachusetts General Hospital, 151 Merrimac St, 6th Fl, Boston, MA 02114. ayule@partners.org.
2
Pediatric Psychopharmacology Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
3
Addiction Recovery Management Service, Center for Addiction Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
4
Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA.

Abstract

OBJECTIVE:

Overdoses (ODs) are among the leading causes of death in youth with substance use disorders (SUDs). Our aim was to identify the prevalence of OD and characteristics associated with a history of OD in youth presenting for SUD outpatient care.

METHODS:

A systematic retrospective medical record review was conducted of consecutive psychiatric and SUD evaluations for patients aged 16 to 26 years with DSM-IV-TR criteria SUD at entry into an outpatient SUD treatment program for youth between January 2012 and June 2013. Unintentional OD was defined as substance use without intention of self-harm that was associated with a significant impairment in level of consciousness. Intentional OD was defined as ingestion of a substance that was reported as a suicide attempt. T tests, Pearson χ² tests, and Fisher exact tests were performed to evaluate characteristics associated with a history of OD.

RESULTS:

We examined the medical records of 200 patients (157 males and 43 females) with a mean ± SD age of 20.2 ± 2.8 years. At intake, 58 patients (29%) had a history of OD, and 62% of those patients had a history of unintentional OD only (n = 36). Youth with ≥ 2 SUDs were 3 times more likely to have a history of OD compared to youth with 1 SUD (all P < .05). Compared to those without a history of OD, those with an OD were more likely to be female and have lifetime histories of alcohol, cocaine, amphetamine, anxiety, depressive, and/or eating disorders (all P < .05).

CONCLUSIONS:

High rates of OD exist in treatment-seeking youth with SUD. OD was associated with more SUDs and psychiatric comorbidity.

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