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Lifetime non-fatal overdose experiences among at-risk adolescents and young adults in the emergency department with past-year opioid use in the USA
  1. Laura Seewald1,2,
  2. Erin Bonar3,4,5,
  3. Amy S B Bohnert6,7,
  4. Patrick M Carter1,2,5,
  5. Cheryl A King3,5,
  6. Eve D Losman2,5,
  7. Linnea Bacon3,
  8. Tiffany Wheeler3,
  9. Maureen Walton1,3,4,5
  1. 1Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan, USA
  2. 2University of Michigan Department of Emergency Medicine, Ann Arbor, Michigan, USA
  3. 3University of Michigan Department of Psychiatry, Ann Arbor, Michigan, USA
  4. 4University of Michigan Addiction Center, Ann Arbor, Michigan, USA
  5. 5Injury Prevention Center, University of Michigan, Ann Arbor, Michigan, USA
  6. 6VA Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Michigan, USA
  7. 7University of Michigan Department of Anesthesiology, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Laura Seewald, Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan, USA; lseewald{at}med.umich.edu

Abstract

Background Adolescents and young adults with risk factors for opioid misuse and opioid use disorder are at elevated risk for overdose. We examined prior non-fatal overdose experiences among at-risk adolescents/young adults to inform prevention efforts.

Methods Adolescents/young adults (ages 16–30) in two US emergency departments self-reporting past year opioid misuse or opioid use plus a misuse risk factor completed a baseline survey as part of an ongoing randomised controlled trial. We describe baseline factors associated with (a) overall non-fatal overdose experiences and (b) groups based on substance(s) used during the worst overdose experience.

Results Among 771 participants (27.9% male), 40.7% reported a non-fatal overdose experience. Compared with those without a prior overdose experience, those with prior overdose experience(s) were less likely to be heterosexual, and more likely to report a prior suicide attempt and greater peer substance misuse. Regarding the worst overdose experience, substance(s) included: 36.6% alcohol only, 28.0% alcohol and cannabis, 22.6% alcohol with other substance(s) and 12.7% other substance(s) only (eg, opioids). Compared with the alcohol only group, the alcohol and cannabis group were younger and less likely to be heterosexual; the alcohol with other substance(s) group were older and had greater peer substance misuse; and the other substance(s) only group were more likely to be male, receive public assistance, screen positive for anxiety and less likely to be heterosexual.

Conclusions Among at-risk adolescents/young adults, findings support the need for tailored overdose prevention efforts based on substance(s) used, with consideration of sexuality, mental health and peer substance use.

Trial registration number NCT04550715.

  • Adolescent
  • Alcohol
  • Drugs
  • Mental Health

Data availability statement

No data are available. Not applicable. Part of our funding agreement with NIDA is that data will be deposited to a repository through our coordinating centre, which has not yet deposited these data given ongoing trial enrollment. Data will be available in the future.

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Data availability statement

No data are available. Not applicable. Part of our funding agreement with NIDA is that data will be deposited to a repository through our coordinating centre, which has not yet deposited these data given ongoing trial enrollment. Data will be available in the future.

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Footnotes

  • Twitter @SeewaldoMD, @cartpatr

  • Contributors LS and MW wrote initial drafts of this paper. EB, ASBB, PMC, EDL and CAK are investigators who made important contributions to the conception or design of the work and edited the manuscript for critical scientific content; LB and TW contributed to the acquisition and interpretation of data. All authors contributed to the critical revisions and approved the final manuscript. LS accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

  • Funding This research was supported by the National Institutes of Health through the NIH HEAL Initiative under award number UG3/UH3 DA050173. LS’s time was funded by NIH/NICHD T32HD108054, NIH/NICHD 5R24HD08714903 and CDC 5R49CE003085-02.

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or its NIH HEAL Initiative.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.