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

Abstract

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.

Recreational Cannabis Use and Risk of Prescription Opioid Overdose: Insights from Pediatric Inpatients

“…We also found that POD-related hospitalizations had comorbid SUDs with opioids, cannabis, and tobacco, with cannabis being the most prevalent substance used due to the rising use of cannabis among the pediatric population [15]. Also, an inpatient study found a higher prevalence of tobacco (36.8%) and cannabis (28.5%) use disorders among pediatric patients hospitalized for heroin overdoses [16].…”

An Item Response Theory Analysis of DSM-5 Heroin Use Disorder in a Clinical Sample of Chinese Adolescents

“…Heroin is a highly addictive opioid drug with a high risk of overdose and death for users. A trend study from 2010 to 2014 revealed that approximately 20% of emergency department visits attributed to heroin overdose, and each year, these numbers were rising (Queeneth et al, 2019). Studies also revealed that nearly 8,986 adolescents have died from heroin overdose in the past 18 years in the US (Centers for Disease Control and Prevention, 2015).…”

Opioid Misuse: A Review of the Main Issues, Challenges, and Strategies

“…Regarding the numerous strategies recommended to deal with the phenomenon, among the most cited, it emerges the clear urge to enhance training and information for both healthcare providers and patients [ 5 , 12 , 14 , 31 , 41 , 45 , 49 , 52 , 53 , 54 , 57 ]. This is essentially related to the recommendation to prevent rather than implement subsequent containment and corrective action [ 12 , 31 , 36 , 40 , 42 , 46 , 54 , 58 ].…”

“…Other strategies suggested by multiple contributions are to implement programs to treat opioid addiction [ 4 , 5 , 34 , 40 , 46 ] and increase research, grants, and funding in the sector [ 36 , 46 , 48 , 50 , 56 ]. In addition, many contributions support the need to implement medical care [ 31 , 36 , 42 , 43 , 46 ] and increase the prescription and use of naloxone [ 12 , 31 , 33 , 42 , 43 ]. Cordes [ 12 ] reports the results of his study as follows:…”