Prevalences of and characteristics associated with single- and polydrug-involved U.S. Emergency Department Visits in 2018. (February 2022)

• Record Type: Journal Article
• Authors: Pickens, Cassandra M.; Hoots, Brooke E.; Casillas, Shannon M.; Scholl, Lawrence
• Is Part Of: Addictive behaviors. Volume 125(2022)
• Publication Date: 2022-02
• Subjects: Drug overdose -- Polydrug overdose -- Surveillance -- Emergency department -- Discharge diagnosis; CI confidence interval -- ED emergency department -- HCUP Healthcare Cost and Utilization Project -- ICD-10-CM International Classification of Diseases, 10th Edition, Clinical Modification -- NEDS Nationwide Emergency Department Sample -- NSAID nonsteroidal anti-inflammatory drug -- OTC over-the-counter -- PR prevalence ratio; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2021.107158
• Languages: English
• ISSNs: 0306-4603

Abstract

Highlights: We examined drug poisoning diagnosis codes in 2018 emergency department (ED) data. Opioids, benzodiazepines, and stimulants were commonly involved in overdoses. Nearly 17% of drug overdoses were polydrug, involving ≥ 2 drug classes. Polydrug overdoses often involved benzodiazepines, opioids, and/or stimulants. Hospitalization and death were more common among polydrug overdose ED visits. Abstract: Introduction: Nonfatal and fatal drug overdoses have recently increased. There are limited data describing the range of illicit, prescribed, and over-the-counter drugs involved in overdoses presenting to U.S. emergency departments (EDs). Methods: Using 2018 Healthcare Cost and Utilization Project (HCUP) Nationwide ED Sample (NEDS) data, we calculated weighted counts and percentages by drug among overdose-related ED visits. Overdose-related ED visits were those having an International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) drug poisoning code falling under parent codes T36-T50 (codes involving alcohol were not explicitly queried). We identified the top 30 mutually exclusive polydrug combinations and compared characteristics of visits by polydrug status. Results: In 2018, 908, 234 ED visits had a T36-T50 drug poisoning code. The most frequently reported drugs involved were opioids (30.3% of visits; heroin: 15.2%), benzodiazepines (11.0%), stimulants (7.9%), other/unspecified antidepressants (7.1%), 4-aminophenol derivatives (6.6%), and other/unspecified drugs, medicaments, and biological substances (11.8%). Overdose was uncommon for most other drug classes (e.g., antibiotics). Polydrug visits were more likely to involve females (prevalence ratio [PR]: 1.14, 95% confidence interval [CI]: 1.12–1.16), be coded intentional self-harm (PR: 1.81, 95% CI: 1.77–1.85), and result in hospitalization (PR: 1.84, 95% CI: 1.79–1.89) or death (PR: 1.37, 95% CI: 1.22–1.53) compared to single-drug overdose-related visits. Benzodiazepines, opioids, and/or stimulants were most frequently involved in polydrug overdoses. Conclusion: Opioids, benzodiazepines, and stimulants were most commonly reported in both single-drug and polydrug overdose-involved ED visits. Other drugs involved in overdoses included antidepressants and 4-aminophenol derivatives. Jurisdictions can use data on drugs involved in overdoses to better tailor prevention strategies to emerging needs.