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Meta-Analysis
. 2019 Aug;29(7):487-497.
doi: 10.1089/cap.2019.0013. Epub 2019 Jun 27.

Risk Factors for Drug Overdose in Young People: A Systematic Review of the Literature

Rachael M Lyons  1 , Amy M Yule  1   2 , Davida Schiff  3 , Sarah M Bagley  4   5 , Timothy E Wilens  1   2
Affiliations
Meta-Analysis

Risk Factors for Drug Overdose in Young People: A Systematic Review of the Literature

Rachael M Lyons et al. J Child Adolesc Psychopharmacol. 2019 Aug.

Abstract

Objectives: Drug overdose (OD) deaths have been increasing over the past 20 years. Although risk factors for drug OD have been identified in adult populations, less is known about risk factors for OD in young people. The aim of this review is to systematically examine the literature to identify risk factors for drug OD specific to young people, including adolescents and young adults. Methods: Our initial PubMed search identified 4001 articles. Included were cross-sectional and longitudinal cohort studies published in English that compared young people who experienced a drug OD to those who did not. Review articles, meta-analyses, case-reports, editorials, epidemiological studies, and qualitative studies were excluded. Two investigators reviewed the full texts of all relevant articles and extracted data on sample demographics, prevalence of OD, and correlates associated with OD. Results: Twelve relevant studies were identified reflective of a sample of 5020 unique individuals with an age range of 14-30 years, and a mean age range of 20.2-26 years. The lifetime prevalence of OD in these young people ranged from 24% to 48%. Substance use characteristics most often associated with OD included injection drug, opioid, and tranquilizer use. Polysubstance use was also found to be strongly associated with OD in three studies. Other replicated risk factors for OD in young people included histories of psychopathology, incarceration, unstable housing, and witnessing an OD. Conclusion: Opioid, tranquilizer, and injection drug use have been identified as risk factors for OD in both younger and older adult populations. Risk factors that emerged as noteworthy predictors of OD in young people specifically include polysubstance use, psychiatric comorbidity, unstable housing, and witnessing an OD. There remains a paucity of literature on drug OD risk factors in young people, with little information regarding medical and treatment history risk factors.

Keywords: overdose; risk factors; substance use disorder; young people.

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Conflict of interest statement

Dr. A.M.Y., MD, received grant support from the Massachusetts General Hospital Louis V. Gerstner III Research Scholar Award from 2014 to 2016. Dr. A.M.Y. is currently receiving funding through the American Academy of Child and Adolescent Psychiatry Physician Scientist Program in Substance Abuse K12DA000357-17. She was a consultant to the Phoenix House from 2015 to 2017 and is currently a consultant to the Gavin House (clinical services). Dr. T.E.W., MD, receives or has received grant support from the following sources: NIH(NIDA). Dr. T.E.W. is or has been a consultant for Alcobra, Neurovance/Otsuka, and Ironshore. Dr. T.E.W. has a published book: Straight Talk About Psychiatric Medications for Kids (Guilford Press); and co/edited books ADHD in Adults and Children (Cambridge University Press), Massachusetts General Hospital Comprehensive Clinical Psychiatry (Elsevier) and Massachusetts General Hospital Psychopharmacology and Neurotherapeutics (Elsevier. Dr. T.E.W. is co/owner of a copyrighted diagnostic questionnaire (Before School Functioning Questionnaire). Dr. T.E.W. is Chief, Division of Child and Adolescent Psychiatry and (Co) Director of the Center for Addiction Medicine at Massachusetts General Hospital. He serves as a clinical consultant to the US National Football League (ERM Associates), U.S. Minor/Major League Baseball; Phoenix/Gavin House and Bay Cove Human Services. Dr. D.S., MD, MSc, is currently supported by NIDA: K12DA043490. Dr. S.M.B., MD, MSc, received grant support from NIDA, 1K23DA044324-01. In addition, she is a consultant to the Center for Evidence in Health at Brown University School of Public Health on an AHRQ grant, and to WBGH for an educational curriculum about opioids. R.M.L., BS: nothing to disclose at this time.

Figures

<b>FIG. 1.</b>
FIG. 1.
Flow diagram of the identification, review, and selection of articles that examined the risk factors for drug overdose in young people 12–30 years of age. OD, overdose.
See this image and copyright information in PMC

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