Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan;75(1):29-38.
doi: 10.1016/j.annemergmed.2019.07.030. Epub 2019 Oct 4.

Characteristics and Receipt of Medication Treatment Among Young Adults Who Experience a Nonfatal Opioid-Related Overdose

Sarah M Bagley  1 , Marc R Larochelle  2 , Ziming Xuan  3 , Na Wang  4 , Aneesh Patel  5 , Dana Bernson  6 , Michael Silverstein  7 , Scott E Hadland  8 , Thomas Land  9 , Jeffrey H Samet  10 , Alexander Y Walley  11
Affiliations

Characteristics and Receipt of Medication Treatment Among Young Adults Who Experience a Nonfatal Opioid-Related Overdose

Sarah M Bagley et al. Ann Emerg Med. 2020 Jan.

Abstract

Study objective: Nonfatal opioid overdose represents an opportunity to engage young adults into using medication for opioid use disorder. We seek to describe characteristics of young adults who experience nonfatal overdose and estimate rates of and time to medication for opioid use disorder for young adults relative to those aged 26 to 45 years.

Methods: We conducted a cohort study using retrospective administrative data of 15,281 individuals aged 18 to 45 years who survived an opioid-related overdose in Massachusetts between 2012 and 2014, using deidentified, individual-level, linked data sets from Massachusetts government agencies. We described patient characteristics stratified by age (18 to 21, 22 to 25, and 26 to 45 years) and evaluated multivariable Cox proportional hazards models to compare rates of medication for opioid use disorder receipt, controlling for age, sex, history of mental health disorders, and addiction treatment.

Results: Among 4,268 young adults in the year after nonfatal overdose, 28% (n=336/1,209) of those aged 18 to 21, 36% (n=1,097/3,059) of those aged 22 to 25 years, and 36% (n=3,916/11,013) of those aged 26 to 45 years received medication for opioid use disorder. For individuals aged 18 to 21 and 22 to 25 years, median time to buprenorphine treatment was 4 months (interquartile range 1.7 to 1.8 months); to methadone treatment, 4 months (interquartile range 2.8 to 2.9 months); and to naltrexone treatment, 1 month (interquartile range 1 to 1 month). Individuals aged 18 to 21 years were less likely (adjusted hazard ratio 0.60 [95% confidence interval 0.45 to 0.70]) to receive methadone than those aged 22 to 25 and 26 to 45 years. Individuals aged 18 to 21 years and those aged 22 to 25 years were more likely to receive naltrexone (adjusted hazard ratio 1.65 [95% confidence interval 1.36 to 2.00] and 1.41 [95% confidence interval 1.23 to 1.61], respectively) than those aged 26 to 45 years.

Conclusion: One in 3 young adults received medication for opioid use disorder in the 12 months after surviving an overdose. Type of medication for opioid use disorder received appeared to be age associated. Future research should focus on how medication choice is made and how to optimize the emergency department for medication for opioid use disorder initiation after nonfatal overdose.

PubMed Disclaimer

Conflict of interest statement

Declarations of competing interests: none

Figures

Figure 1:
Figure 1:. Receipt of medication treatment in 12 months following a nonfatal overdose stratified by age groups. Error bars represent 95% CI*
*Individuals could have received more than one kind of medication type
Figure 2a:
Figure 2a:
Proportion of 18–45 yo who receive methadone in the 12 months following nonfatal overdose by age groups
Figure 2b:
Figure 2b:
Proportion of 18–45 yo who receive buprenorphine in the 12 months following nonfatal overdose by age groups
Figure 2c:
Figure 2c:
Proportion of 18–45 yo who receive naltrexone in the 12 months following nonfatal overdose by age groups
Figure 2d:
Figure 2d:
Proportion of 18–45 yo who receive any medication treatment in the 12 months following nonfatal overdose by age groups
See this image and copyright information in PMC

Comment in

References

    1. Hedegaard H Drug Overdose Deaths in the United States, 1999–2017. 2018;(329):8. - PubMed
    1. Massachusetts Department of Public Health. Data Brief: Opioid-related Overdose Deaths among Massachusetts Residents (2018–11). November 2018. https://archives.lib.state.ma.us/handle/2452/796040. Accessed January 8, 2019.
    1. Martins SS, Sarvet A, Santaella-Tenorio J, Saha T, Grant BF, Hasin DS. Changes in US Lifetime Heroin Use and Heroin Use Disorder: Prevalence From the 2001–2002 to 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions. JAMA Psychiatry. 2017;74(5):445–455. doi:10.1001/jamapsychiatry.2017.0113 - DOI - PMC - PubMed
    1. CDC. Today’s Heroin Epidemic. Centers for Disease Control and Prevention. https://www.cdc.gov/vitalsigns/heroin/index.html. Published July 7, 2015. Accessed January 8, 2019.
    1. Jones CM. The paradox of decreasing nonmedical opioid analgesic use and increasing abuse or dependence - An assessment of demographic and substance use trends, United States, 2003–2014. Addict Behav. 2017;65:229–235. doi:10.1016/j.addbeh.2016.08.027 - DOI - PubMed

Publication types

MeSH terms