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. 2020 Nov 1:216:108323.
doi: 10.1016/j.drugalcdep.2020.108323. Epub 2020 Sep 25.

Recent trends and associated factors of amphetamine-type stimulant overdoses in emergency departments

Alana M Vivolo-Kantor  1 , Brooke E Hoots  2 , Puja Seth  2 , Christopher M Jones  2
Affiliations

Recent trends and associated factors of amphetamine-type stimulant overdoses in emergency departments

Alana M Vivolo-Kantor et al. Drug Alcohol Depend. .

Abstract

Background: Emerging data indicate a resurgence of availability and harms of amphetamine-type stimulant (ATS) use. This study examined ATS overdose-involved emergency department (ED) visit trends and visit characteristics associated with ATS overdose.

Methods: Data from the Healthcare Cost and Utilization Project's (HCUP) 2010-2017 Nationwide Emergency Department Sample identified ATS overdose-involved visits. Predicted trend lines from 2010 to 2015 were fit using weighted logistic regression forany or only ATS-involved overdose using ICD-9-CM discharge diagnosis codes; percentage change from 2016 to 2017 used ICD-10-CM. Multivariable logistic regression examined characteristics in 2017 associated with only ATS-involved overdoses compared to drug overdoses not involving ATS.

Results: Every year from 2010 to 2015 the odds of any ATS overdose-involved ED visits increased 11 % (odds ratio [OR]: 1.11, 95 % CI: 1.09, 1.14) and 7 % for only ATS overdose-involved visits (OR: 1.07, 95 % CI: 1.04, 1.10). From 2016 to 2017, any and only ATS overdose-involved visit rates increased 19.1 % and 20.5 %, respectively (P < .05). In 2017, ATS overdose-involved visits (N = 42,428) accounted for 4.4 % of all drug overdose visits (N = 956,266). In adjusted regression models, characteristics more prevalent among patients with only ATS overdose included Western region; micropolitan and noncore urbanization levels; unintentional, undetermined, and assault intents; and cardiovascular effects.

Conclusions: Our findings, coupled with the rising availability of ATS and related harms, underscore the expansion of current substance use and overdose prevention and response efforts to address stimulant use, particularly among groups at risk. Research to identify additional individual and community-level risk factors for increasing ATS overdose is warranted.

Keywords: Amphetamines; Emergency department visits; Methamphetamine; Overdose risk factors.

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Conflict of interest statement

Conflicts of Interest: No conflicts declared.

Figures

Figure 1:
Figure 1:. Trendsa in amphetamine-type stimulant overdoseb emergency department visits, 2010–2017c
Source: Nationwide Emergency Department Sample a Emergency department visit rates were calculated by applying age-specific emergency department visit rates to the 2000 U.S. standard population age distribution. All rates are per 100,000 population. b International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes included 969.72; International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) included T43.621A, T43.621D, T43.621S, T43.622A, T43.622D, T43.622S, T43.623A, T43.623D, T43.623S, T43.624A, T43.624D, T43.624S. c The vertical line between 2015 and 2016 on the graph of emergency department visit rates denotes the transition in the Nationwide Emergency Department Sample from using ICD-9-CM diagnosis codes to ICD-10-CM on October 1, 2015. ICD-10-CM coded injury data are not comparable to ICD-9-CM coded injury data.
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