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Seewald L, Bonar E, Bohnert ASB, Carter PM, King CA, Losman ED, Bacon L, Wheeler T, Walton M. Lifetime non-fatal overdose experiences among at-risk adolescents and young adults in the emergency department with past-year opioid use in the USA. Inj Prev 2024:ip-2023-045072. [PMID: 38331586 PMCID: PMC11348801 DOI: 10.1136/ip-2023-045072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 01/08/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Adolescents and young adults with risk factors for opioid misuse and opioid use disorder are at elevated risk for overdose. We examined prior non-fatal overdose experiences among at-risk adolescents/young adults to inform prevention efforts. METHODS Adolescents/young adults (ages 16-30) in two US emergency departments self-reporting past year opioid misuse or opioid use plus a misuse risk factor completed a baseline survey as part of an ongoing randomised controlled trial. We describe baseline factors associated with (a) overall non-fatal overdose experiences and (b) groups based on substance(s) used during the worst overdose experience. RESULTS Among 771 participants (27.9% male), 40.7% reported a non-fatal overdose experience. Compared with those without a prior overdose experience, those with prior overdose experience(s) were less likely to be heterosexual, and more likely to report a prior suicide attempt and greater peer substance misuse. Regarding the worst overdose experience, substance(s) included: 36.6% alcohol only, 28.0% alcohol and cannabis, 22.6% alcohol with other substance(s) and 12.7% other substance(s) only (eg, opioids). Compared with the alcohol only group, the alcohol and cannabis group were younger and less likely to be heterosexual; the alcohol with other substance(s) group were older and had greater peer substance misuse; and the other substance(s) only group were more likely to be male, receive public assistance, screen positive for anxiety and less likely to be heterosexual. CONCLUSIONS Among at-risk adolescents/young adults, findings support the need for tailored overdose prevention efforts based on substance(s) used, with consideration of sexuality, mental health and peer substance use. TRIAL REGISTRATION NUMBER NCT04550715.
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Affiliation(s)
- Laura Seewald
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan Department of Emergency Medicine, Ann Arbor, Michigan, USA
| | - Erin Bonar
- University of Michigan Department of Psychiatry, Ann Arbor, Michigan, USA
- University of Michigan Addiction Center, Ann Arbor, Michigan, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Amy S B Bohnert
- VA Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Michigan, USA
- University of Michigan Department of Anesthesiology, Ann Arbor, Michigan, USA
| | - Patrick M Carter
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan Department of Emergency Medicine, Ann Arbor, Michigan, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Cheryl A King
- University of Michigan Department of Psychiatry, Ann Arbor, Michigan, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Eve D Losman
- University of Michigan Department of Emergency Medicine, Ann Arbor, Michigan, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Linnea Bacon
- University of Michigan Department of Psychiatry, Ann Arbor, Michigan, USA
| | - Tiffany Wheeler
- University of Michigan Department of Psychiatry, Ann Arbor, Michigan, USA
| | - Maureen Walton
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan Department of Psychiatry, Ann Arbor, Michigan, USA
- University of Michigan Addiction Center, Ann Arbor, Michigan, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, Michigan, USA
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Li J, He J, Wang P, Li J, Zhang Y, You J, Chongsuvivatwong V. Pathway of effects of adverse childhood experiences on the poly-drug use pattern among adults using drugs: A structural equation modeling. Front Public Health 2023; 11:1043222. [PMID: 37089499 PMCID: PMC10114543 DOI: 10.3389/fpubh.2023.1043222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/13/2023] [Indexed: 04/08/2023] Open
Abstract
IntroductionAdverse childhood experiences (ACEs) are associated with an increased risk of poly-substance use among drug-using adults. However, there is a paucity of literature on a direct or indirect relationship between ACEs and drug use patterns. We thus aimed to identify the pathway of effects of ACEs on drug use patterns in adults by the structural equation model (SEM).MethodsA cross-sectional study was conducted by respondent-driving sampling and consecutive sampling among adult drug users in Southwest China in 2021. Descriptive, univariate, and SEM analyses were performed by R software 4.2.1.ResultsOf 406 participants recruited from a drug abuse clinic, the average age was 34 years. The majority of the participants were male patients (98.3%) from ethnic minorities (79.6%), who were unmarried (71.6%) and employed (81.2%). Nearly 95.5% experienced ACEs with 46.6% of them reporting four or more ACEs. The median value of self-perception of drug abuse score, friend drug use score, and drug use score was 8.0 (3.0, 11.0), 1.0 (0.0, 1.0), and 1.0 (1.0, 2.0) respectively. In the confirmatory analysis part of SEM, the construct of latent variables fitted well with the data. Poly-drug use was significantly and directly affected by three predictors including monthly incomes (β = 0.09), friend drug use (β = 0.50), and ACEs (β = 0.11). The indirect effect of ACEs passing through self-perception of drugs (β = 0.09) was not significant.DiscussionACEs have an independent and direct effect on the drug user for poly-drug use apart from the effect of drug-using friends and family income.
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Affiliation(s)
- Jing Li
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
- International Research Fellow, Prince of Songkla University, Hat Yai, Songkhla, Thailand
- *Correspondence: Jing Li
| | - Jianhui He
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Pei Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Jiashuang Li
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yunjia Zhang
- Chenggong Campus, Yunnan University Secondary School, Kunming, Yunnan, China
| | - Jing You
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Virasakdi Chongsuvivatwong
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
- Virasakdi Chongsuvivatwong
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