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Lin LA, Bonar EE, Zhang L, Girard R, Coughlin LN. Alcohol-involved overdose deaths in US veterans. Drug Alcohol Depend 2022; 230:109196. [PMID: 34894477 PMCID: PMC8714700 DOI: 10.1016/j.drugalcdep.2021.109196] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Alcohol-involved overdose deaths are increasing and often occur with other substances but have been minimally studied compared to other causes of overdose. METHODS We used national Veterans Health Administration (VHA) records linked to National Death Index data from 2012 to 2018 to examine trends in alcohol-related overdose mortality. Patient characteristics and treatment receipt were compared across categories of alcohol overdose deaths (alcohol-only, alcohol+opioids which may include additional substances, and alcohol+other substances without opioids). RESULTS From 2012-2018, 2421 Veterans died from an alcohol-involved overdose (alcohol-only: 868, alcohol+opioids: 1269, alcohol+other substances: 284). The alcohol-involved overdose rate increased 57% during this period. Compared to those who died of an alcohol-only overdose, Veterans who died from alcohol+opioids and alcohol+other substances were more likely Black or Hispanic, and to have an opioid use disorder, but less likely to live in rural areas or to be diagnosed with alcohol use disorder (AUD). Only 32.5% of those who died from alcohol-involved overdose received treatment in a substance use disorder clinic in the year preceding death, compared to 65.1% seen in mental health and 85.7% in primary care. Only 9.5% of Veterans who died from alcohol overdose received medication treatment for AUD and 24.8% received psychotherapy for AUD in the year preceding death. CONCLUSIONS Alcohol overdose is increasing primarily related to overdoses involving opioids and other substances. Most patients did not receive any effective medication or psychotherapy treatments for AUD, suggesting further need to identify those at risk and to target treatment for this vulnerable group in healthcare settings.
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Affiliation(s)
- Lewei A Lin
- VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Building 16 2800 Plymouth Rd, Ann Arbor, MI 48109, United States; Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States; University of Michigan Injury Prevention Center, 2800 Plymouth Road, Suite B10-G080, Ann Arbor, MI 48109-2800, United States.
| | - Erin E Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States; University of Michigan Injury Prevention Center, 2800 Plymouth Road, Suite B10-G080, Ann Arbor, MI 48109-2800, United States
| | - Lan Zhang
- VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Building 16 2800 Plymouth Rd, Ann Arbor, MI 48109, United States; Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States
| | - Rachel Girard
- VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Building 16 2800 Plymouth Rd, Ann Arbor, MI 48109, United States; Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States
| | - Lara N Coughlin
- Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States; University of Michigan Injury Prevention Center, 2800 Plymouth Road, Suite B10-G080, Ann Arbor, MI 48109-2800, United States
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