Avik Chatterjee1, Marc R Larochelle2, Ziming Xuan3, Na Wang4, Dana Bernson5, Michael Silverstein6, Scott E Hadland7, Thomas Land5, Jeffrey H Samet8, Alexander Y Walley9, Sarah M Bagley10. 1. Boston Health Care for the Homeless Program, Boston, MA, United States; Division of Global Health Equity, Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA, United States. Electronic address: avc031@mail.harvard.edu. 2. Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States; Grayken Center for Addiction, Boston Medical Center, Boston, MA, United States. 3. Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States. 4. Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, United States. 5. University of Massachusetts School of Medicine, Worcester, MA, United States. 6. Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States. 7. Grayken Center for Addiction, Boston Medical Center, Boston, MA, United States; Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States. 8. Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States; Grayken Center for Addiction, Boston Medical Center, Boston, MA, United States; Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States. 9. Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States; Grayken Center for Addiction, Boston Medical Center, Boston, MA, United States; University of Massachusetts School of Medicine, Worcester, MA, United States. 10. Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States; Grayken Center for Addiction, Boston Medical Center, Boston, MA, United States; Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States.
Abstract
BACKGROUND: Opioid-related overdoses and deaths among adolescents in the United States continue to increase, but little is known about adolescents who experience opioid-related non-fatal overdose (NFOD). Our objective was to describe (1) the characteristics of adolescents aged 11-17 who experienced NFOD and (2) their receipt of medications for opioid use disorder (MOUD) in the 12 months following NFOD, compared with adults. METHODS: We created a retrospective cohort using six Massachusetts state agency datasets linked at the individual level, with information on 98% of state residents. Individuals entered the cohort if they experienced NFOD between January 1, 2012 and December 31, 2014. We compared adolescents to adults experiencing NFOD, examining individual characteristics and receipt of medications for opioid use disorder (MOUD)-methadone, buprenorphine, or naltrexone. RESULTS: Among 22,506 individuals who experienced NFOD during the study period, 195 (0.9%) were aged 11-17. Fifty-two percent (102/195) of adolescents were female, whereas only 38% of adults were female (P < 0.001). In the year prior to NFOD, 11% (21/195) of adolescents received a prescription opioid, compared to 43% of adults (P < 0.001), and <5% (<10/195) received any MOUD compared to 23% of adults (P < 0.001). In the 12 months after NFOD, only 8% (15/195) of adolescents received MOUD, compared to 29% of adults. CONCLUSION: Among individuals experiencing NFOD, adolescents were more likely to be female and less likely to have been prescribed opioids in the year prior. Few adolescents received MOUD before or after NFOD. Non-fatal overdose is a missed opportunity for starting evidence-based treatment in adolescents.
BACKGROUND: Opioid-related overdoses and deaths among adolescents in the United States continue to increase, but little is known about adolescents who experience opioid-related non-fatal overdose (NFOD). Our objective was to describe (1) the characteristics of adolescents aged 11-17 who experienced NFOD and (2) their receipt of medications for opioid use disorder (MOUD) in the 12 months following NFOD, compared with adults. METHODS: We created a retrospective cohort using six Massachusetts state agency datasets linked at the individual level, with information on 98% of state residents. Individuals entered the cohort if they experienced NFOD between January 1, 2012 and December 31, 2014. We compared adolescents to adults experiencing NFOD, examining individual characteristics and receipt of medications for opioid use disorder (MOUD)-methadone, buprenorphine, or naltrexone. RESULTS: Among 22,506 individuals who experienced NFOD during the study period, 195 (0.9%) were aged 11-17. Fifty-two percent (102/195) of adolescents were female, whereas only 38% of adults were female (P < 0.001). In the year prior to NFOD, 11% (21/195) of adolescents received a prescription opioid, compared to 43% of adults (P < 0.001), and <5% (<10/195) received any MOUD compared to 23% of adults (P < 0.001). In the 12 months after NFOD, only 8% (15/195) of adolescents received MOUD, compared to 29% of adults. CONCLUSION: Among individuals experiencing NFOD, adolescents were more likely to be female and less likely to have been prescribed opioids in the year prior. Few adolescents received MOUD before or after NFOD. Non-fatal overdose is a missed opportunity for starting evidence-based treatment in adolescents.
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