Abstract
Objective: To evaluate the association between psychiatric comorbidities, substance use disorders and heroin overdose-related hospitalizations (HOD). Next, to understand the demographic trend of HOD hospitalizations and comorbidities. Methods: Using the Nationwide Inpatient Sample (NIS), we included 27,442,808 child and adolescent hospitalizations, and 1432 inpatients (0.005%) were managed primarily for HOD. The odds ratio (OR) of the association of variables in HOD inpatients were measured using a logistic regression model. Results: Adolescents had 56 times higher odds (95% CI 43.36–73.30) for HOD-related hospitalizations compared to 4.6% children under 11 years. About three-fifth of the HOD inpatients were male, and they had 1.5-fold higher odds (95% CI 1.30–1.64) compared to 43% females in the study population. Whites were considerably higher in proportion (81%) than other race/ethnicities. A greater portion of HOD inpatients (40%) were from high-income families. Most common comorbid psychiatric disorders were mood (43.8%) and anxiety (20.4%). The prevalent comorbid substance use disorders were opioid (62.4%), tobacco (36.8%) and cannabis (28.5%) use disorders. Conclusion: HOD-related hospitalizations were predominant in males, White and older adolescents (12–18 years). Prescription opioids are the bridge to heroin abuse, thereby increasing the vulnerability to other substance abuse. This requires more surveillance and should be explored to help reduce the heroin epidemic in children.
Highlights
Opioids overdose continues to be a public health emergency globally
Adolescents had 56 times higher odds for heroin opioid overdose (HOD)
A greater portion of HOD inpatients (40%) were from high-income families with a median household income above the 76th percentile, and the likelihood for HOD hospitalization increased with a rising income
Summary
Opioids overdose continues to be a public health emergency globally. In the past 18 years, nearly8986 children and adolescents have died from illicit opioid use, heroin, in the US [1]. Opioids overdose continues to be a public health emergency globally. 8986 children and adolescents have died from illicit opioid use, heroin, in the US [1]. Heroin is an extremely addictive opioid and has no acceptable medical indications; an estimated number of 828,000 people over 12 years of age used heroin in the US within the past year, and the annual rates were highest in adolescents aged 15–19 [2]. 20% of emergency department visits attributed to illegal substance abuse were due to heroin, and each year these numbers are rising [2]. Studies reveal that many heroin abusers switched from prescription opioids to heroin after becoming addicted due to the fact that heroin has become more accessible and less expensive than.
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