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. 2020 Feb:101:106142.
doi: 10.1016/j.addbeh.2019.106142. Epub 2019 Oct 15.

A latent class analysis of drug and substance use patterns among patients treated in emergency departments for suspected drug overdose

Stephen Liu  1 , Alana Vivolo-Kantor  2
Affiliations

A latent class analysis of drug and substance use patterns among patients treated in emergency departments for suspected drug overdose

Stephen Liu et al. Addict Behav. 2020 Feb.

Abstract

Introduction: Polysubstance use and misuse can increase risks for nonfatal and fatal drug overdose. To categorize drugs used in combination in nonfatal overdoses, we analyzed data from emergency department (ED) overdose-related visits in 18 states funded by CDC's Enhanced State Opioid Overdose Surveillance (ESOOS) program.

Methods: From 2017 to 2018, 120,706 ED visits included at least one hospital discharge code indicating acute drug poisoning for opioids, stimulants, hallucinogens, cannabis, anti-depressants, sedatives, alcohol, benzodiazepines, or other psychotropic drugs. Latent class analyses were conducted to determine the groupings of drug combinations in overdose visits.

Results: Latent class analyses indicated a model of 5 classes - mostly heroin overdose (42.5% of visits); mostly non-heroin opioid overdose/use (27.3%); opioid, polysubstance (11.0%); female, younger (<25 years), other non-opioid drugs (10.5%); female, older (>55 years), benzodiazepine (8.0%). Findings indicated that heroin continues to be a large burden to EDs, yet EDs are also seeing overdose survivors with polydrug toxicity.

Conclusions: Medication-assisted treatment could be initiated in the emergency department following overdose for patients with opioid use disorder, and post-overdose protocols, such as naloxone provision and linkage to treatment and harm reduction services, have the potential to prevent future overdose for those at risk.

Keywords: Drug overdose; Emergency department; Opioid; Polysubstance use.

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Conflict of interest statement

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 2.
Fig. 2.
Probability of drug overdose/use diagnosis in the five latent classes identified. Note: Class 1: Mostly heroin overdose; Class 2: Mostly non-heroin opioid overdose/use; Class 3: opioid, polysubstance; Class 4: female, younger (< 25 years), other non-opioid drugs; Class 5: female, older (> 55 years), benzodiazepine.
Fig. 1.
Fig. 1.
Inclusion criteria of latent class analysis involving Emergency Department visits, 2017–2018 ESOOS data.
See this image and copyright information in PMC

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