Trends in substance use-related emergency department visits by youth, 2018-2023

Abstract

Background: We aimed to examine trends in substance use-related emergency department (ED) visits for youth from 2018 to 2023, compare the patient characteristics, types of substance involved, and ED disposition for these visits, and calculate revisit frequency.

Methods: Retrospective review of electronic health records (EHRs) from six EDs in an urban healthcare system to identify 12-21-year-old patients with substance use-related ED visits from 2018 to 2023. Visits were identified by International Classification of Diseases, 10th Revision Clinical Modification codes for substance use. Proportions of substance use-related visits each year were compared by age group (12-14y, 15-17y, 18-21y), sex, race/ethnicity, and substance type. Logistic regression was used to assess characteristics associated with substance use-related visits, hospital admissions, and ED revisits.

Results: Of 151,764 ED visits for 12-21-year-olds, 3.0 % were for substance use. From 2018 to 2023, substance use-related ED visits increased from 2.8 % to 3.4 % of all ED visits (p < 0.001) and were most often by 18-21-year-olds (79.4 %), yet there were significant increases in visits by 12-14-year-olds and 15-17-year-olds. Visits for females increased from 43.4 % to 52.4 % from 2018 to 2023 (p < 0.001). Although visits for alcohol were most frequent (53.4 %), cannabis visits increased from 17.9 % to 35.3 %, with increases across all age groups (p < 0.001). Nineteen percent of visits involved patients that had an ED revisit for a substance use-related diagnosis within one year.

Conclusion: Substance use-related ED visits increased from 2018 to 2023, with an increase in visits for cannabis over time. These findings can inform targeted ED-based interventions for substance use in youth.

Keywords: Adolescent; Emergency service; Hospital; Substance-related disorders.