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Open AccessArticle

Heroin Overdose-Related Child and Adolescent Hospitalizations: Insight on Comorbid Psychiatric and Substance Use Disorders

1
Department of Psychiatry, Maastricht University, 4–6, 6211 LK Maastricht, The Netherlands
2
Department of Public Administration, Drake University, Des Moines, IA 50311, USA
3
Department of Psychiatry, Washington DC VA Medical Center, Washington, DC 20422, USA
4
Harvard School of Public Health, Boston, MA 02115, USA
5
Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India
6
Department of Psychiatry, Griffin Memorial Hospital, Norman, OK 73071, USA
*
Author to whom correspondence should be addressed.
Behav. Sci. 2019, 9(7), 77; https://doi.org/10.3390/bs9070077
Received: 6 June 2019 / Revised: 10 July 2019 / Accepted: 10 July 2019 / Published: 13 July 2019
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. View Full-Text
Keywords: heroin overdose; opioid abuse; adolescents; emergency visits; hospitalization; substance use; epidemiology heroin overdose; opioid abuse; adolescents; emergency visits; hospitalization; substance use; epidemiology
MDPI and ACS Style

Queeneth, U.; Bhimanadham, N.N.; Mainali, P.; Onyeaka, H.K.; Pankaj, A.; Patel, R.S. Heroin Overdose-Related Child and Adolescent Hospitalizations: Insight on Comorbid Psychiatric and Substance Use Disorders. Behav. Sci. 2019, 9, 77.

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