Epidemiology of adolescent and young adult hospital utilization for alcohol and drug use, poisoning, and suicide attempts in the United States (original) (raw)
Related papers
Nonsuicidal Self-Injury: A Neglected Public Health Problem Among Adolescents
American Journal of Public Health, 2018
In this issue of AJPH, Monto et al. (p. XXX) take an important step in providing prevalence estimates and health risk behavior correlates of nonsuicidal self-injury (NSSI) among a large nonclinical sample of high school students in 11 states using 2015 Youth Risk Behavior Surveillance System (YRBSS) data. They found that17.6% of adolescents had engaged in at least one form of NSSI within the past year, including just over one in 10 male adolescents and nearly one in four female adolescents. This work adds to the current body of epidemiological research on NSSI and demonstrates a substantial population-level burden of NSSI among youths. It also builds on research from the 2007 Minnesota Student Survey, a population-based survey of Minnesota high school students that found an NSSI prevalence of 7.3% among youths who had never experienced suicidality. 1 The 2016 Minnesota Student Survey employed an NSSI question similar to that of the YRBSS and showed rates (15%-16%) comparable to those observed by Monto et al. DISENTANGLING NSSI AND SUICIDALITY Monto et al. found strong associations between NSSI and past-year suicide attempts, consistent with previous research demonstrating that adolescents who engage in NSSI are at an increased risk of subsequently attempting suicide. In fact, several studies suggest that specifically among adolescents who are depressed, a history of NSSI may be a stronger risk factor for attempting suicide than is a past suicide attempt. 2 NSSI poses a particular challenge for youth-serving clinicians and mental health systems. Youths are often evaluated in emergency departments for NSSI, and many are admitted unnecessarily to psychiatric inpatient programs. Because the behavior is, by definition, not suicidal in intent, many youths may be best served with community-based mental health
Clinical Toxicology
Objective: To evaluate the substances used, outcomes, temporal and demographics associated with suicide attempts by self-poisoning in children and young adults aged 10-25 years old from 2000 to 2018. Methods: This is a retrospective review of suspected-suicide self-poisoning cases reported to the National Poison Data System (NPDS) from US Poison Centers from 2000 to 2018 for patients 10-25 years old. For comparison of annual rates, we obtained population data by year of age from the US Census Bureau. We evaluated changes in: monthly and annual incidence/rate per 100,000 population, substances used and outcome by patient age and demographics. Results: There were 1,677,435 cases of suicide attempt by self-poisoning among individuals 10-25 years old reported to US PCCs from 2000 to 2018. There were 410,940 self-poisoning cases (24.5%) with a serious medical outcome, and the proportion of exposures that resulted in a serious medical outcome increased with increasing age group. For the age groups of 10-12, 13-15 and 16-18 years of age, there was a significant increase after 2011, which was influenced primarily by females. The substance groups with the greatest number of serious medical outcomes were OTC analgesics, antidepressants, antihistamines and antipsychotics. ADHD medications were common in the younger age groups of 10-15 years, while the sedative/hypnotics occurred more commonly in the older age groups. The groups with the greatest increase in serious medical outcomes after 2011 were antidepressants, OTC analgesics, antihistamines and ADHD medications. Opiates were less commonly involved (7.4%) in cases with serious medical outcomes and decreased significantly in the 19-25 yearold age groups after 2012. States with a lower population per square mile had a greater number of reported cases with serious medical outcomes. There was a significant decrease in the number of cases in the age groups of 10-18 years during the traditional non-school months of June-August compared with September-May. This seasonal trend occurred among cases with all outcomes and among cases with serious medical outcomes. This decrease did not occur in the age group of 19-21 years, and there was an increase during summer months in the age group 22-25 years. Conclusions: The substances used during self-poisoning varies by age group but appears to include substances available to that age group, with a significant increase after 2011, increased rates in more rural states, and a seasonal variation of increased rates during school months among adolescents but not among young adults. Two of the top substances, OTC analgesics and antihistamines, in all age groups, comprising more than a third of all substances used, are widely available over-the-counter with no restrictions regarding access. Of additional concern, ADHD medications had the highest risk of a serious medical outcome.
Social Psychiatry and Psychiatric Epidemiology, 2013
Objective Substance use is associated with suicidal ideation, planning and attempts among adolescents, but it is unclear how this association varies across different types and number of substances. This study examined the association between patterns of substance use and suicidality among a nationally representative sample of high school students in the United States during the last decade. Method Data from the 2001 to 2009 Youth Risk Behavior Survey including 73,183 high school students were analyzed. Logistic regression analyses examined the association between lifetime use of ten common substances of abuse (alcohol, cocaine, ecstasy, hallucinogens, heroin, inhalants, marijuana, methamphetamines, steroids, and tobacco) and four measures of suicidality over the last year (suicidal ideation, suicide plan, suicide attempt, and severe suicide attempt requiring medical attention), controlling for potential confounders (sociodemographic variables, interpersonal violence, sexual intercourse, and symptoms of depression and eating disorder). Results Among the ten substances, univariate analysis demonstrates that adolescents reporting a history of heroin use have the strongest association with suicidal ideation, suicide plan, suicide attempts and severe suicide attempts in the last year (odds ratio = 5.0, 5.9, 12.0, and 23.6 compared to non-users), followed by users of methamphetamines (OR = 4.3-13.1) and steroids (OR = 3.7-11.8). Cocaine, ecstasy, hallucinogens and inhalants had a moderate association with suicidality (OR = 3.1-10.8). Users of marijuana, alcohol and tobacco also had an increased odds ratio of suicidality (OR = 1.9-5.2). The association between each of ten substances and the four measures of suicidality remained significant with multivariate analysis controlling for multiple confounders (p \ 0.05), except for the association between alcohol use and severe suicide attempts. The seven illicit substances had a stronger association with severe suicide attempts as compared to all other confounding risk factors except depression. The number of substances used had a graded relationship to suicidality. Conclusions Substance abuse is a strong risk factor for suicidal thoughts and behaviors among American high school students, with the strength of this relationship dramatically increasing with particular illicit drugs and a higher number of substances. The findings reinforce the importance of routine screening for substance abuse in the assessment of adolescent suicide risk.
Suicide and Life-Threatening Behavior, 2014
One in five adolescents in the United States has engaged in nonsuicidal self-injury (NSSI), one in eight have had serious thoughts of suicide, and one in 25 have attempted suicide. Research suggests that NSSI may increase risk for suicide attempt, yet little is known about the relationship between NSSI and suicidal ideation or attempts. In a primary care setting, 1,561 youth aged 14-24 years completed a brief, comprehensive, mental health screen as part of a routine well visit to determine which factors were most likely to predict suicidal ideation and attempt among youth engaging in NSSI. Results of recursive partitioning revealed that current depression and history of alcohol use best differentiated youth engaging in NSSI with low versus high risk for suicidal ideation and attempts. This simple algorithm is presented as a clinical screening tool that might aid medical providers in determining which youth would benefit from more intensive assessment and intervention.
Suicide trends among persons aged 10-24 years - United States, 1994-2012
MMWR. Morbidity and mortality weekly report, 2015
Suicide is the second leading cause of death among persons aged 10-24 years in the United States and accounted for 5,178 deaths in this age group in 2012. Firearm, suffocation (including hanging), and poisoning (including drug overdose) are the three most common mechanisms of suicide in the United States. Previous reports have noted that trends in suicide rates vary by mechanism and by age group in the United States, with increasing rates of suffocation suicides among young persons. To test whether this increase is continuing and to determine whether it varies by demographic subgroups among persons aged 10-24 years, CDC analyzed National Vital Statistics System mortality data for the period 1994-2012. Trends in suicide rates were examined by sex, age group, race/ethnicity, region of residence, and mechanism of suicide. Results of the analysis indicated that, during 1994-2012, suicide rates by suffocation increased, on average, by 6.7% and 2.2% annually for females and males, respect...
Suicidal Thoughts and Behaviors Among Adults Aged ≥18 Years — United States, 2015–2019
MMWR. Surveillance Summaries, 2022
Problem/Condition: Suicidal thoughts and behaviors are important public health concerns in the United States. In 2019, suicide was the 10th leading cause of death among persons aged ≥18 years (adults); in that year, 45,861 adults died as a result of suicide, and an estimated 381,295 adults visited hospital emergency departments for nonfatal, self-inflicted injuries. Regional-and state-level data on self-inflicted injuries are needed to help localities establish priorities and evaluate the effectiveness of suicide prevention strategies.