Abstract
Background
Emergency departments (EDs) are a promising location for initiating substance use interventions for youth. Our objective was to determine trends in substance use-related ED visits for youth from 2018-2023, and investigate the patient characteristics, types of substance involved, and ED visit disposition and revisits.
Methods
We conducted a retrospective review of electronic health records (EHRs) from six EDs in an urban healthcare system to identify 12-21-year-old patients with a substance use-related ED visit from 2018 through 2023. Visits were identified by International Classification of Diseases, 10 th Revision Clinical Modification codes for substance use involving alcohol, cannabis, sedative/hypnotics, opioids, cocaine/stimulants, and psychoactive substances. The proportion of substance use-related visits each year was calculated by age group (12-14y, 15-17y, and 18-21y), sex, race/ethnicity, and substance type. We used 2-sample tests of binomial proportion to compare proportions. 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, 4,556 (3.0%) were for substance use. From 2018-2023, 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 younger age groups (12-14y and 15-17y). Visits for females increased from 43.4% in 2018 to 52.4% in 2023 (p< 0.001). Although visits for alcohol were most frequent (53.1%), 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.
Full Text Availability
The license terms selected by the author(s) for this preprint version do not permit archiving in PMC. The full text is available from the preprint server.