Table 1:
Visit characteristics for emergency department visits estimating any and only amphetamine-type stimulantsa and comparing only amphetamine-type stimulants to all other drug overdosesb, 2017
| Any amphetamine-type stimulant overdose | Only amphetamine-type stimulant overdose | Drug overdose not including amphetamine-type stimulants | Unadjusted PRc (95%CI) | Adjusted PRc (95%CI) | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Visit characteristic | n | (%) | 95% CI of % | n | (%) | 95% CI of % | n | (%) | 95% CI of % | ||
| All | 42,428 | 27,226 | 929,040 | ||||||||
| Sex | |||||||||||
| Male | 27,316 | (64.4) | (63.0–65.9) | 18,336 | (67.4) | (65.6–69.2) | 444,219 | (47.8) | (47.0–48.6) | 1.41 (1.37–1.45) | d |
| Female | 15,092 | (35.6) | (34.1–37.1) | 8,871 | (32.6) | (30.8–34.4) | 484,715 | (52.2) | (51.4–53.0) | 0.63 (0.59–0.66) | d |
| Age group | |||||||||||
| ≤ 24 | 9,880 | (23.3) | (21.4–25.4) | 6,534 | (24.0) | (21.7–26.3) | 279,025 | (30.0) | (28.9–31.2) | 0.80 (0.73–0.88) | d |
| 25–34 | 13,208 | (31.1) | (29.8–32.5) | 8,037 | (29.5) | (27.9–31.1) | 190,630 | (20.5) | (19.8–21.2) | 1.44 (1.36–1.53) | d |
| 35–54 | 14,859 | (35.0) | (33.7–36.4) | 9,715 | (35.7) | (34.0–37.4) | 255,267 | (27.5) | (26.8–28.1) | 1.30 (1.24–1.36) | d |
| ≥ 55 | 4,482 | (10.6) | (9.2–11.9) | 2,939 | (10.8) | (9.0–12.6) | 204,117 | (22.0) | (21.3–22.6) | 0.49 (0.42–0.58) | d |
| Census regione | |||||||||||
| Northeast | 2,499 | (5.9) | (4.8–7.0) | 1,467 | (5.4) | (4.3–6.4) | 161,810 | (17.4) | (15.0–19.8) | 0.31 (0.26–0.37) | 0.34 (0.29–0.40) |
| Midwest | 8,726 | (20.6) | (17.0–24.1) | 5,066 | (18.6) | (15.2–22.0) | 242,262 | (26.1) | (23.4–28.7) | 0.71 (0.61–0.83) | 0.74 (0.65–0.85) |
| South | 14,988 | (35.3) | (30.7–40.0) | 9,097 | (33.4) | (28.5–38.3) | 344,513 | (37.1) | (33.9–40.2) | 0.90 (0.79–1.03) | 0.94 (0.84–1.06) |
| West | 16,215 | (38.2) | (32.5–43.9) | 11,596 | (42.6) | (36.0–49.2) | 180,454 | (19.4) | (17.6–21.3) | 2.19 (1.89–2.54) | 2.02 (1.78–2.30) |
| County urbanization levelf | |||||||||||
| Large central metro | 13,143 | (32.5) | (27.6–37.5) | 8,821 | (34.2) | (28.5–39.9) | 272,442 | (29.6) | (26.5–32.7) | 1.15 (0.99–1.34) | 1.05 (0.92–1.20) |
| Large fringe metro | 6,240 | (15.4) | (12.8–18.1) | 3,736 | (14.5) | (11.7–17.3) | 193,880 | (21.1) | (18.3–23.8) | 0.69 (0.59–0.81) | 0.82 (0.71–0.93) |
| Medium metro | 9,423 | (23.3) | (19.1–27.5) | 5,828 | (22.6) | (18.2–27.0) | 220,258 | (24.0) | (20.7–27.2) | 0.94 (0.81–1.10) | 0.92 (0.80–1.06) |
| Small metro | 4,107 | (10.2) | (7.7–12.6) | 2,723 | (10.6) | (7.8–13.3) | 89,274 | (9.7) | (7.7–11.7) | 1.09 (0.89–1.33) | 1.06 (0.871.29) |
| Micropolitan (nonmetro) | 4,597 | (11.4) | (9.7–13.1) | 2,860 | (11.1) | (9.4–12.8) | 90,408 | (9.8) | (8.8–10.9) | 1.13 (0.98–1.30) | 1.16 (1.01–1.33) |
| Noncore (nonmetro) | 2,912 | (7.2) | (6.2–8.3) | 1,810 | (7.0) | (5.9–8.1) | 53,101 | (5.8) | (5.2–6.4) | 1.22 (1.05–1.42) | 1.28 (1.12–1.48) |
| Overdose intentg | |||||||||||
| Unintentional | 31,730 | (74.8) | (72.5–77.0) | 21,683 | (79.6) | (77.3–81.9) | 594,259 | (63.9) | (62.5–65.5) | 1.24 (1.20–1.29) | 1.20 (1.16–1.25) |
| Intentional self-harm | 7,540 | (17.8) | (16.0–19.5) | 3,340 | (12.3) | (10.8–13.8) | 295,761 | (31.8) | (30.4–33.3) | 0.39 (0.34–0.44) | 0.45 (0.40–0.50) |
| Assault | 152 | (0.4) | (0.2–0.5) | 119 | (0.4) | (0.3–0.6) | 2,018 | (0.2) | (0.19–0.24) | 2.02 (1.31–3.11) | 2.16 (1.40–3.34) |
| Undetermined | 3,005 | (7.1) | (5.9–8.3) | 2,084 | (7.7) | (6.3–9.0) | 37,003 | (4.0) | (3.6–4.3) | 1.92 (1.64–2.25) | 1.84 (1.58–2.16) |
| Admission to hospital | |||||||||||
| Yes | 23,328 | (55.0) | (41.0–49.1) | 13,306 | (48.9) | (43.8–53.9) | 335,867 | (36.2) | (35.0–37.3) | 1.35 (1.22–1.50) | d |
| No | 19,100 | (45.0) | (50.9–59.0) | 13,920 | (51.1) | (46.1–56.2) | 593,174 | (63.8) | (62.7–65.0) | 0.80 (0.73–0.88) | d |
| Diedh | |||||||||||
| Yes | 673 | (1.6) | (1.3–1.9) | 336 | (1.2) | (0.9–1.5) | 7,574 | (0.8) | (0.77–0.87) | 1.51 (1.16–1.96) | 0.91 (0.71–1.16) |
| No | 41,621 | (98.4) | (98.1–98.7) | 26,813 | (98.8) | (98.5–99.1) | 917,967 | (99.2) | (99.1–99.2) | 1.00 (0.99–1.00) | 1.00 (1.00–1.00) |
| Cardiovascular effectsi | |||||||||||
| Yes | 10,157 | (23.9) | (22.7–25.2) | 7,056 | (25.9) | (24.4–27.5) | 126,567 | (13.6) | (13.1–14.1) | 1.90 (1.79–2.03) | 1.69 (1.59–1.80) |
| No | 32,271 | (76.1) | (74.8–77.3) | 20,170 | (74.1) | (72.5–75.6) | 802,473 | (86.4) | (85.9–86.9) | 0.86 (0.84–0.88) | 0.89 (0.87–0.91) |
| Central nervous system (seizure) effectsj | |||||||||||
| Yes | 1,510 | (3.6) | (3.1–4.0) | 872 | (3.2) | (2.7–3.7) | 31,105 | (3.3) | (3.2–3.5) | 0.96 (0.82–1.11) | 0.80 (0.69–0.93) |
| No | 40,910 | (96.4) | (96.0–96.9) | 26,354 | (96.8) | (96.3–97.3) | 897,935 | (96.7) | (96.5–96.8) | 1.00 (1.00–1.01) | 1.01 (1.00–1.01) |
Source: Nationwide Emergency Department Sample
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) included T43.621A, T43.621D, T43.621S, T43.622A, T43.622D, T43.622S, T43.623A, T43.623D, T43.623S, T43.624A, T43.624D, T43.624S.
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) included T36-T50 diagnosis codes for all encounters (i.e., initial, subsequent, and sequelae) excluding adverse effects and underdosing and excluding amphetamine-type stimulant overdose codes (i.e., T43.621A, T43.621D, T43.621S, T43.622A, T43.622D, T43.622S, T43.623A, T43.623D, T43.623S, T43.624A, T43.624D, T43.624S).
Referent group for prevalence ratios is drug overdose not including amphetamine-type stimulants. Separate bivariable (Unadjusted PR) and multivariable (Adjusted PR) logistic regression models were developed to examine the relationship between each covariable (row) and only ATS-involved overdose compared to overdoses not involving ATS. Predicted marginals from logistic regression models were used to calculate prevalence ratios.
Only bivariable models for sex, age, and admission to the hospital are presented because no covariates remained in adjusted models after model reduction.
Adjusted for county urbanization level.
Determined based on NCHS 2013 Urban-Rural classification scheme (https://www.cdc.gov/nchs/data/series/sr_02/sr02_166.pdf); Adjusted for census region.
Intent is determined based on 5th or 6th character is the ICD–10–CM drug poisoning code; Adjusted for sex.
Adjusted for intent and admission to hospital.
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) included I15.8, I15.9, I16, I20, I21, I24.8, I24.9, I46, I47, I48, I49, I60, I61, I62, I63, I71, I72, R00, R03.0; Adjusted for admission to hospital.
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) included G40; Adjusted for age.