TABLE 2.
Previous Prescriptions in Youth (15–24 y) With a Medically-Treated Overdose Involving a Stimulant, 2016–2018
| Overdoses Involving Stimulants (Amphetamine or Methylphenidate) | N = 971 | Intent of Overdoses Involving Stimulantsa | P | |
|---|---|---|---|---|
| Intentional (n = 388) | Unintentional (n = 524) | |||
| Age at overdose, y, median (IQR) | 19 (17–22) | 18 (16–20) | 20 (18–22) | |
| Female, n (%) | 415 (42.7) | 213 (54.9) | 179 (34.2) | <.001 |
| Mental health diagnosis in previous 6 mo, n (%)b | 634 (65.3) | 299 (77.1) | 299 (57.1) | <.001 |
| Previous stimulant prescription,c n (%) | ||||
| 0–1 mo | 239 (24.6) | 137 (35.3) | 93 (17.7) | <.001 |
| 0–6 mo | 380 (39.1)d | 219 (56.4) | 147 (28.1) | <.001 |
| Days from overdose to most recent prescription, median (IQR) | 20 (8–47) | 21 (9–47) | 14 (5–46) | |
| Subset with stimulant prescription in previous 6 mo | N = 380 | n = 219 | n = 147 | |
| Number of stimulant fills, median (IQR) | 4 (2–5) | 3 (2–5) | 4 (2–6) | |
| >3 fills dispensed, n (%) | 191 (50.3) | 102 (46.6) | 83 (56.5) | .064 |
| Total stimulant days supplied, median (IQR) | 120 (60–180) | 117 (60–150) | 120 (90–180) | |
| >90 d dispensed, n (%) | 213 (56.1) | 112 (51.1) | 95 (64.6) | .011 |
| Mental health diagnosis in previous 6 mo, n (%) | 335 (88.2) | 199 (90.9) | 123 (83.7) | .038 |
ICD-10-CM overdose definitions: overdose involving stimulant: amphetamine (T43.621A, T43.622A, T43.624A) and methylphenidate (T43.631A, T43.632A, T43.634A). Previous stimulant prescriptions identified through records of dispensed prescriptions before overdose event: amphetamines (amphetamine, dextroamphetamine, lisdexamfetamine, methamphetamine) and methylphenidates (methylphenidate, dexmethylphenidate). Mental health diagnoses identified in 6 mo before overdose event (excluding date of overdose event): International Classification of Diseases, 9th and 10th Revisions, Clinical Modification (ICD-9-CM): 290-319; ICD-10-CM: F01-F99; see Supplemental Table 4 for specific diagnoses. IQR, interquartile range.
Undetermined overdose events not displayed (N = 59); if multiple overdose codes were recorded with differing intents (intentional, unintentional, undetermined), precedence in classification was given to intentional then unintentional.
Mental health diagnoses identified in 6 mo before overdose event (excluding date of overdose event): ICD-9-CM: 290–319; ICD-10-CM: F01–F99; see Supplemental Table 4 for specific diagnoses.
Prescription anytime in previous 0 to 12 mo: overall: 416 (42.8%), intentional: 238 (61.3%), unintentional: 162 (30.9%).
Overdose by type: overdose involving amphetamine (n = 833), 31.8% have amphetamine prescription in previous 6 mo; overdose involving methylphenidate (n = 146), 64.4% have methylphenidate prescription in previous 6 mo.