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Patient characteristics and treatment utilization in fatal stimulant‐involved overdoses in the United States Veterans Health Administration
dc.contributor.authorCoughlin, Lara N.
dc.contributor.authorZhang, Lan
dc.contributor.authorBohnert, Amy S. B.
dc.contributor.authorMaust, Donovan T.
dc.contributor.authorGoldstick, Jason
dc.contributor.authorLin, Lewei ( Allison)
dc.date.accessioned2022-04-08T18:05:15Z
dc.date.available2023-05-08 14:05:14en
dc.date.available2022-04-08T18:05:15Z
dc.date.issued2022-04
dc.identifier.citationCoughlin, Lara N.; Zhang, Lan; Bohnert, Amy S. B.; Maust, Donovan T.; Goldstick, Jason; Lin, Lewei ( Allison) (2022). "Patient characteristics and treatment utilization in fatal stimulant‐involved overdoses in the United States Veterans Health Administration." Addiction 117(4): 998-1008.
dc.identifier.issn0965-2140
dc.identifier.issn1360-0443
dc.identifier.urihttps://hdl.handle.net/2027.42/172040
dc.description.abstractBackground and AimsThis study aimed to (1) describe trends in stimulant‐alone and stimulant and other substance use overdose deaths from 2012 to 2018 and (2) measure patient and service use characteristics across stimulant‐related overdose death profiles.DesignRetrospective cohort study of patients who died from stimulant‐involved overdose between annual years 2012 and 2018.SettingUnited States Veterans Health Administration (VHA).A total of 3631 patients died from stimulant‐involved overdose, as identified through the National Death Index.MeasurementsStimulant‐involved overdose deaths were categorized by stimulant type (cocaine or methamphetamine/other) and other substance co‐involvement. Cause of death data were linked to patient characteristics, including demographic and treatment use preceding overdose from VHA administrative data. We examined trends over time and compared treatment use factors between the following mutually exclusive overdose profiles: cocaine alone, methamphetamine alone, cocaine + opioid, methamphetamine + opioid, any stimulant + other substance and cocaine + methamphetamine.FindingsThe rate of overdose death was 3.06 times higher in 2018 than 2012, with increases across all toxicology profiles. Compared with cocaine‐involved overdoses, methamphetamine‐involved overdoses were less likely in people who were older [adjusted odds ratio (aOR) = 0.22, 95% confidence interval (CI) = 0.06–0.87 aged 65+ versus 18–29] and more likely among those who lived in rural areas (aOR = 2.73, 95% CI = 1.43–5.23). People who died from stimulant + opioid overdoses had lower odds of a stimulant use disorder diagnosis compared with stimulant alone deaths (cocaine: aOR = 0.55, 95% CI = 0.41–0.75, methamphetamine: aOR = 0.44, 95% CI = 0.29–0.68).ConclusionsThe rate of deaths among US Veterans from stimulant‐related overdose was three times higher in 2018 than 2012. Key differences in characteristics of patients across overdose toxicology profiles, such as geographic location and health‐care use, point to distinct treatment needs based on stimulant use type.
dc.publisherNational Center for Health Statistics
dc.publisherWiley Periodicals, Inc.
dc.subject.otheroverdose
dc.subject.otherstimulants
dc.subject.othersubstance use
dc.subject.otherveterans
dc.subject.otheropioids
dc.subject.otherMethamphetamine
dc.titlePatient characteristics and treatment utilization in fatal stimulant‐involved overdoses in the United States Veterans Health Administration
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelPublic Health
dc.subject.hlbsecondlevelPsychiatry
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/172040/1/add15714.pdf
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/172040/2/add15714_am.pdf
dc.identifier.doi10.1111/add.15714
dc.identifier.sourceAddiction
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dc.working.doiNOen
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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