Opioid overdoses involving other drugs more common in youth, study finds

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Opioid overdose deaths involving more than one substance are more common in youth, a new study from Boston Medical Center’s Grayken Center for Addiction has found.

The new research shows that cocaine and other stimulants like crystal methamphetamine are most commonly involved in opioid overdose deaths in people between the ages of 13 and 25. Additionally, the study found that opioid overdose deaths involving stimulants in young people increased 351 percent between 2010 and 2018.

Published in the JAMA Pediatrics, the research points to treatment and prevention attention must be given to adolescents and young adults, and that in order to address the national overdose crisis, programs cannot focus solely on opioids.

“Our study provides significant insight into what is driving opioid-related overdoses among adolescents and young adults, which can help improve treatment and outcomes in this population,” said Dr. Scott Hadland, a pediatrician and addiction specialist at Boston Medical Center, the study’s senior author. Hadland is also an assistant professor of pediatrics at Boston University School of Medicine.

Researchers looked at information from the Centers for Disease Control and Prevention’s (CDC) online, cross-sectional data on deaths involving opioids between January 1999 and December 2018 in those between 13 and 25. Opioid overdose death data was then further broken down by the presence of other substances in the body, such as alcohol, cocaine, antidepressants, cannabis, and antipsychotics, among others.

The research found that rates for opioid-only and polysubstance-involved opioid overdose deaths increased dramatically over the study period, rising 384 percent for opioid-only deaths and 760 polysubstance-involved overdose deaths.

In 2018, there were 4,623 opioid overdose deaths in young people. Of those deaths, more than half involved multiple substances. In 1,541 of those deaths, stimulants, like cocaine, contributed to the overdose.

“These results emphasize that we need to be focusing on more than just opioids when treating young people with opioid use disorder,” said Jamie Lim, MD, a pediatrics resident at BMC and Boston Children’s Hospital, who is the study’s corresponding author. “As providers, we need to recognize that co-occurring substance use disorders are common, and they must be addressed simultaneously when treating opioid addiction.”

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