1.102 Temporal Trends in Substance Use among Child/Adolescent Inpatients

ObjectivesSubstance use (SU) in minors has become an increasing public concern over the past decade. We hypothesized that SU would increase over time, particularly affecting minors with a history of trauma, suicide attempt, or violence.MethodsVariables (such as sociodemographics, psychiatric treatment, urine toxicology report, and self-report of substance use) were extracted from the charts of all unique child and adolescent patients admitted to a 17-bed metropolitan inpatient psychiatry unit between June 2018 and November 2021. Statistical analyses included descriptive statistics, χ2 tests, independent t tests, Pearson correlations, and logistic regression.ResultsOf the 1101 patients admitted, 30% (n = 330) were found to have SU by positive urine toxicology (n = 147) or self-report. Patients with SU were older than those without use (mean age 15.4 vs 13.4 years; p < .001). Significant racial differences were found, with White participants making up 21.8% of the SU population but only 14.1% of the non-SU group (p < .01), and Asian participants making up only 1.2% of the SU group (vs 4.2% without; p < .01). SU patients were more likely to have a history of self-harm (nonsuicidal self-injurious behavior [NSSIB]) or suicide attempt (NSSIB: 64.8% vs 52.%, p < .001; suicide attempt: 41.5% vs 25.7%, p < .001). Patients with SU were less likely to be admitted for aggression (14.5% vs 22.8%; p < .01) and more likely to be admitted for mania (2.4% vs 0.8%; p = .03). Positive predictors of SU were older age (OR = 1.41; 95% CI, 1.15-1.72; p < .001), White race (OR = 1.98; 95% CI, 1.19-3.29; p < .01), history of an impulsive/behavioral disorder (OR = 1.69; 95% CI, 1.03-2.79; p < .04), history of suicide attempt (OR = 1.44; 95% CI, 1.04-2.00; p = .03), history of violence (OR = 1.86; 95% CI, 1.26-2.75; p < .01), and history of Administration of Children’s Services (ACS)/Child Protective Services (CPS) involvement (OR = 1.45; 95% CI, 1.03-2.03; p = .03). Gender, other races, history of other diagnoses, trauma history, or history of NSSIB were not found to be significant predictors.ConclusionsOur findings are consistent with emerging literature that SU in minors has had a slow increase in the COVID-19 era, particularly seen among White patients, patients of older age, and patients with a history of NSSIB or suicide attempt. While some of our analyses did control for potential confounding factors (logistic regression), further analyses are required to formulate a preventative plan for SU in youth.SUD, ICP, ALC ObjectivesSubstance use (SU) in minors has become an increasing public concern over the past decade. We hypothesized that SU would increase over time, particularly affecting minors with a history of trauma, suicide attempt, or violence. Substance use (SU) in minors has become an increasing public concern over the past decade. We hypothesized that SU would increase over time, particularly affecting minors with a history of trauma, suicide attempt, or violence. MethodsVariables (such as sociodemographics, psychiatric treatment, urine toxicology report, and self-report of substance use) were extracted from the charts of all unique child and adolescent patients admitted to a 17-bed metropolitan inpatient psychiatry unit between June 2018 and November 2021. Statistical analyses included descriptive statistics, χ2 tests, independent t tests, Pearson correlations, and logistic regression. Variables (such as sociodemographics, psychiatric treatment, urine toxicology report, and self-report of substance use) were extracted from the charts of all unique child and adolescent patients admitted to a 17-bed metropolitan inpatient psychiatry unit between June 2018 and November 2021. Statistical analyses included descriptive statistics, χ2 tests, independent t tests, Pearson correlations, and logistic regression. ResultsOf the 1101 patients admitted, 30% (n = 330) were found to have SU by positive urine toxicology (n = 147) or self-report. Patients with SU were older than those without use (mean age 15.4 vs 13.4 years; p < .001). Significant racial differences were found, with White participants making up 21.8% of the SU population but only 14.1% of the non-SU group (p < .01), and Asian participants making up only 1.2% of the SU group (vs 4.2% without; p < .01). SU patients were more likely to have a history of self-harm (nonsuicidal self-injurious behavior [NSSIB]) or suicide attempt (NSSIB: 64.8% vs 52.%, p < .001; suicide attempt: 41.5% vs 25.7%, p < .001). Patients with SU were less likely to be admitted for aggression (14.5% vs 22.8%; p < .01) and more likely to be admitted for mania (2.4% vs 0.8%; p = .03). Positive predictors of SU were older age (OR = 1.41; 95% CI, 1.15-1.72; p < .001), White race (OR = 1.98; 95% CI, 1.19-3.29; p < .01), history of an impulsive/behavioral disorder (OR = 1.69; 95% CI, 1.03-2.79; p < .04), history of suicide attempt (OR = 1.44; 95% CI, 1.04-2.00; p = .03), history of violence (OR = 1.86; 95% CI, 1.26-2.75; p < .01), and history of Administration of Children’s Services (ACS)/Child Protective Services (CPS) involvement (OR = 1.45; 95% CI, 1.03-2.03; p = .03). Gender, other races, history of other diagnoses, trauma history, or history of NSSIB were not found to be significant predictors. Of the 1101 patients admitted, 30% (n = 330) were found to have SU by positive urine toxicology (n = 147) or self-report. Patients with SU were older than those without use (mean age 15.4 vs 13.4 years; p < .001). Significant racial differences were found, with White participants making up 21.8% of the SU population but only 14.1% of the non-SU group (p < .01), and Asian participants making up only 1.2% of the SU group (vs 4.2% without; p < .01). SU patients were more likely to have a history of self-harm (nonsuicidal self-injurious behavior [NSSIB]) or suicide attempt (NSSIB: 64.8% vs 52.%, p < .001; suicide attempt: 41.5% vs 25.7%, p < .001). Patients with SU were less likely to be admitted for aggression (14.5% vs 22.8%; p < .01) and more likely to be admitted for mania (2.4% vs 0.8%; p = .03). Positive predictors of SU were older age (OR = 1.41; 95% CI, 1.15-1.72; p < .001), White race (OR = 1.98; 95% CI, 1.19-3.29; p < .01), history of an impulsive/behavioral disorder (OR = 1.69; 95% CI, 1.03-2.79; p < .04), history of suicide attempt (OR = 1.44; 95% CI, 1.04-2.00; p = .03), history of violence (OR = 1.86; 95% CI, 1.26-2.75; p < .01), and history of Administration of Children’s Services (ACS)/Child Protective Services (CPS) involvement (OR = 1.45; 95% CI, 1.03-2.03; p = .03). Gender, other races, history of other diagnoses, trauma history, or history of NSSIB were not found to be significant predictors. ConclusionsOur findings are consistent with emerging literature that SU in minors has had a slow increase in the COVID-19 era, particularly seen among White patients, patients of older age, and patients with a history of NSSIB or suicide attempt. While some of our analyses did control for potential confounding factors (logistic regression), further analyses are required to formulate a preventative plan for SU in youth.SUD, ICP, ALC Our findings are consistent with emerging literature that SU in minors has had a slow increase in the COVID-19 era, particularly seen among White patients, patients of older age, and patients with a history of NSSIB or suicide attempt. While some of our analyses did control for potential confounding factors (logistic regression), further analyses are required to formulate a preventative plan for SU in youth.