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Substance Use & Suicide in the ED

Quimby et al. (2021) recently published a study that evaluated the relationship between substance use and suicide in adolescent patients who came to a pediatric emergency department. Using a self-administered assessment to evaluate various mental health concerns to collect patient data, analyses were run to determine what factors (i.e., demographics, substance use, substance impairment) were associated with suicidal behaviors/thoughts.

Title: Evaluating Adolescent Substance Use and Suicide in the Pediatric Emergency Department

Authors: Ernika Quimby, Leah Brogen, Tita Atte, Guy Diamond & Joel Fein


Objectives This study evaluates the relationship between substance use and impairment and current suicidal thoughts or behaviors in adolescent patients screened in a pediatric emergency department (ED).

Methods Data were collected between June 2013 and February 2018 from adolescent patients who presented to a single, urban, pediatric ED. Adolescents completed a computerized, self-administered assessment that evaluates depression, suicide, posttraumatic stress, violence, traumatic exposure, bullying, and substance use. Assessments are administered as standard care to all ED patients aged 14 to 18 years. We used binary logistic regression to estimate the odds of reporting current suicidal thoughts or behaviors associated with patient demographics (ie, age, sex, and race), substance use in the past month, and substance-related impairment.

Results A total of 11,623 adolescent patients (65.4% female and 52.9% African American) completed the assessment. Participants were, on average, 15.7 years old (SD = 1.27). Younger age (odds ratio [OR], 0.79; 95% confidence interval [CI], 0.74–0.84) and substance use impairment (OR, 0.44; 95% CI, 0.33–0.58) decreased the odds of reporting current suicidal thoughts or behaviors, whereas male sex (OR, 1.51; 95% CI, 1.28–1.79) and those with past-month substance use (OR, 1.85; 95% CI, 1.51–2.26) increased the odds.

Conclusions Recent substance use and male sex are associated with a higher likelihood of adolescents reporting current suicidal thoughts or behaviors during an ED visit. Standardized screening during pediatric ED visits may allow for more efficient evaluation of patients in higher-risk groups.

Link to journal page can be found here.

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