Sociodemographic and clinical characteristics associated with overdose among patients with a substance-related diagnosis in the emergency department of Southern California

Harm Reduct J. 2025 May 24;22(1):86. doi: 10.1186/s12954-025-01233-9.

ABSTRACT

BACKGROUND: Drug overdoses are a significant public health concern, but there is limited research on the associated factors among patients presenting to the Emergency Department (ED). We investigated the sociodemographic and clinical characteristics associated with drug overdoses among patients with substance-related diagnoses (SRD) in a Southern California healthcare system’s ED.

METHODS: A cross-sectional study employed EPIC electronic medical records from a sample of 13,477 adults (18-90 years of age) diagnosed with an SRD ICD-10 classification and had an ED encounter within the UCSD Health system in Southern California during the period from January 1, 2020, to December 31, 2023. Bivariate and multiple logistic regression analyses were utilized to ascertain sociodemographic and clinical characteristics correlated with overdoses.

RESULTS: The odds of experiencing an overdose were higher among individuals with a cannabis-related diagnosis (aOR = 1.21, p < 0.05) in comparison to those lacking such a diagnosis, among individuals with an Opioid-related diagnosis (aOR = 1.14, p < 0.05) when compared to those without an Opioid-related diagnosis. Individuals aged 40-54 had higher odds (aOR = 1.37, p < 0.05) of experiencing an overdose compared to those aged 18-24. Additionally, the odds were more pronounced among Black or African American (aOR = 1.31, p < 0.001) individuals compared to whites, among individuals of Hispanic/Latinx origin (aOR = 1.22, p < 0.001) compared to those of non-Hispanic/Latinx origin, among those with public health insurance (aOR = 1.40, p < 0.001) compared to those with commercial health insurance, and among individuals with any mental health diagnosis (aOR = 1.13, p < 0.05) compared to those without such a diagnosis. In contrast, individuals experiencing overdose were less likely to be female (aOR = 0.78, p < 0.001) compared to male, and less likely to be married/living as married/having a significant other (aOR = 0.69, p < 0.001) compared to those who were single.

CONCLUSION: Our research showed that individuals with cannabis or Opioid-related diagnoses had higher odds of experiencing an overdose. Patients with an overdose were typically middle-aged, Black or African American, and Hispanic/Latinx, had public health insurance, and had comorbid mental health diagnoses. They were less likely to be female, married, or in a significant relationship. These findings highlight the importance of sociodemographic and clinical factors in identifying at-risk individuals for targeted interventions.

PMID:40410736 | DOI:10.1186/s12954-025-01233-9