the pc program captures drug exposures from participating pcs using a standard electronic system to...
TRANSCRIPT
• The PC Program captures drug exposures from participating PCs using a standard electronic system to record calls from the public; RADARS System personnel perform quality control checks to verify coding accuracy
• Included in analysis were intentional exposure (IE) cases and associated medical outcomes involving individuals 50 years of age and older
• IE cases from 1Q2009 – 2Q2010 were analyzed• Cases involved: suspected suicide, misuse, abuse,
intentional unknown, or withdrawal Opioids: buprenorphine, fentanyl, hydrocodone,
hydromorphone, oxycodone, oxymorphone, methadone, morphine, tapentadol, and tramadol
Stimulants: amphetamines and methylphenidate
• Multivariate logistic regression was used• Covariates included; gender, age, methadone, opioids,
multiple drug exposures• Methadone use was separated from opioid use due to
the potential differences between methadone abusers and other prescription drug abusers
• Model 1 explored associations between attempted suicide vs. other intentional exposure reasons (Figure 1)
• Model 2 explored associations between suicide completion vs. non-completion in a group subset from those used in model 1 (Figure 2)
Suicidal Behaviors Involving Prescription Drugs in Individuals 50 Years of Age and Olderas Identified by the RADARS® System Poison Center Program
J Davis¹, H Miller¹, E Winter¹, R Dart1,2, RADARS® System Poison Center Group 1Rocky Mountain Poison & Drug Center - Denver Health, Denver, CO 2University of Colorado School of Medicine, Aurora, CO
Introduction• Relationships between suicide attempts and completed
suicides using prescription opioids and stimulants may vary by age and gender
Objectives• Compare suspected suicide vs. other intentional
exposures involving opioid drug types and stimulants as reported to RADARS® System Poison Center (PC) Program
• Evaluate risk factors for suicide attempts and suicide completions involving prescription opioids vs. stimulants
• Differentiate trends of suicide attempts and suicide completions
Results Conclusions• Among individuals 50 years of age and older, the odds of a
suicide attempt decrease with increasing age
• In this sample, multiple drugs exposure was not a significant risk factor for suicide attempt, but it was a significant risk factor for suicide completion
RADARS® SystemParticipating Poison Centers
Arizona Poison and Drug Information Center: Boesen K.Banner Good Samaritan Poison and Drug Information Center: Stevens D, Welch S.Blue Ridge Poison Center: Holstege CP, Bechtel LK, Wenger, KL.California Poison Control System: Alsop JA. Central Ohio Poison Center: Baker SD. Central Texas Poison Center: Borys D. Children’s Hospital of Michigan: Smolinske S. Cincinnati Drug and Poison Information Center: Bond GR, Pierce B. Connecticut Poison Control Center: McKay C, Sangalli B. Florida Poison Information Center – Jacksonville: Schauben JL, Sollee D. Florida Poison Information Center – Miami: Bernstein J, Weisman RS. Florida Poison Information Center – Tampa: Kimball T, Cullen T.Georgia Poison Center: Geller RJ, Wright N.Hennepin Regional Poison Center: Anderson D, Lintner C.Illinois Poison Center: Wahl M, DesLauries C, Kubic A. Indiana Poison Center: Mowry JB. Iowa Statewide Poison Control Center: Bottei E, Kalin L, Ringling S. Kentucky Regional Poison Center: Spiller HA. Long Island Regional Poison and Drug Information Center: Caraccio T, Jao D. – (closed December 2010) Louisiana Poison Center: Ryan M. Maryland Poison Center: Doyon S. Massachusetts/Rhode Island Poison Center: Burns Ewald M, Sheroff A.Missouri Regional Poison Center: Weber J, Enders S, Odom C.Nebraska Regional Poison Center: Jacobitz K, Rasmussen M. New Jersey Poison Information and Education System: Ruck B, Marcus S, Rego R.New York City Poison Control Center: Hoffman, R, Mercurio-Zappala, M. North Texas Poison Center: Abron D, Uzoegwu L, Gardner M. Northern New England Poison Center: Simone KE, Bubar J.Northern Ohio Poison Center: Aleguas A.Oklahoma Poison Control Center: McGoodwin L, Schaeffer S. Oregon Poison Center: Giffin S, McKeown N.Palmetto Poison Center: Michels J.Pittsburgh Poison Center: Krenzelok E, Kurta D. Regional Poison Control Center of Alabama: Liebelt E, Slattery A. Rocky Mountain Poison & Drug Center: Dart RC, Westberry RS. South Texas Poison Center: Fernández MC, Cobb DB, Villarreal, CL. Tennessee Poison Center: Kumar S.Texas Panhandle Poison Center: Jaramillo J, Rivers R. The Ruth A. Lawrence Poison & Drug Information Center
Serving Finger Lakes: Barton N, McFarland S, Rekkerth D. – (closed December 2010)The University of Kansas Hospital Poison Control Center (KS): Lowry J, Oller L.Upstate New York Poison Center: Cantor, R, Stork, C, Caliva, M.Virginia Poison Center: Rose SR, Waring E. Washington Poison Center: Martin T, Chew A, Von Derau K.West Texas Regional Poison Center: Artalejo L, Baeza S. West Virginia Poison Center: Scharman EJ. Western New York Poison Center: Joshi P. – (closed December 2010)Wisconsin Poison Center: Kostic M.
Suicide Attempt Associations
Suicide Completion Associations
odds ratio 95% Cl odds ratio 95% Cl
Female gender 1.323 1.212 - 1.445 1.354 0.812 – 2.257
Age (years) 0.984 0.979 - 0.989 1.023 0.995 – 1.050
Methadone 0.618 0.490 - 0.780 1.794 0.645 – 4.988
Opioids 0.966 0.773 – 1.207 1.071 0.340 – 3.372
Multiple drugs 0.955 0.925 – 1.105 2.392 1.267 – 4.514
Financial Support: The RADARS® System is a public non-profit organization providing post-marketing surveillance of prescription medications to pharmaceutical manufacturers. The authors are all employees of Denver Health and Hospital Authority, which operates the RADARS® System. Several manufacturers of controlled substances are subscribers to the RADARS® System. The authors have no direct financial relationships or non-financial relationships with pharmaceutical companies outside of their roles at the Rocky Mountain Poison & Drug Center.
Methods
8,667 Intentional exposures met criteria
Suicide Attempts Suicide Completions
5,365 (61.9% of IEs) 66 (1.2% of attempts)
58% female 65% female
mean age 57.7 (sd 8.0) mean age 59.0 (sd 7.6)