Concurrent Paper Session III

Depression, Suicidality and Co-Occurring Substance Use Among Adolescent Hallucinogen Users

Summary
Hallucinogens have received renewed attention in recent years, exploring their potential role in the treatment of psychiatric disorders such as anxiety, depression, and PTSD. Despite these positive developments, hallucinogens remain one of the recreational substances with inconclusive evidence of such positive effects when used in non-therapeutic settings. Thus, we decided to analyze YRBSS’ 2001- 2019 to explore the prevalence and trends of hallucinogen use among school-going American adolescents. Additionally, we explored the prevalence of depression, suicidality, and co-occurring substance use among hallucinogen users. We found an overall decreasing trend in hallucinogen use. We found a high prevalence of depression suicidality and co-occurring substance use among hallucinogen users. In adjusted regression, we found that hallucinogen use was associated with high odds of feeling sad, hopeless, and considering/planning suicide but not an actual suicide attempt. With our study, we highlight the need for further research in exploring the effects of both recreational and therapeutic hallucinogen use among the adolescent population.

Methods
We performed a retrospective analysis of CDC's YRBSS 2001-2019 data that nationally represents the school-going US adolescents. We identified hallucinogen use using the survey question exploring the use of LSD, acid, PCP, angel dust, mescaline and mushrooms. We used univariate analysis to identify the prevalence and trends of hallucinogen use as well as depression, suicidality, and co-occurring substance use among hallucinogen users using the Rao-Scott chi-square test for categorical variables and unpaired t-test for continuous variables. Multivariable logistic regression analysis was performed to establish an association between depression, suicidality, and hallucinogen use after adjusting for sociodemographics and co-occurring substance use.

Results
Out of a total of 125,550 participants, 8.4% reported ever using hallucinogens. Overall, the trend of hallucinogen use decreased from 13.3% (2001) to 7.0% (2019)(pTrend<0.0001). A higher percentage of male participants reported hallucinogen use than females (10.3% vs. 6.3%; p<0.0001). Compared to adolescents without hallucinogen use, adolescents with hallucinogen use were found to have a higher prevalence of feeling hopeless (48.4 vs. 27.8%), considering suicide (36.3% vs. 15.1%), and attempting suicide that required medical attention (12.0 vs. 1.5%)(p<0.0001 for all). Additionally, adolescent hallucinogen users had a higher prevalence of alcohol, cigarette, e-cigarette, marijuana, synthetic marijuana, inhalants, heroin, cocaine, methamphetamine, and ecstasy use. In regression, hallucinogen users were at high odds of feeling sad and hopeless (aOR: 1.38; 95%CI: 1.19-1.60; p<0.0001), considering suicide (1.31; 1.02-1.69; p=0.03), and planning suicide (1.44; 1.13-1.83; p=0.003).

Conclusion
We found an overall decreasing trend of hallucinogen use among American Adolescents. We found a high prevalence of depression, suicidality, and co-occurring substance use among hallucinogen users. In adjusted regression, we found that hallucinogen users were at high odds of feeling sad, hopeless, and considering and planning suicide. However, we did not find an association between hallucinogen use and suicide attempts. The cross-sectional nature of our study can only identify association, not causation. Further research is needed to explore the effects of recreational hallucinogen use among the adolescent population.

Scientific Significance
We found a high prevalence of depression, suicidality, and co-occurring substance use among adolescent hallucinogen users. Due to the cross-sectional nature of our study, it was not possible to identify the direction of this association. It is possible that hallucinogen use could lead to depression and suicidal ideation among the adolescent population. At the same time, there remains a possibility that depressed and suicidal adolescents may use hallucinogens as a form of self-medication/coping. We highlight the need for further research in exploring the effects of both recreational and therapeutic hallucinogen use among the adolescent population.

Learning Objectives

Participants will identify the prevalence and trends of hallucinogen use among US adolescents.
Participants will identify the prevalence of depression, suicidality, and co-occurring substance use among adolescent hallucinogen users.
Participants will identify the association between depression, suicidality, and hallucinogen use among US adolescents.

State Requirement Topic Category

Addiction- Substance Use Disorders: Identifying, Diagnosing, Treating, and/or Managing
Behavioral Health
Suicide- Risk, AssessmentPrevention, and Treatment

Keywords

Suicide Risk
Substance Use
Adolescent

Presenter
Saral Desai, MD

Saral Desai, MD, is a certified clinical research professional and a PGY-1 psychiatry resident physician at Tower Health/Drexel University College of Medicine Program in Philadelphia. He is passionate about research in psychiatry and actively involved in research on topics related to adolescent health, substance use, and health risk behaviors. As a resident, he plans to continue scholarly activities and inspire more medical students and residents to join him in his research endeavors.

Inpatient Management of Pregnant Patients With Opioid Use Disorder in the Peripartum Period at a Large Academic Medical Center

Summary
In the last decade, substance use has increased among pregnant people and is now a leading cause of postpartum death after obstetric complications. To our knowledge, treatment of hospitalized peripartum patients with opioid use disorder (OUD) evaluated by an inpatient consult service has not been previously described. Chart review was completed for patients who were pregnant or within 3-months of delivery who received consult services from an inpatient OUD treatment team at Duke University Hospital. From May 2020 – May 2022, 25 patients were identified across 27 admissions. When offered, most patients (68%) received medication for OUD (MOUD) during their hospitalization. Over half of these patients were newly started or restarted on MOUD while the rest were continued on therapy they were already receiving outside the hospital. Buprenorphine mono- or bi-products were the primary pharmacotherapies for most patients (84%). A majority of patients gave birth during an admission in which the OUD team had been consulted. Most infants were born pre-term and were treated in intensive care. A majority of patients (70%) were referred to community treatment at discharge, however, naloxone was prescribed only half of the time. Nearly one-third of patients self-directed their discharges. Pregnancy is an opportune time for OUD treatment with longstanding implications for mother and child, yet large gaps in treatment exist. Additional work is needed to understand the impact of inpatient OUD treatment in pregnancy, in order to develop strategies to improve care for this population.

Methods
Manual chart review was conducted for all patients pregnant or less than 3 months postpartum who were admitted to Duke University Hospital and evaluated by Project COMET from May 1, 2020 through May 1, 2022. Data collected included patient demographics, medical and psychiatric history, substance use history, substance use treatment history and MOUD administered during the hospitalization. In addition, MOUD prescriptions at discharge, outpatient referrals, and hospital readmissions following discharge were also captured. Birth outcomes for infants born at Duke University Hospital were included, when available through review of the mother's chart. This study was reviewed and approved by the Duke University Health System Institutional Review Board (DUHS IRB).

Results
There were 25 pregnant or recently postpartum patients who received a COMET consult from May 2020 – May 2022. Average age was 30-years-old and all identified as female. Mean gravity was four and parity was two. Twenty-four (96%) patients were pregnant at admission. Medical comorbidities included chronic pain (28%), hypertension (24%), hepatitis C (20%), and previous episode(s) of endocarditis (8%). The most common psychiatric diagnoses were anxiety (36%), depression (28%), ADHD (12%), and bipolar disorder (8%). Over one-quarter (28%) reported experiences of intimate partner violence.

Type of opioid misuse prior to presentation included heroin (59%), opioid pills (26%), and fentanyl (11%), with 32% of patients reporting intravenous opioid use. Cannabis (52%), cocaine (44%), benzodiazepines (22%) and methamphetamines/amphetamines (11%) were the most commonly misused non-opioids. Over three-quarters (78%) of women reported tobacco/nicotine use. Prior or current MOUD use was reported by 68% of patients.

COMET consults were usually completed one day after admission. Most (88%) women evaluated had active OUD. The average number of DSM-5 criteria met for OUD diagnosis was 6, indicating severe disease. The average Clinical Opioid Withdrawal Scale on initial evaluation was 6, indicating mild withdrawal. A urine drug screen was completed for 78% of presentations, with 71% positive for at least one opioid: opiates (62%), oxycodone (14%), methadone (14%). Notably, the rapid urine drug screen at our institution does not detect fentanyl. Samples were also positive for THC (57%), cocaine (48%), benzodiazepines (19%) and methamphetamines/amphetamines (14%).

Patients received MOUD during 68% of admissions. Of patients receiving MOUD, 53% were newly started or were restarted following a break from treatment. MOUD types during admission included buprenorphine-naloxone (56%), methadone (33%), and buprenorphine (28%). For admissions that did not include provision of MOUD, 38% declined MOUD treatment, 38% self-directed discharge and 25% did not meet criteria for OUD.

Average gestational age (GA) at admission was 33 weeks and 48% of women had received limited prenatal care. While hospitalized, 68% of women gave birth. Average GA was 35 weeks. Routes of birth included routine C-section (35%), emergent or urgent C-section (35%), spontaneous vaginal birth (18%) and induction of vaginal birth (12%). Average Apgar scores at 1 and 5 minutes were 7 and 8, respectively. The majority (65%) of infants spent time in intensive care. At the time of the mother’s discharge, 36% of infants were discharged with the mother. Less than half of mothers (41%) provided breast milk. Child Protective Services was involved in 50% of cases. Contraception was re received or prescribed at discharge for 59% of women.

Average length of stay was 9 days. Most patients were discharged home (67%), although 30% self-directed discharge and a small proportion (4%) went to inpatient substance use treatment. Most patients (70%) were referred to community MOUD providers. Thirty-seven percent discharged with an MOUD prescription (buprenorphine-naloxone 80%, buprenorphine 20%). Those with OUD who did not receive a prescription for MOUD were either taking methadone or had self-directed their discharge. Naloxone was prescribed at discharge during 52% of admissions. Only one patient is known to have been re-hospitalized within 3 months postpartum.

Conclusion
To our knowledge, this is the first work to characterize peripartum patients who were treated by an inpatient OUD consult service. When offered, most patients elected to receive MOUD treatment during admission and the majority of those who received inpatient MOUD were new inductions or restarts of treatment following a period off treatment. Although most patients received buprenorphine-naloxone or buprenorphine, one-third received methadone. A majority of women gave birth during admission and most infants were born pre-term and required intensive care.

Reaching pregnant women with OUD during hospitalization and/or around time of delivery is an opportunity for engaging in substance use disorder treatment. Our descriptive analysis adds valuable information to the growing body of literature supporting inpatient MOUD use, as MOUD should be offered in all treatment settings.(9) More work is needed to develop strategies for reaching patients who do not receive MOUD, who self-direct their discharges, or who are not provided naloxone at discharge.

Scientific Significance
This work demonstrates that a hospitalist-led consult team can provide evidence-based OUD treatment to pregnant patients. An OUD consult service resulted in induction/restart of MOUD for the majority of patients as well as connection to community services on discharge. Characterizing this population may offer an understanding of MOUD treatment trends and identify gaps in care, ultimately increasing or improving OUD treatment for this vulnerable population.

Learning Objectives

Gain an understanding of a unique population, pregnant and peripartum patients, who receive consultation care from an inpatient OUD service.
Explore ways to improve care for hospitalized patients with OUD in the peripartum period.
Review the challenges in providing appropriate community transition and harm reduction support.

State Requirement Topic Category

Addiction- Substance Use Disorders: Identifying, Diagnosing, Treating, and/or Managing

Keywords

MOUD
Induction
Hospitalized Patients
Pregnancy
Peripartum

Presenter
Shelby Powers, MD

Shelby A. Powers completed both an MD (2020) and an MS in Biomedical Science (2018) at the Brody School of Medicine at East Carolina University. She is in her third year of psychiatry training at Duke University. She is active in research with Project COMET – Caring for patients with Opioid Misuse through Evidence-based Treatment, a quality improvement initiative seeking to improve care for hospitalized patients with opioid use disorder. Her other interests include psychotherapy and benzodiazepine-sparing protocols for alcohol withdrawal.

Co-Authors: Shelby Powers, Noel Ivey, Dana Clifton, Amy O'Regan, Melissa Walker, Shavone Hamilton, Rebecca Lumsden

Longitudinal Outcomes of the Top 20 Utilizers of the VA Psychiatric Emergency Services Between 2010 and 2020

Summary
This study identified the top 20 utilizers of Psychiatric Emergency Services (PES) at VA Connecticut and examined their longitudinal outcomes during an 11-year period. The highest utilizers were defined by collating the total PES encounters per patient during the 5-year period between Jan 1, 2010, and Dec 31, 2014. Chart review allowed us to describe the longitudinal outcomes of psychiatric and medical variables between 2010 and 2020. The following information was obtained at the index PES encounter and at the final PES encounter during the study period: Basic demographic information, PES visit diagnosis, psychiatric comorbidities, presence of on-going substance use, chronic medical comorbidities, and chronic medications. If the patient had no PES visits in 2020, the status of the patient was investigated through notes from other providers. If the patient had passed away during the study time period, date and cause of death were noted. Furthermore, the total numbers of primary care visits and hospitalizations were obtained for the cohort.

The characterization of the longitudinal clinical outcomes of this cohort is necessary to better understand the clinical implications of high utilization and to plan for appropriate interventions for these patients, to improve patient outcomes and to reduce healthcare costs.

Methods
The top 20 utilizers of VA Connecticut’s PES were identified by collating the total PES encounters in the 5-year period between Jan 1, 2010-Dec 31, 2014 from the electronic medical record. We then tracked that cohort during the 11-year period from Jan 1, 2010, to Dec 31, 2020, for longitudinal outcomes. Information obtained at the index visit and then again at the last visit of the study period includes: Basic demographic information including date and cause of death, PES visit diagnosis, psychiatric comorbidities, presence of on-going substance use, chronic medical comorbidities, hospital utilization and chronic medications. CDC’s Alcohol-Related Disease Impact ICD-10 codes (https://www.cdc.gov/alcohol/ardi/alcohol-related-icd-codes.html), along with chart history of alcohol abuse, were used to identify alcohol-attributable medical comorbidities. Clinical judgments were used to discern chronic conditions and medications from acute conditions and medications listed in the patient’s chart. (For example, acute skin infection and a short course of antibiotics were not counted towards a patient’s number of medical conditions and medications). If the patient died during the time period, the recorded cause of death was also verified through chart review. If the patient was not deceased but had no contact with the VA Connecticut health system in 2020, chart review was done to discern whether the patient had moved and/or no longer requiring VA care for any reason.

Results
The top 20 utilizers of the VA Connecticut PES between Jan 2010-Dec 2014 were all male, with a mean age of 51.4 years (95% CI: 48.6-54.2) in 2010. Fourteen were white and 6 were African American. The mean total PES visits was 61.45 (95% CI: 49.1-73.8) between Jan 2010-Dec 2014, and 109.9 visits (95% CI: 69.3-150.5) between Jan 2010-Dec 2020, accounting for a total of 2,198 PES visits. The 20 patient cohort represent 0.38% of all unique patients but 15% of PES visits in the 11-year period. Of the 20 index visits, 15 were due to substance use, 3 were due to psychotic symptoms, 1 was related to mood symptoms, and 1 was due to anxiety symptoms related to PTSD. At the index visit, 19 patients reported substance use disorder, with 9 patients having a history of polysubstance use. Alcohol use was most frequently reported (16 patients), followed by stimulant use (9 patients), opioid use (7 patients), and then other substances such as sedative hypnotics and cannabis (4 patients). Fourteen of 20 patients had at least one non-substance psychiatric diagnosis, including mood disorder, psychotic disorder, anxiety disorder, and personality disorder. On average, these patients had 3.9 medical comorbidities (95% CI: 2.7-5.0), and 11 patients had at least one alcohol-attributable condition, including hypertension, alcohol-related pancreatitis, and upper GI bleed due to alcohol use. On average, these patients were taking 5.4 chronic medications (95% CI: 3.4-7.3).

Of the 20 highest utilizers, 18 had at least one alcohol-related PES visit between 2010 and 2020 (due to acute intoxication, withdrawal, seeking detoxification, chronic alcohol use disorder, etc.) and 10 had at least 1 non-PES related homelessness encounter. All 20 patients had primary care visits and hospitalizations within the VA healthcare system during the 2010-2020 period, with an average of 43 primary care visits (95% CI: 33.6-52.4) and 53.7 hospitalizations (95% CI: 35.3-72.1). At the end of 2020, of the 20 highest utilizers, 5 were deceased and 3 had moved out of state, thus no longer utilizing VA Connecticut’s services. Median age of death was 57 years. All 5 of the deceased patients had a substance use disorder. Causes of death reported were “natural causes” for 2 patients, “alcohol-related reason”, and “cancer-related” for 2 patients (stage IV squamous cell carcinoma of tongue and refractory large B-cell lymphoma). Of the 12 patients who were alive and living in Connecticut in 2020, only 1 patient was no longer visiting the PES as he suffered a stroke in 2018 requiring ongoing nursing home care. Eleven patients continued to utilize the PES in 2020, with 4 having between 1-3 visits, and 7 having 4 or more visits. Eight of these 11 patients reported current substance abuse at the time of their last visit in 2020.

The remaining 11 patients still utilizing PES in 2020 had on average 7 chronic medical conditions (95% CI: 3.8-10.2), with 6 patients having at least 1 alcohol-attributable condition, and were taking on average 11 chronic medications (95% CI: 8.5-13.5).

Conclusion
An overwhelming majority (19) of the top 20 highest utilizers of the VA Connecticut PES in the 5-year period between 2010-2014 had substance use disorder, with alcohol being the most frequent substance represented. The patients tended to continue to be frequent PES utilizers, as defined as 4 or more visits in a year, between 2010-2020, in addition to requiring high levels of medical care as evidenced by the total number of primary care and hospitalizations in the time period. Although they represented only 0.38% of the total patients seen in the PES between 2010 and 2020, they made 15% of the total visits, meaning nearly 1 out of 6 presentations to the PES during the 11-year period was one of those 20 patients.

Among all 12 patients still alive and within the state of Connecticut in 2020, all but one patient who required nursing home care continued to utilize PES services, and the majority of patients with substance use disorder continued to report substance use in 2020. From 2010 and 2020, these patients had almost double the number of chronic medical comorbidities (3.9 in 2010 compared to 7 in 2020) and medications (5.4 medications in 2010 compared to 11 in 2020). Only those who died, moved out of state, or became admitted to long-term nursing home care stopped utilizing VA Connecticut’s PES services between 2010-2020. Since this is purely an observational study of a small sample using chart review without a comparison group, this study cannot characterize the attributable risk on mortality and morbidity of being a high PES user among VA patients. However, this study reveals how the highest utilizers of the VA PES show a pattern of persistent—rather than declining—frequent use of emergency psychiatric care, with continued substance use and increased medical comorbidities, despite having access to primary care services. This could indicate a high burden of disease, resistant illness, and/or inadequate psychiatric medical care and support. More research on this population is needed to identify long-term solutions that are not dependent on emergency psychiatric care for improved long-term outcomes for these patients.

Scientific Significance
Existing research has tried to identify and characterize frequent utilizers of medical and psychiatric emergency services, as high service utilization indicates unmet needs as well as have implications for cost efficiency. Due to the heterogeneity within the group, defining this cohort’s characteristics has been difficult, and much less is known about long-term outcomes of frequent PES utilizers. Although it can be clinically assumed that those who require continued PES care would have poor longitudinal outcomes, not much is evidenced in the literature.

Understanding the VA patients to be a unique population with increasing utilization of psychiatric services as well as higher rates of emergency room care and higher rates of substance use compared to the general population, this study sought to examine the highest utilizers of the VA Connecticut’s PES and compare their psychiatric and medical outcomes between 2010 and 2020. Within our cohort, all patients remain persistent utilizers of psychiatric emergency services in 2020, except for those who died, those who moved out of state, and one patient who had a debilitating stroke that required long-term nursing home care. These patients represented 0.38% of the total unique visitors between 2010 and 2020 and accounted for 15% of the total visits, meaning nearly 1 in 6 PES visits between 2010 and 2020 were made by one of these 20 patients.

The results show that the overwhelming majority of these patients have substance use disorder and continue to utilize substances between 2010 and 2020, while also receiving primary care services as well as in-patient medical care. These persistent PES users in 2020 had on average double the number of chronic medical comorbidities and chronic medications compared to their index visit, indicating a decline in their health. Although risks cannot be assessed in this observational chart review study without a comparison group, the results of this study reveal a concerning pattern of persistent use and an overall decline health longitudinally, indicating the need for not just further characterizations of these patients, but for assessment of risk and a plan for intervention. The study’s results implicate that in the current medical system, without a specialized intervention for this high-utilizer cohort, patients may continue to require emergency psychiatric care long-term, which may lead to negative health outcomes with unmet needs as well as disproportionately burden the healthcare system.

Learning Objectives

To summarize existing literature on what is known about frequent users of emergency services for psychiatric patients
To evaluate the outcomes of the top 20 psychiatric emergency room utilizers at VA Connecticut between 2010-2020 time period, including the frequency of psychiatric emergency room use over the years, presence of substance use, number of medical comorbidities, and mortality
To discuss the significance of the pattern of persistent psychiatric emergency services by highest need patients

State Requirement Topic Category

Addiction- Substance Use Disorders: Identifying, Diagnosing, Treating, and/or Managing
Behavioral Health

Keywords

Emergency Psychiatry
Alcohol Use Disorder
Medical

Presenter
Brian Fuehrlein, MD, PhD

Dr. Fuehrlein graduated from the M.D. Ph.D. program at the University of Florida in 2008, adult psychiatry residency program at the University of Texas Southwestern Medical Center in 2012 and addiction psychiatry fellowship at Yale University in 2013. He is currently an Associate Professor and the director of the psychiatric emergency room at the VA Connecticut. Dr. Fuehrlein has a strong interest in medical student and resident education, particularly surrounding addiction psychiatry and serves on multiple local and national committees in this role. In 2017 he was awarded the Irma Bland award for excellency in psychiatry resident education through the APA. In 2018 he was awarded the Clerkship Faculty Teaching Award for Outstanding Medical Student Educator and Role Model. He is also passionate about emergency psychiatry and substance use disorders and has presented and published his work surrounding opioid use disorder in the emergency room setting. In 2019 he was inducted into the American College of Psychiatrists, an organization that recognizes excellence in clinical practice, research, academic leadership, or teaching.

Co-Authors: Brian Fuehrlein, Danielle Cosentino, Yu Kyung Lee

Prevalence of Substance Use Disorder in Hospitalized Pediatric Patients With Eating Disorders: Analysis of the Kids Inpatient Database

Summary
We aim to study the prevalence of substance use disorder in hospitalized pediatric patients with eating disorders in the United States.

Methods
We obtained data from the 2016 Kids Inpatient Database (KID). The KID is the largest inpatient all-payer public pediatric database in the U.S. The 2016 KID database contains about 7 million weighted discharges. KID contains hospitalization data for pediatric patients aged < 21 years. The KID was created and maintained by the Agency for Healthcare Research and Quality. It is part of the healthcare cost and utilization project (HCUP) databases. It is a nationally representative stratified sample of approximately 4000 US community hospitals. Hospitalizations are weighted to provide national estimates. Each hospitalization in the KID has a principal diagnosis (the main reason for hospitalization) and can have up to 29 secondary diagnoses (any other diagnosis other than the principal). We searched for hospitalizations for pediatric patients aged <21 years, with and without any diagnosis of ED using the International Classification of Diseases (ICD)-10 code “F50”. We used chi-square to compare demographic characteristics and percentage of co-existing substance use disorders among adult hospitalized patients with and without a diagnosis of ED. ED includes patients with anorexia nervosa, bulimia nervosa, binge ED, avoidant/restrictive ED, and other unspecified ED. All p-value were 2-sided, and 0.05 was used as the threshold for statistical significance. STATA, version 16 was used for analysis. Since KID contains depersonalized patient-level data, Institutional Board Review (IRB) review was not sought.

Results
Out of about 6.3 million hospitalized pediatric patients in 2016, 13,115 (0.2%) had ED. Mean age of hospitalized patients with ED was 15.6 years, with 87.2% females. Hospitalized patients with ED has greater prevalence of nicotine use (7.7% vs 1.6%, p<0.0001), alcohol related disorder (4.8% vs 0.4%, p<0.0001), cannabis related disorders (10.8% vs 1.4%, p<0.0001), cocaine related disorders (0.9% vs 0.1%, p<0.0001), opioid related disorders (1.4% vs 0.3%, p<0.0001), sedative, hypnotic or anxiolytic related disorders (0.8% vs 0.1%, p<0.0001), amphetamine/caffeine related disorders (1% vs 0.2%, p<0.0001), inhalant related disorders (0.05% vs 0.004%, p<0.0001), hallucinogen related disorders (0.4% vs 0.04%, p<0.0001) and polysubstance/indiscriminate substance related disorders (1.6% vs 0.2%, p<0.0001) compared to those without ED.

Conclusion
Pediatric hospitalized patients with ED have an increased prevalence of substance use disorders. Hospitalized pediatric patients with ED should be screened for substance use disorders during admission. Those who screen positive should be provided counseling and resources to seek help. A multidisciplinary approach involving mental health providers, social workers, and the primary team is essential in addressing this issue.

Scientific Significance
Hospitalized pediatric patients with ED have an increased prevalence of various substance use disorders.

Learning Objectives

To study the prevalence of various types of substance use disorder in hospitalized pediatric patients with and without ED.
To study baseline characteristics of hospitalized pediatric patients with ED and co-existing substance use disorder

State Requirement Topic Category

Addiction- Substance Use Disorders: Identifying, Diagnosing, Treating, and/or Managing

Keywords

Child and Adolescent Psychiatry
Substance Abuse
Hospitalized Patients
Eating Disorder

Presenter
Adeolu Oladunjoye, MD, MPH

Large database researcher. I use large national databases to study prevalence and patterns of substance use disorders and other addictions among hospitalized patients with mental health disorders in the United States.

Co-Authors: Precious Obehi Eseaton, Samuel Nwaobi, Henry Onyeaka, Abby Enosolease, Adeolu Funso Oladunjoye, Ehizogie Edigin, Adeolu Oladunjoye

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