Young mothers see rapid increase in substance-related emergency department visits

Emergency department (ED) visits for use of substances, especially opioids, amphetamines, and cannabis, by mothers with dependent children increased almost 5% a year, in contrast to an increase of almost 2% a year among females without children, according to a large study in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.260078. These increases were largely in mothers under age 25, in whom rates grew more than four times faster than among other females.

Highlights:

• Over the study period, substance-related emergency visits increased on average about 5% each year for birthing parents compared with just under 2% for the comparison group.
• The period from 2014 to 2018 had the highest increases (11% per year), with the rates then decreasing to 2% a year.
• Hospital admissions for substance use also increased for birthing parents (from 99 to 259 per 100 000 person-years), whereas visits by females who did not have children increased from 136 to 209 per 100 000 person-years.
• In mothers under age 25, substance-related emergency visits increased about 8% per year compared with other females (2%).

In particular, the youngest mothers are driving the increases in substance use, with rates for emergency visits increasing more than four times faster than for other females. Patterns for hospital admissions for substance use were similar.

The authors emphasize that the study does not examine whether it's motherhood or parenthood itself that is resulting in increasing substance use. The higher rates in mothers younger than 25 likely relate to other factors leading to having children earlier in life that may also increase the risk of substance use.

Although relative increases were highest for amphetamines, cannabis, and opioids, alcohol is still the biggest driver of emergency visits and hospital admissions for substance use, with alcohol use accounting for 46% of ED visits and 41% of hospitalizations for substance use in mothers in 2024.

"While ED visits and hospitalizations for substance use remain relatively rare in mothers, affecting around 0.5%, we should be concerned that for each mother seeking care in these settings there are multiple others who did not seek care either because of stigma or because their substance use was not severe enough to need hospital care," says Dr. Myran.

They call for better supports for young parents.

"Adapting care to better meet the needs of this unique population could include integrated services that address both substance use and mental health and programs that accommodate parenting responsibilities. Upstream interventions, including income and housing supports and measures to mitigate and prevent intimate-partner violence, may help address some of the social drivers that contribute to substance use," the authors write.

Source:

Canadian Medical Association Journal

Journal reference: