Cost of Intentional Drug Overdose and Other Self-Harm Among Youth in the United States, 2021

To quantify the annual direct health care cost of intentional overdose and other types of self-harm resulting in emergency department and/or inpatient encounters among youth in the United States.

Using the 2021 Nationwide Emergency Department Sample and National Inpatient Sample datasets, produced by the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project, we determined nationally representative cross-sectional frequencies and costs for specific types of self-harm encounters among 8- to 21-year-old pediatric and young adult patients.

The total combined 1-year cost of all self-harm encounters was $869 million (95% confidence interval [CI] $841M-$897M). The majority of this cost was due to intentional overdose-related encounters, which totaled $530 million (95% CI $512M-$547M). Of this total, $232 million (95% CI $223M-$241M) was paid by public insurers and $296 million (95% CI $281M-$312M) was paid by private insurers. Encounters by females accounted for 79% of the intentional overdose costs ($420 million, 95% CI $404M-$435M).

Based on 2021 data, preventing youth intentional overdose could save the US health system up to $530 million, annually. As we collectively work to prevent suicide deaths among young people, it is important to recognize the needs of the larger group of youth who are engaging in serious self-harm and nonfatal suicidal acts, the majority of whom are young females. Prevention of intentional overdose in this population should be a priority, both in terms of upstream public health efforts and promotion of evidence-based methods of safer storage.