Dataset Information

Assessment of Changes in the Geographical Distribution of Opioid-Related Mortality Across the United States by Opioid Type, 1999-2016.

ABSTRACT:

Importance

As the opioid epidemic evolves, it is vital to identify changes in the geographical distribution of opioid-related deaths, and the specific opioids to which those deaths are attributed, to ensure that federal and state public health interventions remain appropriately targeted.

Objective

To identify changes in the geographical distribution of opioid-related mortality across the United States by opioid type.

Design, setting, and participants

Cross-sectional study using joinpoint modeling and life table analysis of individual-level data from the National Center for Health Statistics on 351?630 US residents who died from opioid-related causes from January 1, 1999, to December 31, 2016, for all of the United States and the District of Columbia. The analysis was conducted from September 6 to November 23, 2018.

Exposures

Deaths involving any opioid, heroin, synthetic opioids, and natural and semisynthetic opioids.

Main outcomes and measures

Opioid-related mortality rate, annual percent change in the opioid-related mortality rate, and life expectancy lost at age 15 years by state and opioid type.

Results

From 1999 to 2016, a total of 231?264 men and 120?366 women died from opioid-related causes across the whole United States. Sixty-six observations were removed owing to missing data on age; therefore, 351?564 US residents were included in this study. The mean (SD) age at death was 39.8 (12.5) years for men and was 43.5 (12.9) years from women. Opioid-related mortality rates, especially from synthetic opioids, rapidly increased in all of the eastern United States. In most states, mortality associated with natural and semisynthetic opioids (ie, prescription painkillers) remained stable. In contrast, 28 states had mortality rates from synthetic opioids that more than doubled every 2 years (ie, annual percent change, ?41%), including 12 with high mortality rates from synthetic opioids (>10 per 100?000 people). Among these 28 states, the mortality rate from natural and semisynthetic opioids ranged from 2.0 to 18.7 per 100?000 people (with a mean mortality rate of 6.0 per 100?000 people). The District of Columbia had the fastest rate of increase in mortality from opioids, more than tripling every year since 2013 (annual percent change, 228.3%; 95% CI, 169.7%-299.6%; P?Conclusions and relevanceOpioid-related mortality, particularly mortality associated with synthetic opioids, has increased in the eastern United States. These findings indicate that policies focused on reducing opioid-related deaths may need to prioritize synthetic opioids and rapidly expanding epidemics in northeastern states and consider the potential for synthetic opioid epidemics outside of the heroin supply.

SUBMITTER: Kiang MV

PROVIDER: S-EPMC6484620 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Assessment of Changes in the Geographical Distribution of Opioid-Related Mortality Across the United States by Opioid Type, 1999-2016.

Kiang Mathew V MV Basu Sanjay S Chen Jarvis J Alexander Monica J MJ

JAMA network open 20190201 2

<h4>Importance</h4>As the opioid epidemic evolves, it is vital to identify changes in the geographical distribution of opioid-related deaths, and the specific opioids to which those deaths are attributed, to ensure that federal and state public health interventions remain appropriately targeted.<h4>Objective</h4>To identify changes in the geographical distribution of opioid-related mortality across the United States by opioid type.<h4>Design, setting, and participants</h4>Cross-sectional study u ...[more]

PMID: 30794299

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Dataset Information

Assessment of Changes in the Geographical Distribution of Opioid-Related Mortality Across the United States by Opioid Type, 1999-2016.

Importance

Objective

Design, setting, and participants

Exposures

Main outcomes and measures

Results

Publications

Assessment of Changes in the Geographical Distribution of Opioid-Related Mortality Across the United States by Opioid Type, 1999-2016.

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