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Sociodemographic factors and social determinants associated with toxicology confirmed polysubstance opioid-related deaths.

ABSTRACT: BACKGROUND AND AIMS:While prescribed and illicit opioid use are primary drivers of the national surges in overdose deaths, opioid overdose deaths in which stimulants are also present are increasing in the U.S. We determined the social determinants and sociodemographic factors associated with opioid-only versus polysubstance opioid overdose deaths in Massachusetts. Particular attention was focused on the role of stimulants in opioid overdose deaths. METHODS:We analyzed all opioid-related overdose deaths from 2014 to 2015 in an individually-linked population database in Massachusetts. We used linked postmortem toxicology data to identify drugs present at the time of death. We constructed a multinomial logistic regression model to identify factors associated with three mutually exclusive overdose death groups based on toxicological results: opioid-related deaths with (1) opioids only present, (2) opioids and other substances not including stimulants, and (3) opioids and stimulants with or without other substances. RESULTS:Between 2014 and 2015, there were 2,244 opioid-related overdose deaths in Massachusetts that had accompanying toxicology results. Toxicology reports indicated that 17% had opioids only, 36% had opioids plus stimulants, and 46% had opioids plus another non-stimulant substance. Persons older than 24 years, non-rural residents, those with comorbid mental illness, non-Hispanic black residents, and persons with recent homelessness were more likely than their counterparts to die with opioids and stimulants than opioids alone. CONCLUSIONS:Polysubstance opioid overdose is increasingly common in the US. Addressing modifiable social determinants of health, including barriers to mental health services and homelessness, is important to reduce polysubstance use and overdose deaths.

SUBMITTER: Barocas JA

PROVIDER: S-EPMC6588486 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Sociodemographic factors and social determinants associated with toxicology confirmed polysubstance opioid-related deaths.

Barocas Joshua A JA Wang Jianing J Marshall Brandon D L BDL LaRochelle Marc R MR Bettano Amy A Bernson Dana D Beckwith Curt G CG Linas Benjamin P BP Walley Alexander Y AY

Drug and alcohol dependence 20190508

<h4>Background and aims</h4>While prescribed and illicit opioid use are primary drivers of the national surges in overdose deaths, opioid overdose deaths in which stimulants are also present are increasing in the U.S. We determined the social determinants and sociodemographic factors associated with opioid-only versus polysubstance opioid overdose deaths in Massachusetts. Particular attention was focused on the role of stimulants in opioid overdose deaths.<h4>Methods</h4>We analyzed all opioid-r ...[more]

PMID: 31100636

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Dataset Information

Sociodemographic factors and social determinants associated with toxicology confirmed polysubstance opioid-related deaths.

Publications

Sociodemographic factors and social determinants associated with toxicology confirmed polysubstance opioid-related deaths.

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