Dataset Information

Individual and county-level variation in outcomes following non-fatal opioid-involved overdose.

ABSTRACT: BACKGROUND:A lack of large-scale, individually linked data often has impeded efforts to disentangle individual-level variability in outcomes from area-level variability in studies of many diseases and conditions. This study investigated individual and county-level variability in outcomes following non-fatal overdose in a state-wide cohort of opioid overdose patients. METHODS:Participants were 24?031 patients treated by emergency medical services or an emergency department for opioid-involved overdose in Indiana between 2014 and 2017. Outcomes included repeat non-fatal overdose, fatal overdose and death. County-level predictors included sociodemographic, socioeconomic and treatment availability indicators. Individual-level predictors included age, race, sex and repeat non-fatal opioid-involved overdose. Multilevel models examined outcomes following non-fatal overdose as a function of patient and county characteristics. RESULTS:10.9% (n=2612) of patients had a repeat non-fatal overdose, 2.4% (n=580) died of drug overdose and 9.2% (n=2217) died overall. Patients with a repeat overdose were over three times more likely to die of drug-related causes (OR=3.68, 99.9%?CI 2.62 to 5.17, p<0.001). County-level effects were limited primarily to treatment availability indicators. Higher rates of buprenorphine treatment providers were associated with lower rates of mortality (OR=0.82, 95%?CI 0.68 to 0.97, p=0.024), but the opposite trend was found for naltrexone treatment providers (OR=1.20, 95%?CI 1.03 to 1.39, p=0.021). Cross-level interactions showed higher rates of Black deaths relative to White deaths in counties with high rates of naltrexone providers (OR=1.73, 95%?CI 1.09 to 2.73, p=0.019). CONCLUSION:Although patient-level differences account for most variability in opioid-related outcomes, treatment availability may contribute to county-level differences, necessitating multifaceted approaches for the treatment and prevention of opioid abuse.

SUBMITTER: Lowder EM

PROVIDER: S-EPMC7079264 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Individual and county-level variation in outcomes following non-fatal opioid-involved overdose.

Lowder Evan Marie EM Amlung Joseph J Ray Bradley R BR

Journal of epidemiology and community health 20200109 4

<h4>Background</h4>A lack of large-scale, individually linked data often has impeded efforts to disentangle individual-level variability in outcomes from area-level variability in studies of many diseases and conditions. This study investigated individual and county-level variability in outcomes following non-fatal overdose in a state-wide cohort of opioid overdose patients.<h4>Methods</h4>Participants were 24 031 patients treated by emergency medical services or an emergency department for opio ...[more]

PMID: 31919146

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Project description:BackgroundOpioid-related deaths constitute a problem of pandemic proportions in the United States, with no clear solution in sight. Although addressing addiction-the heart of this problem-ought to remain a priority for health practitioners, examining the community-level psychological factors with a known impact on health behaviors may provide valuable insights for attenuating this health crisis by curbing risky behaviors before they evolve into addiction.ObjectiveThe goal of this study is twofold: to demonstrate the relationship between community-level psychological traits and fatal opioid overdose both theoretically and empirically, and to provide a blueprint for using social media data to glean these psychological factors in a real-time, reliable, and scalable manner.MethodsWe collected annual panel data from Twitter for 2891 counties in the United States between 2014-2016 and used a novel data mining technique to obtain average county-level "Big Five" psychological trait scores. We then performed interval regression, using a control function to alleviate omitted variable bias, to empirically test the relationship between county-level psychological traits and the prevalence of fatal opioid overdoses in each county.ResultsAfter controlling for a wide range of community-level biopsychosocial factors related to health outcomes, we found that three of the operationalizations of the five psychological traits examined at the community level in the study were significantly associated with fatal opioid overdoses: extraversion (β=.308, P<.001), neuroticism (β=.248, P<.001), and conscientiousness (β=.229, P<.001).ConclusionsAnalyzing the psychological characteristics of a community can be a valuable tool in the local, state, and national fight against the opioid pandemic. Health providers and community health organizations can benefit from this research by evaluating the psychological profile of the communities they serve and assessing the projected risk of fatal opioid overdose based on the relationships our study predict when making decisions for the allocation of overdose-reversal medication and other vital resources.

Dataset Information

Individual and county-level variation in outcomes following non-fatal opioid-involved overdose.

Publications

Individual and county-level variation in outcomes following non-fatal opioid-involved overdose.

Similar Datasets

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