Citation

Marshall JR, Gassner SF, Anderson CL, Cooper RJ, Lotfipour S, Chakravarthy B. Subst. Abuse 2019; 40(1): 80-86.

Affiliation

Department of Emergency Medicine , University of California, Irvine , Irvine , California , USA.

Copyright

(Copyright © 2019, Informa - Taylor and Francis Group)

DOI

10.1080/08897077.2018.1442899

PMID

29465301

Abstract

Background Reports indicate a geographic effect of socioeconomic inequalities on the occurrence of opioid-related fatal overdoses. We aim to (1) estimate the rates of opioid-related overdoses, (2) estimate the association of benzodiazepine co-ingestion with opioid-related deaths, (3) estimate associations between socioeconomic indicators and opioid-related deaths, and (4) map the distribution of fatal overdoses, in Orange County (OC), California.

METHODS We conducted an ecologic study of all opioid related deaths (1205 total) obtained from the OC Coroner Division database from 2010-2014 (1065 OC residents, 55 non-residents, 85 OC homeless) (analyzed 2016-2017). We calculated rates of opioid overdose, benzodiazepine co-ingestion prevalence and associations with SES (education, poverty, median income) using zip code analysis in the residential and homeless communities.

RESULTS Of 1205 deaths, 904 involved prescription type opioids, 223 involved heroin, 39 involved both, and 39 not stated. 973 were classified unintentional overdoses, 180 suicides, and 52 undetermined. 49% of cases involved benzodiazepines. Prescription type opioid and heroin death rates for residents were 5.4/100,000 person years (95% CI 5.0-5.8) and 1.2/100,000 person years respectively (95% CI 1.0-1.4). Males, age group 45-54 and Caucasian race had the highest rate (13.6/100,000) of opioid mortality. The highest death rates were seen in homeless adults at 136/100,000 person years for prescription type opioids (95% CI 99.0-185.5) and 156/100,000 person years for heroin (95% CI 116.8-209.5).

CONCLUSIONS The burden of prescription type opioid-related death in OC affects all demographics and levels of SES, there is a disproportionately high rate of opioid-related deaths in the OC homeless population.

Language: en

Keywords

Abuse; California; alcohol; heroin; opioid; prescription opioid; public health; socioeconomic status