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Opioid analgesics and rates of fatal drug poisoning in the United States.
Am J Prev Med. 2006 Dec; 31(6):506-11.AJ

Abstract

OBJECTIVE

To determine whether the variability in rate of sale of prescription opioid analgesics is related to the variability in rates of drug poisoning mortality among states in the United States in 2002.

METHODS

Drug poisoning deaths were defined as unintentional deaths or those of undetermined intent whose underlying cause was coded to "narcotics" (X42) or "other and unspecified" drugs (X44) in the National Vital Statistics System. Per capita sales of ten opioid analgesics from the Drug Enforcement Administration and combined sales in morphine equivalents were correlated with drug poisoning mortality rates by state using multivariate linear regression. Regression coefficients between mortality rates and sales rates were adjusted for race (percent white, percent black) and age (percent aged 24 years or younger, and percent aged 65 years and older).

RESULTS

There was over a ten-fold variability in sales of some opioid analgesics. Combined sales ranged 3.7-fold, from 218 mg per person in South Dakota to 798 mg per person in Maine. Drug poisoning mortality varied 7.9-fold, from 1.6/100,000 in Iowa to 12.4/100,000 in New Mexico. Drug poisoning mortality correlated most strongly with non-OxyContin oxycodone (r=0.73, p<0.0001), total oxycodone (r=0.68, p<0.0001), and total methadone (r=0.66, p<0.0001) in the multivariate analysis. A scatterplot demonstrated a linear relationship between total opioid analgesic sales and drug poisoning mortality.

CONCLUSIONS

The extent of opioid analgesics use varies widely in the United States. Variation in the availability of opioid analgesics is related to the spatial distribution of drug poisoning mortality by state.

Authors+Show Affiliations

Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. lbp4@cdc.govNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17169712

Citation

Paulozzi, Leonard J., and George W. Ryan. "Opioid Analgesics and Rates of Fatal Drug Poisoning in the United States." American Journal of Preventive Medicine, vol. 31, no. 6, 2006, pp. 506-11.
Paulozzi LJ, Ryan GW. Opioid analgesics and rates of fatal drug poisoning in the United States. Am J Prev Med. 2006;31(6):506-11.
Paulozzi, L. J., & Ryan, G. W. (2006). Opioid analgesics and rates of fatal drug poisoning in the United States. American Journal of Preventive Medicine, 31(6), 506-11.
Paulozzi LJ, Ryan GW. Opioid Analgesics and Rates of Fatal Drug Poisoning in the United States. Am J Prev Med. 2006;31(6):506-11. PubMed PMID: 17169712.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Opioid analgesics and rates of fatal drug poisoning in the United States. AU - Paulozzi,Leonard J, AU - Ryan,George W, PY - 2006/04/12/received PY - 2006/06/19/revised PY - 2006/08/01/accepted PY - 2006/12/16/pubmed PY - 2007/2/28/medline PY - 2006/12/16/entrez SP - 506 EP - 11 JF - American journal of preventive medicine JO - Am J Prev Med VL - 31 IS - 6 N2 - OBJECTIVE: To determine whether the variability in rate of sale of prescription opioid analgesics is related to the variability in rates of drug poisoning mortality among states in the United States in 2002. METHODS: Drug poisoning deaths were defined as unintentional deaths or those of undetermined intent whose underlying cause was coded to "narcotics" (X42) or "other and unspecified" drugs (X44) in the National Vital Statistics System. Per capita sales of ten opioid analgesics from the Drug Enforcement Administration and combined sales in morphine equivalents were correlated with drug poisoning mortality rates by state using multivariate linear regression. Regression coefficients between mortality rates and sales rates were adjusted for race (percent white, percent black) and age (percent aged 24 years or younger, and percent aged 65 years and older). RESULTS: There was over a ten-fold variability in sales of some opioid analgesics. Combined sales ranged 3.7-fold, from 218 mg per person in South Dakota to 798 mg per person in Maine. Drug poisoning mortality varied 7.9-fold, from 1.6/100,000 in Iowa to 12.4/100,000 in New Mexico. Drug poisoning mortality correlated most strongly with non-OxyContin oxycodone (r=0.73, p<0.0001), total oxycodone (r=0.68, p<0.0001), and total methadone (r=0.66, p<0.0001) in the multivariate analysis. A scatterplot demonstrated a linear relationship between total opioid analgesic sales and drug poisoning mortality. CONCLUSIONS: The extent of opioid analgesics use varies widely in the United States. Variation in the availability of opioid analgesics is related to the spatial distribution of drug poisoning mortality by state. SN - 0749-3797 UR - https://www.unboundmedicine.com/medline/citation/17169712/Opioid_analgesics_and_rates_of_fatal_drug_poisoning_in_the_United_States_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-3797(06)00327-8 DB - PRIME DP - Unbound Medicine ER -