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Socioeconomic and geographical disparities in prescription and illicit opioid-related overdose deaths in Orange County, California, from 2010-2014.
Subst Abus. 2019; 40(1):80-86.SA

Abstract

Background:

Reports indicate a geographic effect of socioeconomic inequalities on the occurrence of opioid-related fatal overdoses. This study aims 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:

An ecologic study was conducted of all opioid- related deaths (1205 total) from 2010 to 2014 obtained from the OC Coroner Division database (1065 OC residents, 55 nonresidents, 85 OC homeless) (analyzed 2016-2017). Rates of opioid overdose, benzodiazepine co-ingestion prevalence, and associations with socioeconomic status (SES; education, poverty, median income) using ZIP code analysis in the residential and homeless communities were calculated.

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% confidence interval [CI]: 5.0-5.8) and 1.2/100,000 person-years (95% CI: 1.0-1.4), respectively. 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 deaths in OC affects all demographics and levels of SES; there is a disproportionately high rate of opioid-related deaths in the OC homeless population.

Authors+Show Affiliations

a Department of Emergency Medicine , University of California, Irvine , Irvine , California , USA.b University of Miami School of Medicine , Miami , Florida , USA.a Department of Emergency Medicine , University of California, Irvine , Irvine , California , USA.c Department of Emergency Medicine , University of California Los Angeles , Los Angeles , California , USA.a Department of Emergency Medicine , University of California, Irvine , Irvine , California , USA.a Department of Emergency Medicine , University of California, Irvine , Irvine , California , USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29465301

Citation

Marshall, John R., et al. "Socioeconomic and Geographical Disparities in Prescription and Illicit Opioid-related Overdose Deaths in Orange County, California, From 2010-2014." Substance Abuse, vol. 40, no. 1, 2019, pp. 80-86.
Marshall JR, Gassner SF, Anderson CL, et al. Socioeconomic and geographical disparities in prescription and illicit opioid-related overdose deaths in Orange County, California, from 2010-2014. Subst Abus. 2019;40(1):80-86.
Marshall, J. R., Gassner, S. F., Anderson, C. L., Cooper, R. J., Lotfipour, S., & Chakravarthy, B. (2019). Socioeconomic and geographical disparities in prescription and illicit opioid-related overdose deaths in Orange County, California, from 2010-2014. Substance Abuse, 40(1), 80-86. https://doi.org/10.1080/08897077.2018.1442899
Marshall JR, et al. Socioeconomic and Geographical Disparities in Prescription and Illicit Opioid-related Overdose Deaths in Orange County, California, From 2010-2014. Subst Abus. 2019;40(1):80-86. PubMed PMID: 29465301.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Socioeconomic and geographical disparities in prescription and illicit opioid-related overdose deaths in Orange County, California, from 2010-2014. AU - Marshall,John R, AU - Gassner,Stephen F, AU - Anderson,Craig L, AU - Cooper,Richelle J, AU - Lotfipour,Shahram, AU - Chakravarthy,Bharath, Y1 - 2018/04/05/ PY - 2018/2/22/pubmed PY - 2020/4/28/medline PY - 2018/2/22/entrez KW - Abuse KW - California KW - alcohol KW - heroin KW - opioid KW - prescription opioid KW - public health KW - socioeconomic status SP - 80 EP - 86 JF - Substance abuse JO - Subst Abus VL - 40 IS - 1 N2 - Background: Reports indicate a geographic effect of socioeconomic inequalities on the occurrence of opioid-related fatal overdoses. This study aims 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: An ecologic study was conducted of all opioid- related deaths (1205 total) from 2010 to 2014 obtained from the OC Coroner Division database (1065 OC residents, 55 nonresidents, 85 OC homeless) (analyzed 2016-2017). Rates of opioid overdose, benzodiazepine co-ingestion prevalence, and associations with socioeconomic status (SES; education, poverty, median income) using ZIP code analysis in the residential and homeless communities were calculated. 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% confidence interval [CI]: 5.0-5.8) and 1.2/100,000 person-years (95% CI: 1.0-1.4), respectively. 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 deaths in OC affects all demographics and levels of SES; there is a disproportionately high rate of opioid-related deaths in the OC homeless population. SN - 1547-0164 UR - https://www.unboundmedicine.com/medline/citation/29465301/Socioeconomic_and_geographical_disparities_in_prescription_and_illicit_opioid_related_overdose_deaths_in_Orange_County_California_from_2010_2014_ L2 - http://www.tandfonline.com/doi/full/10.1080/08897077.2018.1442899 DB - PRIME DP - Unbound Medicine ER -