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Sociodemographic factors, prescription history and opioid overdose deaths: a statewide analysis using linked PDMP and mortality data.
Drug Alcohol Depend. 2018 09 01; 190:62-71.DA

Abstract

BACKGROUND

Opioid overdose deaths have continued to rise in Tennessee (TN) with fentanyl emerging as a major contributor. Current data are needed to identify at-risk populations to guide prevention strategies. We conducted a large statewide observational study among TN adult decedents (2013-2016) to evaluate the association of sociodemographic factors and prescribing patterns with opioid overdose deaths.

METHODS

Among drug overdose decedents identified using death certificate data (n = 5483), we used logistic regression to estimate adjusted odds ratios and 95% confidence intervals for characteristics associated with prescription opioid (PO) (excluding fentanyl), fentanyl, and heroin alone overdoses. Among decedents linked to TN's Prescription Drug Monitoring Database using deterministic algorithms, we obtained prescription history in the year before death (n = 3971), which was evaluated by type of overdose using descriptive statistics.

RESULTS

Younger, non-White decedents had lower odds of PO overdose, while females and benzodiazepines as a contributing cause were associated with increased odds of PO overdose. Younger age, Non-Hispanic Black race/ethnicity, greater than high school education, and cocaine/other stimulants as a contributing cause were associated with increased odds of fentanyl or heroin overdoses. Over 55% of PO, 39.2% of fentanyl, and 20.7% of heroin overdoses had an active opioid prescription at death. For PO, fentanyl, and heroin decedents, respectively, 46.0%, 30.5%, and 26.2% had an active prescription for benzodiazepines at death.

CONCLUSIONS

Prescription opioid overdose deaths were associated with different sociodemographic profiles and prescribing history compared to fentanyl and heroin overdose deaths in TN. Data can guide prevention strategies to reduce opioid overdose mortality.

Authors+Show Affiliations

Tennessee Department of Health, Office of Informatics and Analytics, 665 Mainstream Drive, Nashville, TN, 37243, United States; Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, 2525 West End Avenue, Nashville, TN, 37240, United States. Electronic address: sarah.nechuta@tn.gov.Tennessee Department of Health, Office of Informatics and Analytics, 665 Mainstream Drive, Nashville, TN, 37243, United States.Tennessee Department of Health, Office of Informatics and Analytics, 665 Mainstream Drive, Nashville, TN, 37243, United States.Tennessee Department of Health, Office of Informatics and Analytics, Andrew Johnson Tower, 7th Floor, 710 James Robertson Parkway, Nashville, TN, 37243, United States; Department of Health Policy, Vanderbilt University Medical Center, 2525 West End Ave, Suite 1200, Nashville, TN, 37203, United States.

Pub Type(s)

Journal Article
Observational Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

29981943

Citation

Nechuta, Sarah J., et al. "Sociodemographic Factors, Prescription History and Opioid Overdose Deaths: a Statewide Analysis Using Linked PDMP and Mortality Data." Drug and Alcohol Dependence, vol. 190, 2018, pp. 62-71.
Nechuta SJ, Tyndall BD, Mukhopadhyay S, et al. Sociodemographic factors, prescription history and opioid overdose deaths: a statewide analysis using linked PDMP and mortality data. Drug Alcohol Depend. 2018;190:62-71.
Nechuta, S. J., Tyndall, B. D., Mukhopadhyay, S., & McPheeters, M. L. (2018). Sociodemographic factors, prescription history and opioid overdose deaths: a statewide analysis using linked PDMP and mortality data. Drug and Alcohol Dependence, 190, 62-71. https://doi.org/10.1016/j.drugalcdep.2018.05.004
Nechuta SJ, et al. Sociodemographic Factors, Prescription History and Opioid Overdose Deaths: a Statewide Analysis Using Linked PDMP and Mortality Data. Drug Alcohol Depend. 2018 09 1;190:62-71. PubMed PMID: 29981943.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sociodemographic factors, prescription history and opioid overdose deaths: a statewide analysis using linked PDMP and mortality data. AU - Nechuta,Sarah J, AU - Tyndall,Benjamin D, AU - Mukhopadhyay,Sutapa, AU - McPheeters,Melissa L, Y1 - 2018/06/13/ PY - 2018/02/08/received PY - 2018/05/08/revised PY - 2018/05/08/accepted PY - 2018/7/10/pubmed PY - 2018/10/24/medline PY - 2018/7/9/entrez KW - Benzodiazepines KW - Drug mortality KW - Drug overdose KW - Fentanyl KW - Heroin KW - Prescription drugs SP - 62 EP - 71 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 190 N2 - BACKGROUND: Opioid overdose deaths have continued to rise in Tennessee (TN) with fentanyl emerging as a major contributor. Current data are needed to identify at-risk populations to guide prevention strategies. We conducted a large statewide observational study among TN adult decedents (2013-2016) to evaluate the association of sociodemographic factors and prescribing patterns with opioid overdose deaths. METHODS: Among drug overdose decedents identified using death certificate data (n = 5483), we used logistic regression to estimate adjusted odds ratios and 95% confidence intervals for characteristics associated with prescription opioid (PO) (excluding fentanyl), fentanyl, and heroin alone overdoses. Among decedents linked to TN's Prescription Drug Monitoring Database using deterministic algorithms, we obtained prescription history in the year before death (n = 3971), which was evaluated by type of overdose using descriptive statistics. RESULTS: Younger, non-White decedents had lower odds of PO overdose, while females and benzodiazepines as a contributing cause were associated with increased odds of PO overdose. Younger age, Non-Hispanic Black race/ethnicity, greater than high school education, and cocaine/other stimulants as a contributing cause were associated with increased odds of fentanyl or heroin overdoses. Over 55% of PO, 39.2% of fentanyl, and 20.7% of heroin overdoses had an active opioid prescription at death. For PO, fentanyl, and heroin decedents, respectively, 46.0%, 30.5%, and 26.2% had an active prescription for benzodiazepines at death. CONCLUSIONS: Prescription opioid overdose deaths were associated with different sociodemographic profiles and prescribing history compared to fentanyl and heroin overdose deaths in TN. Data can guide prevention strategies to reduce opioid overdose mortality. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/29981943/Sociodemographic_factors_prescription_history_and_opioid_overdose_deaths:_a_statewide_analysis_using_linked_PDMP_and_mortality_data_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(18)30319-3 DB - PRIME DP - Unbound Medicine ER -