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Unintentional drug overdose deaths involving cocaine among middle-aged and older adults in New York City.
Drug Alcohol Depend. 2019 05 01; 198:121-125.DA

Abstract

BACKGROUND

Cocaine is commonly involved in unintentional drug poisoning (overdose) deaths, accounting for 46% of overdose deaths in New York City (NYC) in 2016. However, little research exists regarding cocaine use by middle-aged and older adults, who are more likely than younger individuals to have underlying cardiovascular disease (CVD) and therefore, may be at increased risk for the adverse health consequences of cocaine.

METHODS

We conducted a retrospective analysis of unintentional drug overdose deaths of middle-aged and older NYC residents age 45-84 from 2000 to 2016 using two linked sources, NYC death certificates and toxicology results from the Office of the Chief Medical Examiner.

RESULTS

From 2000 to 2016, there were 6061 unintentional drug overdose deaths among New Yorkers age 45-84. Of those, cocaine was involved in 53% (n = 3183). Co-occurring opioid involvement (fentanyl, heroin, methadone, or opioid analgesics) among deaths involving cocaine was common (58%). Compared to decedents of non-cocaine involved overdose, decedents of cocaine-involved overdose were more likely to be male and non-Latino Black. Multivariable analysis showed that adults age 45-54 (adjusted odds ratio [AOR] = 1.34, 95% 1.05, 1.70), males (AOR = 1.30, 95% CI 1.15, 1.46), Bronx residence (AOR = 1.29, 95% CI 1.08, 1.54), and non-Latino black race/ethnicity (AOR = 2.37, 95% CI 2.07, 2.72) were independently associated with cocaine-involved overdose.

CONCLUSION

Characteristics of decedents of cocaine-involved overdose overlap with populations with high CVD burden in NYC. Studies are needed to better understand the risks of cocaine among adults with underlying CVD.

Authors+Show Affiliations

Division of Geriatric Medicine and Palliative Care, New York University School of Medicine, United States. Electronic address: Benjamin.Han@nyumc.org.New York City Department of Health and Mental Hygiene, United States.New York City Department of Health and Mental Hygiene, United States.New York City Department of Health and Mental Hygiene, United States.New York City Department of Health and Mental Hygiene, United States.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

30909019

Citation

Han, Benjamin H., et al. "Unintentional Drug Overdose Deaths Involving Cocaine Among Middle-aged and Older Adults in New York City." Drug and Alcohol Dependence, vol. 198, 2019, pp. 121-125.
Han BH, Tuazon E, Kunins HV, et al. Unintentional drug overdose deaths involving cocaine among middle-aged and older adults in New York City. Drug Alcohol Depend. 2019;198:121-125.
Han, B. H., Tuazon, E., Kunins, H. V., Mantha, S., & Paone, D. (2019). Unintentional drug overdose deaths involving cocaine among middle-aged and older adults in New York City. Drug and Alcohol Dependence, 198, 121-125. https://doi.org/10.1016/j.drugalcdep.2019.01.042
Han BH, et al. Unintentional Drug Overdose Deaths Involving Cocaine Among Middle-aged and Older Adults in New York City. Drug Alcohol Depend. 2019 05 1;198:121-125. PubMed PMID: 30909019.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unintentional drug overdose deaths involving cocaine among middle-aged and older adults in New York City. AU - Han,Benjamin H, AU - Tuazon,Ellenie, AU - Kunins,Hillary V, AU - Mantha,Shivani, AU - Paone,Denise, Y1 - 2019/03/14/ PY - 2018/11/28/received PY - 2019/01/26/revised PY - 2019/01/27/accepted PY - 2019/3/26/pubmed PY - 2019/11/26/medline PY - 2019/3/26/entrez KW - Cocaine KW - Middle-aged KW - Older adults KW - Overdose SP - 121 EP - 125 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 198 N2 - BACKGROUND: Cocaine is commonly involved in unintentional drug poisoning (overdose) deaths, accounting for 46% of overdose deaths in New York City (NYC) in 2016. However, little research exists regarding cocaine use by middle-aged and older adults, who are more likely than younger individuals to have underlying cardiovascular disease (CVD) and therefore, may be at increased risk for the adverse health consequences of cocaine. METHODS: We conducted a retrospective analysis of unintentional drug overdose deaths of middle-aged and older NYC residents age 45-84 from 2000 to 2016 using two linked sources, NYC death certificates and toxicology results from the Office of the Chief Medical Examiner. RESULTS: From 2000 to 2016, there were 6061 unintentional drug overdose deaths among New Yorkers age 45-84. Of those, cocaine was involved in 53% (n = 3183). Co-occurring opioid involvement (fentanyl, heroin, methadone, or opioid analgesics) among deaths involving cocaine was common (58%). Compared to decedents of non-cocaine involved overdose, decedents of cocaine-involved overdose were more likely to be male and non-Latino Black. Multivariable analysis showed that adults age 45-54 (adjusted odds ratio [AOR] = 1.34, 95% 1.05, 1.70), males (AOR = 1.30, 95% CI 1.15, 1.46), Bronx residence (AOR = 1.29, 95% CI 1.08, 1.54), and non-Latino black race/ethnicity (AOR = 2.37, 95% CI 2.07, 2.72) were independently associated with cocaine-involved overdose. CONCLUSION: Characteristics of decedents of cocaine-involved overdose overlap with populations with high CVD burden in NYC. Studies are needed to better understand the risks of cocaine among adults with underlying CVD. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/30909019/Unintentional_drug_overdose_deaths_involving_cocaine_among_middle_aged_and_older_adults_in_New_York_City_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(19)30074-2 DB - PRIME DP - Unbound Medicine ER -