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Examining opioid-involved overdose mortality trends prior to fentanyl: New York City, 2000-2015.
Drug Alcohol Depend. 2019 12 01; 205:107614.DA

Abstract

BACKGROUND

Rates of overdose death in New York City (NYC) increased 26% from 2000 to 2015, with a notable decrease in rate from 2006 to 2010. Beginning in 2016, the synthetic opioid fentanyl entered the NYC illicit drug market and has been associated with large increases in overdose death. This study assessed NYC trends in opioid-involved overdose death prior to fentanyl to understand the contribution of specific opioids and inform overdose prevention strategies.

METHODS

Data were derived from death certificates linked to postmortem toxicology testing. We stratified cases into three mutually exclusive groups: (1) heroin without opioid analgesics (OAs); (2) OAs without heroin; and (3) the combination of heroin and OAs. We calculated mortality rates by year, and compared rates by the demographic characteristics age, sex, and race/ethnicity. Joinpoint regression identified junctures in trends between 2000 and 2015.

RESULTS

Rates of overdose death involving heroin without OAs decreased from 2006 to 2010, then increased from 2010 to 2015 among males, persons age 15 to 54, and Blacks and Whites. Rates of overdose death involving OAs with and without heroin increased from 2000 to 2015 across all demographic subgroups.

CONCLUSIONS

The identified trends in overdose death are suggestive of demographic shifts in drug use. In particular, the tamper-resistant reformulation of oxycodone 80 mg may have increased the use of heroin among primary OA users. Notably, older adults may have had established heroin use practices prior to the proliferation of OAs and thus may have been less likely to modify drug use practices.

Authors+Show Affiliations

Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, 42-09 28th Street, 19th Floor, Queens, NY 11101, United States. Electronic address: etuazon@health.nyc.gov.Division of Mental Hygiene, New York City Department of Health and Mental Hygiene, 42-09 28th Street, 19th Floor, Queens, NY 11101, United States. Electronic address: hkunins1@health.nyc.gov.Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, 42-09 28th Street, 19th Floor, Queens, NY 11101, United States. Electronic address: ballen1@health.nyc.gov.Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, 42-09 28th Street, 19th Floor, Queens, NY 11101, United States. Electronic address: dpaone@health.nyc.gov.

Pub Type(s)

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

Language

eng

PubMed ID

31689642

Citation

Tuazon, Ellenie, et al. "Examining Opioid-involved Overdose Mortality Trends Prior to Fentanyl: New York City, 2000-2015." Drug and Alcohol Dependence, vol. 205, 2019, p. 107614.
Tuazon E, Kunins HV, Allen B, et al. Examining opioid-involved overdose mortality trends prior to fentanyl: New York City, 2000-2015. Drug Alcohol Depend. 2019;205:107614.
Tuazon, E., Kunins, H. V., Allen, B., & Paone, D. (2019). Examining opioid-involved overdose mortality trends prior to fentanyl: New York City, 2000-2015. Drug and Alcohol Dependence, 205, 107614. https://doi.org/10.1016/j.drugalcdep.2019.107614
Tuazon E, et al. Examining Opioid-involved Overdose Mortality Trends Prior to Fentanyl: New York City, 2000-2015. Drug Alcohol Depend. 2019 12 1;205:107614. PubMed PMID: 31689642.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Examining opioid-involved overdose mortality trends prior to fentanyl: New York City, 2000-2015. AU - Tuazon,Ellenie, AU - Kunins,Hillary V, AU - Allen,Bennett, AU - Paone,Denise, Y1 - 2019/10/16/ PY - 2019/01/31/received PY - 2019/07/23/revised PY - 2019/08/27/accepted PY - 2019/11/7/pubmed PY - 2020/7/1/medline PY - 2019/11/6/entrez KW - Heroin KW - Joinpoint KW - New York City KW - Opioid analgesic KW - Overdose SP - 107614 EP - 107614 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 205 N2 - BACKGROUND: Rates of overdose death in New York City (NYC) increased 26% from 2000 to 2015, with a notable decrease in rate from 2006 to 2010. Beginning in 2016, the synthetic opioid fentanyl entered the NYC illicit drug market and has been associated with large increases in overdose death. This study assessed NYC trends in opioid-involved overdose death prior to fentanyl to understand the contribution of specific opioids and inform overdose prevention strategies. METHODS: Data were derived from death certificates linked to postmortem toxicology testing. We stratified cases into three mutually exclusive groups: (1) heroin without opioid analgesics (OAs); (2) OAs without heroin; and (3) the combination of heroin and OAs. We calculated mortality rates by year, and compared rates by the demographic characteristics age, sex, and race/ethnicity. Joinpoint regression identified junctures in trends between 2000 and 2015. RESULTS: Rates of overdose death involving heroin without OAs decreased from 2006 to 2010, then increased from 2010 to 2015 among males, persons age 15 to 54, and Blacks and Whites. Rates of overdose death involving OAs with and without heroin increased from 2000 to 2015 across all demographic subgroups. CONCLUSIONS: The identified trends in overdose death are suggestive of demographic shifts in drug use. In particular, the tamper-resistant reformulation of oxycodone 80 mg may have increased the use of heroin among primary OA users. Notably, older adults may have had established heroin use practices prior to the proliferation of OAs and thus may have been less likely to modify drug use practices. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/31689642/Examining_opioid_involved_overdose_mortality_trends_prior_to_fentanyl:_New_York_City_2000_2015_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(19)30391-6 DB - PRIME DP - Unbound Medicine ER -